Breaking Bad News Demonstration - OSCE Guide | Breast Cancer Diagnosis | UKMLA | CPSA

This video provides a demonstration of breaking bad news (a breast cancer diagnosis) in the context of an OSCE station using the SPIKES framework.

Check out our other awesome clinical skills resources including:

Chapters:
00:00 Introduction
00:17 Set up
00:49 Perception
02:28 Invitation
02:59 Knowledge
05:40 Empathy
07:02 Strategy & summary
11:03 Closing the consultation

Join the Geeky Medics community: 👩👩👧👧

Always adhere to your medical school/local hospital guidelines when performing examinations or clinical procedures. DO NOT perform any examination or procedure on patients based purely upon the content of these videos. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video.

Achieve success in your medical school OSCEs, UKMLA CPSA, and PLAB 2 exams with our free clinical skills videos. Subscribe to our channel to be informed of our latest releases. 🙂

[samamallick]

Meredith: When you walk into a room to tell someone that their loved one has died, it’s more than just a list of bullet points you’ve memorized. Yours is the face they will remember for the rest of their life. They were fine before they met you. They picked up their children from school, they made dinner, and they got a call. The police showed up at their door and brought them here with those children to this room so that you can give them the worst news of their entire life. You are changing this person’s life forever. You are responsible for this moment. For the instant that person goes from wife to widow is you. All you. Nobody but you. So this person isn’t an inconvenience. They not a box on a list to be checked off. You are a part of their life now. Your words, your face. So take that seriously and recognize the important of your role. And respect the fact that that person’s pain is the biggest thing in the room.
☝🏻 This dialogue is one of the examples of how we should treat someone who is in immense pain and grief.

[matheusa]

I came to this subject searching about that but in a corporate environment, but now I realise, the only bad news is given in hospitals, the rest are just casualties.
Big up to those professionals that can keep a straight face in such tough moments but also have empathy for the ones in need. That's a sad job, but somehow beautiful.

[oishi]

really helpful, thank you geeky medics for all the hard work you put for us 💜.... The lady who played the patient is a great actress, I've noticed in some other videos too👏

[Pavlovsobaka]

In our hospital there was that old man who thought he was being treated for pneumonia in the surgical ward. We (students) were examining him and then the treating surgeon came in and casually dropped that the patient had small cell lung cancer. The man was utterly devastated. Our doctors are quite skilled but have absolutely no clue how to communicate. There are stories of another patient who jumped from the 8th floor and committed suicide.

[yulnikita]

When I had a traumatic injury my doctor shot it to me straight! She didn't sugar coat it and didnt give me false hope of a recovery and that was just what I needed in the moment. I didnt want to be lied to bc I knew what was going on. She let me react to a certain degree but basically signaled me to reign it in after a period of time. Her reaction was raw but it really helped me process in the moment and in retrospect.

However, I know everyone reacts differently to different methods.

[abdelrahmanaminel-khsosy]

Great actor and great doctor. Thank you for the very informative video.

[MultiRextreme]

When I saw this on my feed I legit thought this was some news regarding breaking bad 😂.Great video though!

[abhishekbhatta]

Oscar 🏆🥇 winning performance by both actresses, didn't know before that to become a good international doctor you need too be good actor too.

[bare_bear_hands]

Such a necessary point to cover! Dealing with emotions just isn't easy.

[jonathannavarro-marin]

When they diagnosed my dad with bladder cancer a few years ago the doctor just sat him down and didn't beat the bush about it. My dad reacted by just leaving the hospital and crying in the car. My mum was in the car picking him up so she grabbed him and stormed him back into the hospital to find out more info re prognosis, therapy etc lol. I am surprised they let him just leave.

[roronoazoro]

This incoming osce exam will be the most stressful experience in my life

[dangp]

Breaking bad news isn’t something an OSCE can teach or assess. There isn’t a checklist to go down. There isn’t a “use this phrase to sound empathetic”, or a “ask them how they are going before shell-shocking them”

Geeky Medics is a great resource for medical knowledge and being a good doctor clinically. They nail OSCEs

Breaking bad news shouldn’t be an OSCE. In my opinion of course. Humanity can react in so many different ways, some laugh, some cry, some stare at you saying nothing, some swear at you, some start throwing things around. What they need is a human. Not a checklist.

It’s the one time where, as a medical person, you pull the veil down and show you are more than a permanent student who spent 6 years with your head in a book.

You are a human telling another human something they either weren’t expecting or don’t want to hear. You can’t treat it like a textbook, patients will say (and have said in the past) that they felt like their doctor felt fake, didn’t care, or was reading from a script.

The advice I got for breaking bad news? Three things: Know your audience. Be without ambiguity. Patients and family members won’t remember exactly what you said, but they will remember how you said it and how they felt.

At the end of the day, that’s all that matters. Be that a hand hold, a hug, an informal approach, a detailed explanation with many big words, even a joke…. It’s about the people, not the process. They are learning something awful, when they look back did their doctor make them feel better or worse?

[Lala]

I understand you need to use spikes for the osce markscheme, but as a patient I would feel soooo stressed with the doctor dilly dallying and not getting straight to the point. In real life surely as soon as you start saying things like "are you happy for me to discuss the results now, do you need anyone with you" they'd start getting stressed

[HappyLife]

I, personally, would be very suspicious of a long intro as this and would be more nervous….thus prefer straight to the point! I guess everyone is different 🌝

[zedddr]

Perfect as usual Great simulation and acting skills

[earthbound]

The most shocking thing is that it is not that time-consuming. So time is not an excuse to just drop the bomb.

[kenapa_tgitu]

Thank you very much, really gaves me an idea about how to breaking bad news to someone

[winniegloria]

This is good practical, thank you dear

[dharmendrarana]

I can see every vdo is more than 8 minutes will we be able to finish in 8min in plab 2 cheers!

[tm]

Would it be appropriate to give the patient some statistics, such as "In X amount of cases the cancer can be treated."? This doesn't feel too big of a stretch from the discussion they had about cyst vs cancer commonality.