Mock examiner feedback from the free mock session conducted on 19/06/24
Initial Preparation
Understand the Case: Know the diagnosis and the terminal nature of the condition.
Collect Necessary Information: Gather key details about the patient's medical history and the events leading up to the current situation.
Structured Approach: SPIKES Protocol
Setting (S):
Ensure a quiet, private setting to minimize disturbances.
Introduce yourself and your role clearly.
Express empathy and prepare the relative for the discussion.
Perception (P):
Assess the relative's understanding of the situation.
Ask them to describe what happened, their perceptions, and concerns.
Invitation (I):
Ask if the relative would like someone to join them during the discussion.
Prepare them for the news by asking if they want detailed information about the patient’s condition.
Knowledge (K):
Present information in layers, starting with the basics and gradually moving to the terminal diagnosis.
Explain the findings from medical investigations (e.g., CT scan) and the implications.
Use simple and clear language, avoiding medical jargon.
Emotions (E):
Recognize and respond to the relative’s emotional reactions.
Validate their feelings and show empathy.
Use the EVE (Emotion, Validation, Empathy) protocol:
Emotion: Identify the relative’s emotional response.
Validation: Acknowledge their emotions as legitimate.
Empathy: Express understanding and compassion.
Strategy and Summary (S):
Discuss the next steps, including what to expect and available support services.
Offer leaflets and pamphlets on bereavement services and end-of-life care.
Ensure the relative understands the information and provide contact details for follow-up questions.
Key Points to Cover
Diagnosis Explanation:
The patient has a massive brain bleed due to a ruptured berry aneurysm.
The condition is terminal and no surgical intervention is possible.
Management Plan:
Focus on keeping the patient comfortable and pain-free.
Discuss the patient's current state and what is being done to manage symptoms.
End-of-Life Considerations:
Ask about the patient’s advance directives or wishes regarding end-of-life care.
Discuss organ donation if applicable.
Support for Relatives:
Encourage the relative to call other family members.
Offer assistance in communicating the news to distant relatives.
Provide information about bereavement services for emotional and logistical support.
Safety Netting:
Inform the relative about signs to watch for and when to seek further help.
Provide contact information for follow-up questions or concerns.
Emotional Support:
Reiterate your empathy and understanding.
Offer follow-up meetings or phone calls for additional support.
Summary
Setting Up:
Quiet, private room; clear introduction and expression of empathy.
Information Gathering:
Focused questions to understand the event and the patient’s medical history.
Breaking the News:
Layered delivery of the diagnosis; clear and compassionate communication.
Emotional Response:
Validate and empathize with the relative’s emotions; use the EVE protocol.
Next Steps:
Discuss end-of-life care, patient’s wishes, and available support services.
Follow-Up:
Provide information for further assistance and support, including leaflets and contact details.
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