The Art of Breaking Bad News: Awareness, Practice, and Training of Spikes Protocol among oral Healthcare Professionals on Oral Cancer

告知坏消息的艺术:口腔医疗保健专业人员对口腔癌突发事件应对方案的认识、实践和培训

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Abstract

BACKGROUND: Effective communication is a skill for oral healthcare professionals, particularly while delivering bad news to patients. Structured approaches such as the SPIKES protocol can reduce patient anxiety, improve satisfaction, and support patient-centered care. While the SPIKES protocol is well recognized and increasingly practiced worldwide, in India, its awareness, practice, and training remain limited. AIM: To assess the awareness, application, and training needs related to the SPIKES protocol among oral healthcare professionals in Indore, India. MATERIALS AND METHODS: A descriptive and cross-sectional survey was conducted between April and June 2024 at the Government College of Dentistry, Indore. A total of 200 oral healthcare professionals completed a validated, structured questionnaire with 18 items divided into three domains: professional background, awareness and use of the SPIKES protocol, and training needs. RESULTS: Overall, 72% of participants agreed that following a structured protocol is essential when delivering bad news. Awareness of the SPIKES protocol was reported by only 38%, and among them, <20% had applied it in practice. A significant majority (84%) expressed the need for formal training in communication skills and the SPIKES protocol, with postgraduate students showing the highest demand (P < 0.05). CONCLUSION: Awareness of the SPIKES protocol among oral healthcare professionals in India remains low, and its practice is also limited. At the same time, the strong demand for formal training highlights the need for immediate action. Incorporating SPIKES training modules, simulation-based teaching, and structured communication skill workshops into both undergraduate and postgraduate curricula are essential to ensure patient-centered cancer care.

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