Publication:

Impact of SPIKES -protocol on knowledge, attitude and practice on breaking bad news in obstetrics practice among obstetrics and gynecology postgraduate residents

Background Breaking bad news (BBN) is a critical communication skill in Obstetrics and Gynaecology, particularly when dealing with adverse pregnancy outcomes such as stillbirth, congenital anomalies, and miscarriage. Despite its importance, formal communication training is often inadequately addressed during postgraduate medical education.

Methods A prospective interventional study was conducted in the Department of Obstetrics and Gynaecology at Era's Lucknow Medical College and Hospital, Lucknow, over a period of 24 months from January 2024 to December 2025. Twenty-five postgraduate residents participated in the study. Baseline assessment of knowledge, attitude and practice was performed using a validated questionnaire. Participants subsequently underwent structured training based on the SPIKES protocol, including interactive lectures, role-play sessions and simulation exercises. Communication skills were evaluated using Objective Structured Clinical Examination (OSCE) and SPIKES-based assessment before and after training. Participant feedback regarding the training programme was also obtained.

Results Only 12% of residents reported prior formal training in breaking bad news. Baseline assessment demonstrated positive attitudes but inconsistent communication practices and limited familiarity with structured communication protocols. Significant improvements were observed following training across all OSCE domains (p<0.001). Participants reported increased confidence, preparedness and satisfaction following the training programme.

Conclusions Structured SPIKES-based communication training significantly improves knowledge, communication skills and confidence among postgraduate residents. Incorporation of formal communication training into postgraduate obstetrics and gynaecology curricula may enhance patient-centred care and improve management of adverse pregnancy outcomes.