A physician is preparing to disclose a new diagnosis of metastatic lung cancer to a 62-year-old patient in the clinic. According to the widely accepted SPIKES protocol for delivering bad news, arrange the following physician actions in the correct chronological order from first to last.
- 1Arrange for a private environment, sit down at eye level, and silence the pager.
- 2Ask the patient, "What is your understanding of why we did the biopsy?"
- 3Inquire, "Would you prefer to know all the specific medical details today, or just the big picture?"
- 4State clearly, "I am so sorry to tell you this, but the biopsy results show lung cancer."
- 5Observe the patient's tearful reaction, hand them a tissue, and say, "I can see this is very difficult news to hear."
Answer
The correct order follows the SPIKES framework: Setting up the interview, assessing the patient's Perception, obtaining an Invitation, giving Knowledge, and addressing Emotions with empathy.
The correct sequence mirrors the SPIKES protocol: (1) Setting up the interview to ensure privacy, (2) assessing the patient's Perception of their illness, (3) obtaining an Invitation to share information, (4) giving Knowledge and facts directly, and (5) addressing Emotions with empathetic responses. The final step, Strategy/Summary, follows the emotional support phase.
Step-by-Step Solution
Key Concept
SPIKES protocol for delivering bad news
Estimated Time:1m 0s