Our novel approach to teaching Breaking Bad News (BBN) involves having students actively participate in an unsuccessful resuscitation (mannequin) followed immediately by BBN to a standardized patient wife (SPW) portrayed by an actress. Thirty-nine 3rd year medical students completed a questionnaire and then were divided as follows: Group 1 (n=21) received little to no training prior to speaking with the SPW. Group 2 (n =18) received a lecture and practiced for 1 hour in small groups prior to the resuscitation and BBN. Both groups self assessed ability to BBN (p<.0002 & p<.00001), and ability to have a plan (p<.0004 & p <.0003) improved significantly over base line with greater improvement in group 2. Group 2 (pre-trained) students were rated superior by SPW's in several key areas. This novel approach to teaching BBN to 3rd year medical students was well received by the students and resulted in marked improvement of self assessed skills over baseline.