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OSCE > Breaking Bad News > Flashcards

Breaking Bad News Flashcards

1
Q

What model can be used to help facilitate breaking bad news?

A

SPIKES

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2
Q

How should you start a consultation in which you would be breaking bad news?

A
  • Introduction
  • Identity check
  • Consent
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3
Q

How can active listening skills be displayed in a consultation?

A
  • Appropriate eye contact
  • Open body language
  • Nodding
  • Avoid interrupting
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4
Q

What is the first ‘S’ in SPIKES?

A

Setting

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5
Q

What is the ideal setting for breaking bad news?

A

A comfortable, quiet and private room

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6
Q

Where should breaking bad news never be done?

A

Standing in a corridor

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7
Q

What are the bare minimum essentials for breaking bad news?

A
  • Everyone sitting
  • Some privacy
  • Tissues
  • No interruptions
  • Essential information
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8
Q

Who else may be in the room when breaking bad news?

A
  • Other HCP
  • Relatives
  • No one
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9
Q

Who decides who else may be in the room when breaking bad news?

A

The patient

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10
Q

What does the ‘P’ stand for in SPIKES?

A

Perception

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11
Q

What does ‘perception’ involve in breaking bad news?

A
  • Establishing preceding events

- Establish patient’s knowledge

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12
Q

What does ‘I’ stand for in the SPIKES model?

A

Invitation

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13
Q

What does ‘invitation’ imply when breaking bad news?

A

Check that the patient wants to receive the news today

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14
Q

What does the ‘K’ in SPIKES stand for?

A

Knowledge

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15
Q

What does ‘knowledge’ mean when breaking bad news?

A

Delivering the information in sizeable chunks and checking regularly for understanding

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16
Q

What should be given before imparting the information on the patient when breaking bad news?

A

Give a warning shot

17
Q

What is an appropriate warning shot when breaking bad news?

A

‘Unfortunately the results were not what we were hoping for…’

18
Q

What sort of language should be used when breaking bad news?

A

Simple language

19
Q

After giving the diagnosis, when should you continue speaking?

A

Usually after the patient speaks, or when you feel enough time has passed that they are able to process more information

20
Q

What should you do if a patient has a strong emotional reaction to the news?

A

Allow them time and space to do so offering tissues where appropriate

21
Q

What does ‘E’ stand for in SPIKES?

A

Empathy and emotions

22
Q

What does ‘empathy and emotions’ involve when breaking bad news?

A

Empathise with their emotions, acknowledge their feelings and be honest with any information given following the bad news

23
Q

What does ‘S’ stand for in SPIKES?

A

Strategy and summary

24
Q

What does ‘strategy and summary’ involve when breaking bad news?

A

Making plans for the future and summarising the consultation to check patient understanding

25
Q

What should a future strategy involve when breaking bad news?

A
  • Plans for follow-up
  • Plans for further investigations
  • Plans for management
26
Q

Do all future strategies have to be planned on the day?

A

No, allow patients time if they need it to process the information

27
Q

How should breaking bad news be summarised?

A
  • Check understanding
  • Repeat any information necessary
  • Answer any concerns
  • Offer assistance and written information to answer future questions

OSCE (19 decks)

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