Medical student empathy and breaking bad news communication in a simulated consultation

•We describe psychological factors influencing breaking bad news communication.•Aspects of self-reported empathy predicted communication competence in medical students.•Communication skills training may need to address moderating influence of personality. This study examined the relationship between self-reported empathy and breaking bad news (BBN) communication skills performance in a sample of undergraduate medical students (n = 100) in the clinical years of their program. Correlational and regression analysis examined the relationship between Jefferson Scale of Physician Empathy (JSPE-S) and Empathy Quotient (EQ) scores, and communication skills performance based on students’ application of the SPIKES protocol to a BBN scenario in a simulated encounter. Higher BBN communication skills performance was positively correlated with scores on the “Social Skills” EQ sub-scale (r (99) = 0.31, p = 0.002), which measures spontaneous and context-independent use of social skills. Multiple regression confirmed that “Social Skills” sub-scale variation predicted BBN score variation (B = 2.17, 95% CI = 0.65–3.69, p