💬 SPIKES protocol
Breaking Bad News Role Play (SPIKES)
A model conversation following SPIKES: checking what the patient knows, a warning shot, space for silence, responding to emotion and agreeing next steps.
Script (1 speaker)
Doctor: Mrs. Ortiz, thank you for coming in. Before we talk about the results, can you tell me what you understand so far?
Mrs. Ortiz: They found a lump. They said it was probably nothing.
Doctor: That's right, that's what we hoped. <short pause> I'm afraid the biopsy results are not what we were hoping for.
Mrs. Ortiz: <long pause> Is it cancer?
Doctor: Yes. It shows an early breast cancer.
Mrs. Ortiz: [shaky] I... I came here alone. I thought it was nothing.
Doctor: <long pause> This is a lot to hear. Take all the time you need.
Mrs. Ortiz: What happens now?
Doctor: The good news is we found it early. Next week you'll meet the surgical team, and I'll be with you through each step. Would you like me to call someone to be with you today?
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What Makes This Work
- ✓Asks what the patient knows first
- ✓Gives a warning shot before the news
- ✓Uses silence and does not rush
- ✓Responds to emotion, then gives a clear plan
More Examples
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Clinical skills
Patient History Taking Role Play
A student doctor takes a history for chest pain.
⏱️
De-escalation
Angry Patient Role Play: Long Wait Times
A patient has waited three hours in the emergency department.
💊
Patient education
Explaining Medication with Teach-Back
An elderly patient starts a new blood thinner.
🏠
Nursing
Discharge Instructions Role Play
A nurse prepares a patient and her son for going home after surgery.
Make Your Own Version
Change the names, the product or the situation. The AI rewrites it and voices every speaker.
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