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4 scenarios
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Serious news: first update after stroke deterioration
Check privacy, understanding, and readiness, explain the serious update in plain language, respond to emotion, and agree on a supported next step.
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Serious news: worsening stroke with interruptions
Check privacy and readiness, explain a serious clinical change, respond calmly to interruptions and emotions, and confirm understanding, support, and follow-up.
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Complication disclosure: bowel injury during surgery
Explain the surgical complication and current status plainly, acknowledge distress, apologize, and outline monitoring, uncertainty, and a concrete follow-up plan.
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Error disclosure: missed wrist fracture
Explain the missed diagnosis, take responsibility and apologize, respond to the patient’s concerns, and confirm prompt treatment and investigation follow-up.
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Practice SPIKES from a standard talk through error disclosure.