MMI Flashcards
What Pneumonic can be used to break bad news to a patient?
SPIKES
What is the first S in SPIKES
Setting the scene. This involves asking the actor if they are okay with discussion to take place where they are now, introducing yourself and role, confirming the patients identity, and asking if they have any loved ones they would want to be here
What is P in SPIKES?
Perception. The process of clarifying that you are on the same page as the actor (“eg what is your understanding of why we are meeting today?”), to minimise any shock from the news they receive
What is I in SPIKES
Invitation. Involves explaining that you have bad news and asking them permission to talk about this with them, giving them time to prepare themselves.
What is K in SPIKES?
Knowledge. This involves explaining to the actor what has happened. This should be done carefully and sensitively. Simplify explanations and avoid Jargon to allow the actor to process this information.
What is E in SPIKES?
Emotion. This involves listening to the actors concerns, allow for short periods of science, for the actor to vent feelings, ask open questions about their feelings (eg “what are your thoughts?”). It is important to display empathy and active listening, and apologise when appropriate.
What is the second S in SPIKES?
Summary. Reiterate briefly the information given, and if appropriate suggest some plans or solutions for the future
What must we do when given role play information, before it even begins?
Always read the role play scenario carefully. You never get a second chance at a first impression, so it is important that in the pressure of the interview, you do not misinterpret information.
What must we begin the role play with ?
Always start by introducing yourself to the actor, give a handshake, making eye contact, smiling where appropriate, explaining job title, and ask permission to speak where appropriate.
In terms of body language, what must we do during roleplay?
Use open body language, maintain eye contact, alter the tone of your voice depending on the conversation, head nodding, leaning in, etc.
What is a large number of the marks during roleplay going to be dedicated to?
Our empathy to the actor. This means we must demonstrate empathy (eg “I’m very sorry, I know this must be difficult for you.”)
