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The application of the Practitioners in Applied Practice Model during breaking bad news communication training for medical students: a case study

Research output: Contribution to journalArticle


Rose Dunning, Anita Helen Laidlaw

School/Research organisations


Background and Aims
Breaking bad news is a key skill within clinical communication and one which can impact outcomes for both the patient and practitioner. The evidence base for effective clinical communication training in breaking bad news is scarce. Frameworks have been found to assist the practitioner, such as SPIKES, however the pedagogical approach used alongside such frameworks can vary. This study sought to examine the impact of utilising the Practitioners in Applied Practice Model (PAPM) alongside the SPIKES framework for training undergraduate medical students in breaking bad news.

Methods and Results
A case study approach is used to highlight the impact of training based on the PAPM and SPIKES on patient-centred communication and simulated patient satisfaction with the clinical communication behaviour.
Results showed that following training, both patient-centred behaviour and patient satisfaction improved. With detailed communication behaviour changes a balance was established between rapport building behaviour, lifestyle and psychosocial talk alongside biomedical information.

This case study shows how the PAPM could be utilised alongside the SPIKES framework to improve breaking bad news communication in medical undergraduate students and describes the behavioural basis of the improvement. Further research is required to show the generalisability of this training intervention.



Original languageEnglish
Pages (from-to)170-175
JournalScottish Medical Journal
Issue number4
Early online date23 Sep 2015
Publication statusPublished - Nov 2015

    Research areas

  • Clinical communication training, SPIKES, Patient satisfaction, Patient-centered

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