Background and objective: Breaking bad news is a very stressful task for both health professionals and patients. Teaching how to break bad news appropriately is one of the important concerns in medical education. So, this study aimed to compare role play and multimedia methods based on SPIKES strategy on midwifery students’ knowledge and attitude in breaking bad news to patients.

Materials and Methods:  A clinical trial study was done in three groups on 90 midwifery students in Mashhad University of Medical Sciences who were selected randomly. Students were trained by role play and multimedia methods. Control group had not received any intervention. Knowledge and attitude questionnaires were filled out before and two weeks after intervention.

Results: Knowledge and attitude mean scores after intervention in the 3 groups had significant difference (P< 0.05). Moreover, attitude score in multimedia group was higher than role play group and there was a significant difference between them (P=0.045).

Conclusion: Multimedia as an independent and non-attendance program can increase students’ knowledge as same as the role play while, it can change students’ attitude more than the role play method.