Further Education
Delivering bad news stations
Delivering bad news stations
When you enter a health-related profession, generally you will be taught how to deliver bad news to a patient. While it is not expected that you know how to do this in your admissions interview, often you will be asked about this to get a sense of your empathy and compassion. For example, “How would you tell a 65-year-old woman she has cancer?” Sometimes this scenario is used with an MMI acting/role play station. A tip for delivering bad news is to keep your facial expressions neutral. As a health care professional, you want to be careful about displaying emotion when delivering bad news. This format is taught in medical school and may be helpful:
SPIKES:
SPIKES was developed by Robert Buckman, MD, Associate Professor of Medical Oncology, University of Toronto and modified from the original version (Sandrick, K.1998).
- Setting (where you as healthcare professional sit in relation to patient/family members; create best physical circumstances)
- Perception (why here today: as you know we have done some tests; ask before tell to get patient’s understanding of medical situation)
- Invitation (how much does the patient want to know? e.g. “how would you like me to provide information about your test results?” Some prefer the big picture and some prefer every small detail; let patient ask questions)
- Knowledge (Physician tells “bad” news: don’t tell them they have cancer immediately — use “tumour” first; did I answer your questions?)
- Empathy (listen for and identify emotions of patient and identify cause, validate patient’s feelings and expressions, offer resources and other support)
- Summary (summarize discussion)