A useful stepwise cognitive map for discussing serious news is SPIKES: Setup, Perception, Invitation, Knowledge, Emotion, Summary. These videos illustrate the Perception, Knowledge and Emotion steps. More details are in the learning modules on this site or our book Mastering Communication with Seriously Ill Patients .

SPIKES: assessing perception before giving serious news

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SPIKES: knowledge, emotion

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SPIKES: knowledge, emotion

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Additional Video Collections


About These Videos

We created these videos to make our overview talks--so important in the early part of the learning trajectory--more effective. To explain our design decisions: we wanted to show how clinicians and patients respond to each other, so we shot the videos in a studio so we could frame and light facial expressions much more clearly than in most medical videos (where you often see the patient and doctor from the side and can't see their expressions well). We also wanted to show how communication skills that are well developed in the doctor influence how the patient responds, but we also wanted the videos to be spontaneous. So the communication skills videos were completely unscripted, and the doctors and patients are both improvising.

The teaching videos were created somewhat differently. These videos were based on spontaneous videotaped interactions that Tony had with 3 different first year Medical Oncology fellows that we did not want to distribute freely; thus we transcribed the original interactions and used these scripts to films these videos using actors. So what the fellows say in these videos is what real fellows said when they were talking to Tony and talking to patients.

The point of all these videos is to illustrate some specific skills we think are useful in communicating with patients, and in teaching communication to trainees. We aren't presenting them as perfect examples. But we did not film videos where we were intentionally trying to communicate poorly--while we've seen (and in our past lives used) bad examples, we now think that it's much more powerful teaching to show good examples. Think of these videos as virtual role modeling, and when you're using them as a teacher, remember that most medical types are so trained to pick out what they don't like, what's imperfect, that they won't even notice what was good--and unless they know what they should be doing, they won't be able to stop doing the stuff that they need to lose.

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Jeannie Walla, John Dillon
Tom Furtwangler
Mike Attie, Riley Morton
Riley Morton, Julia Welbourne
Graphic design
Sarah Conradt
Web programming
Andrew Karpenko at UW Creative + Communications
Oncotalk Investigators
Bob Arnold, Anthony Back, Walter Baile, Kelly Edwards, James Tulsky