University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences, 751 Brookside Road, Stockton, CA, 95211, United States.
University of the Pacific, Department of Mathematics, 3601 Pacific Ave, Stockton, CA, 95211, United States.
Curr Pharm Teach Learn. 2023 Mar;15(3):283-288. doi: 10.1016/j.cptl.2023.03.008. Epub 2023 Apr 7.
Delivery of bad news or negative health information is a complex skill critical to the provision of patient care. While counseling models with this focus exist within other health care professions, their use in pharmacy education is lacking. The purpose of this study is to assess pharmacy students' ability to deliver bad news with the implementation of a counseling model titled SPIKES (Setting, Perception, Invitation, Knowledge, Emotions with Empathy, and Strategy/Summary).
First-year pharmacy students attended a one-hour training on the SPIKES model and completed three simulations with its application. Pre- and post-training surveys were administered to assess confidence, attitudes, and perceptions. Student performance during the simulations was evaluated by teaching assistants (TAs) as well as a self-assessment using the same grading rubric. A paired t-test was used to test for significant mean improvement in competency scores, confidence, attitudes, and perceptions from Week 1 to Week 3.
One hundred and sixty-seven students were included in the analysis. There was a significant improvement in the student's self-assessment of their performance for each of the SPIKES components and summative scores. For the TA assessment, there was a significant mean improvement in the summative SPIKES score; however, within each component of SPIKES, only the knowledge component showed significant mean improvement. There was also a significant improvement in student confidence in the post-training surveys.
Implementation of the SPIKES protocol in the pharmacy curriculum showed an overall improvement in students' self-assessed performance in delivering bad news.
传递坏消息或负面健康信息是提供患者护理的一项关键复杂技能。虽然其他医疗保健专业中存在以该技能为重点的咨询模式，但在药学教育中却缺乏应用。本研究旨在评估通过实施 SPIKES（设置、感知、邀请、知识、共情与情感、策略/总结）咨询模式，药学学生传递坏消息的能力。
一年级药学学生参加了一个关于 SPIKES 模型的一小时培训，并完成了三次应用该模型的模拟练习。在培训前后进行调查，以评估信心、态度和认知。教学助理（TA）和学生使用相同的评分标准对模拟练习中的学生表现进行评估。使用配对 t 检验来检验从第 1 周到第 3 周，在能力评分、信心、态度和认知方面是否有显著的平均提高。
共纳入 167 名学生进行分析。在 SPIKES 各组成部分和综合得分方面，学生对自己表现的自我评估均有显著提高。对于 TA 评估，SPIKES 综合得分的平均值有显著提高；然而，在 SPIKES 的每个组成部分中，只有知识部分的平均值有显著提高。在培训后的调查中，学生的信心也有显著提高。
在药学课程中实施 SPIKES 方案，学生在自我评估传递坏消息的表现方面总体有所提高。
