Research shows us that clinicians can feel their job is done when the news is delivered. Patients, however, often feel the most important part of the conversation has just begun — they want to know what they can do about their illness.

Below you can access a one-page “Quick Guide” for the popular SPIKES tool. We share this with the awareness that the imagery of ‘breaking’ may reinforce, if unintentionally, the sense that the clinician’s job involves force. Our hope is that this is useful but that you do not get bogged down in trying to forecast the news during the ‘invitation’ step, because delivering serious news is often the first step to a new chapter of medical care and clinicians need to equip the patient for what will happen next — a test, a consultant, a medication, or a procedure.