How to break bad news.

Introduced by Dr. Robert Buckman, Medical Oncologist at the University of Toronto, the S-P-I-K-E-S protocol for breaking bad news is given. SPIKES is a six-step protocol: Setting / Perception / Invitation / Knowledge / Explore Emotions & Empathise / Strategy and Summary - each of these points is explained in detail. Then dramatised case studies are enacted including telling a sportsman he has rheumatoid arthritis, telling a woman with breast cancer how long she has to live, telling a man how long he has left to live, a young man who doesn't want his mother to be told she has breast cancer and informing a woman that her husband has died from a heart attack.