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← How to Break Bad News: The SPIKES Protocol

Lesson

K — Knowledge: how to deliver the news itself

Be able to give a “warning shot” and to speak without jargon, in small chunks.

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Knowledge: the news, with care

K — Knowledge

Now for the news itself. Three techniques make it bearable — they're in the diagram below. A word on jargon: not “the neoplasm has undergone malignant transformation” but “it's cancer”; not “inoperable” but “this tumor can't be removed with surgery.” Jargon is a way to hide from the weight of it, but the person is left alone with what they didn't understand. And remember: after the word “cancer,” a person often can't take in anything for the next minute. Don't bury them in details — say one or two sentences and stop. Let it sink in. Ask: “Does that make sense? Shall I go on?”
Three techniques of step K
  1. 1
    “Warning shot”

    “Unfortunately, I don't have the best news…” — a second for them to brace themselves.

  2. 2
    Plain words

    Without jargon — the way you'd say it to someone outside your profession.

  3. 3
    In small chunks

    One or two sentences — pause — check understanding — continue.

Lesson notes
K — Knowledge
Now for the news itself. Three techniques make it bearable — they're in the diagram below. A word on jargon: not “the neoplasm has undergone malignant transformation” but “it's cancer”; not “inoperable” but “this tumor can't be removed with surgery.” Jargon is a way to hide from the weight of it, but the person is left alone with what they didn't understand. And remember: after the word “cancer,” a person often can't take in anything for the next minute. Don't bury them in details — say one or two sentences and stop. Let it sink in. Ask: “Does that make sense? Shall I go on?”
K — Knowledge: how to deliver the news itself — How to Break Bad News: The SPIKES Protocol