Between Theory and Practice: a comparative analysis of knowledge of the SPIKES Protocol in the delivery of bad news

  • Thallyta Katarina Santos Pimenta UnirG
  • Mateus Silva Santos Biomédico, Doutor em Medicina Tropical e Saúde Pública pela Universidade Federal de Goiás - UFG com ênfase na área de genética, biologia molecular e bioinformática. Possui especialização na área de neurociência e neurogenética aplicada ao comportamento.
  • Guilherme Silva de Souza Graduando em Medicina pela Universidade de Gurupi (UnirG)
  • André Victor Reis Santos Graduando em Medicina pela Universidade de Gurupi (UnirG)
  • Iran Johnathan Silva Oliveira Doutor em psicologia. Especialização em Criminologia e Ciências Criminais pela Escola Superior da Magistratura Tocantinense - ESMAT (2016). Possui graduação em Psicologia pela Pontifícia Universidade Católica de Goiás (PUC-GO) em (2007).

Abstract

This study examined medical students’ understanding of the SPIKES protocol and identified how their formative experiences influence the development of communication competencies in delivering bad news. The mixed-methods research involved eighteen students from two institutions in Tocantins, organized into two focus groups. Data analysis revealed that all participants recognize the importance of SPIKES; however, 60% demonstrate only partial understanding of its steps, with greater difficulty in Invitation, Knowledge, and Summary. Practical experiences such as role-playing and simulations were identified by 70% of the participants as the moments of greatest learning, whereas exclusively theoretical approaches limited mastery of the protocol. Students reported emotional and communicational challenges related to managing their own emotions and choosing appropriate wording. Institutional factors also emerged, including time constraints, environment, and the need for interdisciplinarity. The findings indicate that teaching the SPIKES protocol requires curricular continuity, experiential practices, and emotional support in order to strengthen humanized communication competencies.

Published
2026-03-18