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Palliative Medicine – End Of Life Conversations

This 3-hour course gives residents, fellows, and nurse practitioner students an opportunity to practice delivering bad news to standardized patients using the Setting, Permission, Information, Knowledge, Empathy, and Summary (SPIKES) format. In this safe, “low stakes” environment, participants are expected to verbally and non-verbally respond to and encourage patient emotion. Participants refine the communication skills needed to build therapeutic relationships with patients.

Learning objectives

  • Practice delivering bad news to a standardized patient
  • Practice non-verbal and verbal communication skills to create a rapport with patients
  • Encourage learners to think ahead to the eventual diagnosis when presented with ominous symptoms and begin to prepare the patient for the potential results of proposed testing

Expected outcomes

  • Understand and implement the structured SPIKES format for delivering bad news (Setting, Permission, Information, Knowledge, Empathy, and Summary)
  • Be more comfortable exploring patient concerns and expressions of emotion
  • Be more apt to counsel and educate patients using everyday language, avoiding medical jargon


  • Residents, fellows, and nurse practitioner students

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