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HSC Center for Older Adults: 2022-24 SPIKES - A Six-step Protocol for Delivering Bad News
Healthcare providers will potentially deliver bad news to patients many times throughout their careers. Disclosing bad news is inherently negative and can contribute to stress and anxiety. When practitioners are uncomfortable giving bad news, they may avoid discussing distressing information or convey unwarranted optimism. Having a strategy to increase confidence during this patient interaction, has been demonstrated to reduce anxiety and burnout.
The six-step SPIKES framework for communication with the patient will help determine a patient's values, level of participation in decision-making, and provide a plan for addressing the emotions and reactions when bad news is conveyed. A pneumonic like SPIKES breaks down the process of disclosing unfavorable clinical information to patients.
Target Audience
This activity is intended for physicians, physician assistants, nurse practitioners, nurses, clinical pharmacists, certified public health professionals, social workers, physical therapists, and licensed professional counselors.
Learning Objectives
When you complete this module, you will be able to:
- Define "bad news" and how it relates to clinical outcomes;
- Identify barriers and strategies to disclosing “bad news”; and
- Apply the six-step protocol of disclosing information that adversely affects a patients' perception of their future and quality of life.
Funding
This project is supported by grant funding from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1QHP28735. The contents are solely the responsibility of the authors and do not necessarily represent the official view of the Health Resources and Services Administration or the U.S. Department of Health and Human Services. No commercial support was received for this activity.
Disclosures
In accordance with the appropriate accrediting bodies, all planners, teachers, and authors with control over activity content are required to disclose to the provider any relevant financial relationships (those held by the person, currently or within the last 24 months) with ineligible interests. Accredited providers are required to provide this information to learners before the start of an activity. The University of North Texas Health Science Center at Fort Worth Division of Academic Innovation's office planning team nor the subject matter experts have anything to disclose.
Primary Author
Valerie Agena, DO, FACOI
Assistant Professor, Departments of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth
Instructional Design
Brenda Wilson, MS, CHCP
Senior Instructional Designer
CE & Assessment Department, Division of Academic Innovation, University of Texas Health Science Center at Fort Worth
Accreditation Statements
In support of improving patient care, The University of North Texas Health Science Center at Fort Worth is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing Education for the healthcare team.
As a Jointly Accredited Organization, The University of North Texas Health Science Center at Fort Worth is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit.
American Osteopathic Association
The University of North Texas Health Science Center at Fort Worth is accredited by the American Osteopathic Association to award continuing medical education to physicians.
National Board of Public Health Examiners
This activity is approved for ## credit(s) accepted by the National Board of Public Health Examiners' Certified Public Health (CPH) recertification program.
Texas Administrative Code
The University of North Texas Health Science Center at Fort Worth certifies this activity meets the requirements for continuing education for Texas-licensed Professional Counselors and Texas-licensed Marriage and Family Therapists.
Texas Physical Therapy Association
This activity is offered by the Texas Board of Physical Therapy Examiners Accredited Provider #2409035TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE.
Designation Statements
Physicians
The University of North Texas Health Science Center at Fort Worth designates this program for a maximum of .75 contact hour of AOA Category 1B CME credits and will report CME and specialty credits commensurate with the extent of the physician's participation in the activity.
The University of North Texas Health Science Center at Fort Worth designates this activity for a maximum of .75 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Pharmacist
This knowledge-based activity has been assigned JA0004637-0000-22-012-H04-P and will award .75 contact hour of continuing pharmacy education credit in states that recognized ACPE Providers.
Statements of participation will indicate hours and CEUs based on participation and will be issued online at the conclusion of the activity. Successful completion includes completing the activity, its accompanying evaluation and/or posttest (score 70% or higher) and requesting credit online at the conclusion of the activity.
Credit will be uploaded to CPE Monitor, and participants may print a statement of credit or transcript from their NABP e-profile. HSC complies with the Accreditation Standards for Continuing Pharmacy Education.
Nurses
This activity provides up to .75 contact hours.
Certified Public Health Professionals
This activity provides .75 contact hours.
Social Workers
Social Workers completing this course receive .75 contact hour of continuing education credits.
Licensed Professional Counselors
This activity provides .75 contact hours.
Physical Therapists
This course provides .75 contact hours for PTs and PTAs licensed in Texas.
For successful completion, a participant must attend the program, complete the evaluation, and request credit online at the conclusion of the activity.
Certificate of Attendance
The University of North Texas Health Science Center at Fort Worth certifies this activity for .75 hours of participation.
Available Credit
- 0.75 ACPE Pharmacy
- 0.75 AMA PRA Category 1 Credit™
- 0.75 ANCC
- 0.75 AOA Category 1-B
- 0.75 ASWB Credit
- 0.75 Certified Public Health (CPH)
- 0.75 HSC Participation
- 0.75 Physical Therapist (PT)
Price
Required Hardware/software
This activity is best experienced using the most current browser (or one back) of Firefox, Chrome, Safari, Internet Explorer, or Microsoft Edge. For all activities featuring audio, you must have a sound card and speakers. To view graphic images and references that appear in separate "pop-up" windows, you must have session cookies enabled on your computer. Adobe Acrobat Reader may be required for certain activities.
Accessibility Statement
If you require special assistance to participate in this activity, please call (817) 735-2539 or email: register@unthsc.edu. An Equal Opportunity University.