Appendix 1.
Gagne’s lesson plan template [22]
| Session title: How to break bad news using SPIKES protocol Student/trainee level: Residents, medical students | ||
|---|---|---|
| Level number | Level | Activity |
| 1 | Gaining attention | Asking learners about their prior experience in witnessing BBN |
| Providing a bad example of BBN | ||
| 2 | Informing learner of objectives | Collect relevant information from the patient |
| Deliver bad news based on SPIKES protocol | ||
| Express empathy towards patient’s reaction via verbal and nonverbal response | ||
| 3 | Stimulate recall of prior learning | Discuss definition of bad news and barriers to BBN |
| Comment on the case on elements of BBN based on presession reading on Buckman’s model | ||
| 4 | Presenting stimulus | The six steps on Buckman’s model for BBN would be presented with examples given |
| Getting started | ||
| What does the patient know? | ||
| How much does the patient want to know? | ||
| Sharing the information | ||
| Responding to patient and family feelings | ||
| Planning and follow-up | ||
| 5 | Providing learning guidance | Introduce SPIKES protocol for easier memorization |
| Refer back to prior case scenario and discuss using SPIKES protocol | ||
| 6 | Eliciting performance | Learner generated case or a prepared case would be used for role play |
| Participation would be encouraged by volunteering | ||
| Preparation for strategies in case of reluctance to role play | ||
| 7 | Providing feedback | Participants provide reflection and self-evaluation first |
| Observers and facilitator also give feedback | ||
| Review learning objectives | ||
| 8 | Assessment of performance | Assess learners by SPs, role play under simulation |
| Supervisors assess learners in the clinical setting | ||
| 9 | Enhancing retention and transfer | Meet regularly for reflection of clinical encounter of witness of BBN |
| Review SPIKES protocol | ||
BBN: Breaking bad news, SPs: Standardized patients