Medical School Interview MMI - Breaking Bad News [ROLEPLAY]

hi andre here from the msag team we're going to jump right into the video we made about how to break bad news to patients from our award-winning online interview course timestamps and link to the free course in the description below let's get started breaking bad news is one of the most common types of role play scenarios in medical school interviews it is commonly used by medical schools as it tests the ability of the candidate to remain calm under pressure in addition breaking bad news to patients loved ones or strangers requires practice as it can be an uncomfortable environment to be in however as doctors we are required to break bad news on a regular basis and hence this is a vital skill we must all pick up in this video we will teach you a common framework which can be used when breaking bad news we will then show you a live example of how this framework can be successfully applied to gain maximum marks in this mmi station the role play scenarios you're faced with may be non-clinical for example you could be asked to tell a friend that you're unable to attend their birthday party they may also be based on clinical scenarios such as telling a patient that they have cancer remember to demonstrate empathy and active listening skills throughout the scenario let us imagine you were given a scenario where you had to tell a patient that they had a terminal diagnosis of cancer what are the important elements not to miss in this role play bail and bachmann came up with a useful mnemonic to deliver bad news to patients in a medical setting the mnemonic we recommend that you use is called spikes the s stands for setting the scene for the discussion usually in an mmi the setting is already adequate for the discussion but remember if you are having a sensitive discussion and the scenario puts in a public area it may be appropriate to ask the role player if they are happy for the discussion to take place in the current environment they are in you must always introduce yourself explain your position or role to the patient and confirm the patient's identity for example you could say hello my name is david and i'm a junior doctor am i talking to jane we also recommend that you ask the patient or actor if they have any relatives or loved ones with them who may want to participate in the discussion if this is appropriate the p stands for perception this is the process of clarifying that you're on the same page as the actor if this is relevant for the scenario ask them questions such as what is your understanding of why we are meeting today this is important to ensure you minimize any shock the actor may experience from the news the i stands for invitation at this point you should explain to the actor that you have some bad news to tell them and ask them permission to proceed this gives the actor a warning that there is some difficult news and allows them time to prepare themselves for example you could say i'm afraid i have some bad news and after a pause you could then say is this an appropriate time to discuss something with you the k stands for knowledge this is where you must explain to the actor exactly what has happened this should be done in a sensitive and careful manner avoid the use of jargon and simplify your explanations to allow the actor to process the information being delivered the e stands for emotion having delivered the bad news listen to the actors concerns do not be afraid of short periods of silence it is important to let the actor process the information you have delivered candidates often feel the need to continue speaking after delivering bad news to try and regain control of the situation instead we recommend that you allow the actor to vent his or her emotions and ask them open questions about their feelings often they can be forthcoming but sometimes you may need to ask open questions such as what are your thoughts to address their emotional needs it is important to display empathy and show active listening skills we recommend that you apologize if appropriate even if the situation isn't directly your fault finally the s stands for summary reiterate briefly the information you have given and if appropriate suggest a plan for the future this may also involve discussing some solutions to make the actor feel better in the moment or solving a problem for example you could say i'm sorry that this news has made you feel upset is there anything i can do to help finally we recommend that you ask the actor if they have any further questions or concerns and then thank them for their time in order to conclude the station the spikes framework can be adapted to any breaking bad new scenario let us now look at an example of spikes being put into practice as you listen to the role play we recommend that you make notes on how the spikes framework is being implemented mr parker is an olympic high jumper he fractured his ankle during training and it will take at least eight months to heal he is being training hard for the commonwealth games which are three months away you are his doctor and you must break the bad news of his ankle to him and explain that he will be unable to perform in the upcoming tournament hello i'm dr reed you're my parker yes that's right hi nice to meet you okay well nice to see you today um do you know why you're here um yeah i think just coming here for some results yes scanned your your your test results yes have you got anybody that you'd like to have sitting in with you no no it's just me today yeah yeah well i'm going to talk to you about your ankle injury that you had yeah and unfortunately it's quite a significant injury do you mind if i talk it through in a bit of detail now yeah i suppose you better do so yeah what do you think might have happened to your ankle well i've been training really hard as you know for the commonwealth games and uh and i sustained this injury with my ankle it still hurts a little bit but i thought i was over the most of it well looking at the scans yeah looking at the history and the kind of the nature of the injury it looks as though you had quite a significant injury and unfortunately the bone is broken in such a way it's quite a bad fracture it could take quite a long time to heal really how long are we thinking well i think given the nature and the degree of the injury yeah we're talking quite a long period of time we're talking at least eight months or so months for this to get fully better doc i mean i i've been training so hard for these games you know i've been working so so many times with the physiotherapist is there nothing that we can do in the next three months to get me to those commonwealth games well unfortunately and this is quite difficult news to convey given the nature of the injury itself yeah and the degree of the break it's going to take a long time to heal up so there are other things that we have considered such as surgical intervention or physiotherapy yeah i'll do that i'll do them all dog please there must be something unfortunately i don't think with this kind of injury they would be adequate i don't think they would do enough and that's a really hard thing to have to tell you because i know that you've got the commonwealth games coming up in a short space of time ah it just can't be this is such a nightmare um nothing else we can do then well we kind of wrapped our brains and thought about all the standard things that we would do in this kind of uh scenario and it and it's really difficult to uh to heal this kind of fracture and i'm really sorry to have to convey this news to you because it's not going to be healed up within such a short pace of time okay right well thank you for being honest with me well i think that's the main thing is to kind of be up front and let you know because i wouldn't want you being unrealistic in terms of how this might heal yeah yeah of course okay all right well thank you very much for the information that's right is there anything i can do at the moment um no i guess i'll just go home and tell the team and my wife and i don't really have any questions at this point well if you do later on or if your family or your team want to discuss it in more detail then i'd be very happy to you always get in contact so we can talk about it again in more detail okay all right well thank you doctor thank you for being honest with me okay we hope you're able to successfully pick up on the spikes framework through watching this role play that's everything you want to cover in this video we have discussed a common framework which can be used to approach breaking bad news role play stations we have shown you a live example of how this framework can be successfully applied to gain maximum marks in this type of station hopefully you can now begin to use spikes yourself when practicing role plays thanks for watching is there a specific breaking bad news scenario you're preparing for do you have any questions about how to use spikes for medical or dentistry interviews let us know in the comments below if you find this video helpful please leave a like and if you want to see more interview or exam prep then subscribe to our channel for new content every week take care and best of luck with your admissions you

Channel: theMSAG

Views: 34,280

Rating: 4.9652176 out of 5

Keywords: medical school interview mmi, mmi, multiple mini interview, mmi interview, medical school interviews, themsag

Id: WYLbx0CK0YQ

Length: 8min 59sec (539 seconds)

Published: Fri Sep 18 2020