Julie Marshall,Michael  S. Brown,Marty  Runyan,Dena  Higbee,
SKIPS: A Simple Modification of a Prior Simulation Tool for Difficult Patient Discussions
Anesthesia and Clinical Research
2020
2733-2500
http://dx.doi.org/10.31487/j.ACR.2020.01.05
https://www.sciencerepository.org/skips-a-simple-modification-of-a-prior-simulation-tool-for_ACR-2020-1-105 
Abstract: Patient communication during ethical or difficult treatment decisions is a complex interaction. We present
our initial experience with a structured framework for discussion, SKIPS (setting, knowledge, invitation,
perception and strategy), as a modification to a previously reported tool for breaking bad news, SPIKES.
Our new framework emphasizes patient beliefs and wishes in the setting of a discussion requiring ethical
considerations or treatment decisions. Initial evaluations of the SKIPS tool were favourable by resident and
faculty, with faculty reporting a greater chance of utilizing SKIPS than the residents.Keywords: Simulation, communication, residency education, milestones