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SPIKES Protocol (High-Pressure)

Deliver bad news to a highly anxious and demanding patient's spouse, testing your ability to maintain control and empathy under pressure.

  1. 1
    Briefing
  2. 2
    Simulation
  3. 3
    Feedback

How This Works

This is an interactive phone call simulation. You'll speak with Susan in a realistic clinical communication scenario.

1. Start Call

Click "Start Call" when you're ready. Speak naturally as you would on a real call.

2. Have the Conversation

10 minutes to complete the call. The AI responds in real-time to what you say.

3. Get Feedback

End the call when finished. You'll receive AI-powered feedback on your communication.

💡 Tip: Speak clearly and at a natural pace. If you need a moment to think, it's okay to pause briefly - just as you would in a real conversation.

Briefing Details

1. Learning: What is SPIKES?

Purpose of this Scenario

This simulation is designed to help you practice the SPIKES protocol, a structured framework for delivering difficult news. This advanced scenario will test your skills under pressure.

2. Scenario Briefing

Your Objective

Your goal is to deliver difficult news to a highly emotional and demanding Susan while adhering to the SPIKES protocol. This simulation will test your ability to manage interruptions, de-escalate panic, and maintain a therapeutic presence under stress.

Patient Background

You are about to call Susan, a 52-year-old woman, to provide a critical update on her husband, John. She is at home, highly anxious, and awaiting your call.

Crucial Information: Earlier, other medical staff told Susan that John was "responsive" after he was brought in. She is clinging to this as a source of hope and will challenge anything that contradicts it.

Key Medical Facts

  • Event: John, 55, collapsed suddenly at home.
  • Initial Findings: Large ischemic stroke, but was responsive to voice/touch on arrival.
  • Deterioration: Stroke has expanded with significant brain swelling.
  • Current Status: Unresponsive in the ICU, extremely poor prognosis.

3. How to Interact

Starting the Simulation

Follow these steps to begin the role-playing exercise:

  1. When you have reviewed the learning material and briefing, press the Start Call button below.
  2. You will hear the phone ringing for a few seconds.
  3. When the ringing stops, the AI patient will answer, but will wait for you to speak. You must initiate the conversation by saying "Hello?" or a similar greeting.
  4. Once the call begins, this orientation panel will be replaced by a live transcript of your conversation.

Learning Objectives

Optional prep details

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Optional Pre-Call Knowledge Check

Optional self-check before you start

Knowledge Check loading

Make sure you are in a quiet environment with a good internet connection

After completing this scenario, you will be able to:

  • Apply the six steps of the SPIKES protocol to structure the delivery of bad news under high-pressure conditions.
  • Formulate adaptive communication strategies to de-escalate a highly anxious and demanding individual.
  • Identify verbal and non-verbal cues of emotional distress and respond appropriately to manage the conversation flow.

In the SPIKES protocol, what is the primary purpose of the 'P' (Perception) step?

Which component of the SPIKES protocol is most critical for managing a highly emotional response, as described in this scenario?

According to the 'S' (Setting) step of SPIKES, which action is most important before starting a high-pressure conversation?