Paeds Cases · professional-practice-and-evidence
Delivering a new diagnosis — OSCE
OSCE on delivering a new serious diagnosis to parents using a structured SPIKES approach, with attention to setting, emotion and follow-up.
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Target exams
MRCPCH ClinicalRACP DCERCPSC Pediatrics
Prompt
Parents of a 6-year-old admitted overnight with pallor and bruising are waiting to hear the results; the blood film shows blasts consistent with leukaemia; a trained interpreter is available; the child is on the ward.
Station brief (8–10 minutes)
Break the news of a likely new diagnosis of leukaemia to the parents using a structured approach. Address their emotion and arrange appropriate follow-up. Do not invent local statutory wording or specific survival statistics. [1]
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References5Show ledgerHide ledger
- [1]Baile WF SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. The oncologist, 2000.PMID 10964998
- [2]Back AL Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Archives of internal medicine, 2007.PMID 17353492
- [3]Levetown M Communicating with children and families: from everyday interactions to skill in conveying distressing information. Pediatrics, 2008.PMID 18450887
- [8]Kaye EC Prognostic Communication Between Oncologists and Parents of Children With Advanced Cancer. Pediatrics, 2021.PMID 33952691
- [14]Davidson JE Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU. Critical care medicine, 2017.PMID 27984278