Training pharmacy students to deliver bad news using the SPIKES model

Delivery of bad news or negative health information is a complex skill critical to the provision of patient care. While counseling models with this focus exist within other health care professions, their use in pharmacy education is lacking. The purpose of this study is to assess pharmacy students' ability to deliver bad news with the implementation of a counseling model titled SPIKES (Setting, Perception, Invitation, Knowledge, Emotions with Empathy, and Strategy/Summary).

First-year pharmacy students attended a one-hour training on the SPIKES model and completed three simulations with its application. Pre- and post-training surveys were administered to assess confidence, attitudes, and perceptions. Student performance during the simulations was evaluated by teaching assistants (TAs) as well as a self-assessment using the same grading rubric. A paired t-test was used to test for significant mean improvement in competency scores, confidence, attitudes, and perceptions from Week 1 to Week 3.

One hundred and sixty-seven students were included in the analysis. There was a significant improvement in the student's self-assessment of their performance for each of the SPIKES components and summative scores. For the TA assessment, there was a significant mean improvement in the summative SPIKES score; however, within each component of SPIKES, only the knowledge component showed significant mean improvement. There was also a significant improvement in student confidence in the post-training surveys.

Implementation of the SPIKES protocol in the pharmacy curriculum showed an overall improvement in students' self-assessed performance in delivering bad news.