Fundamental Principles

The Foundation    Top of Page

In this section, you'll learn about four useful communication strategies:

  • CLASS is the fundamental protocol for all clinical interviews.
  • EVE is a special strategy to use inside of other protocols when responding to emotions within any type of interaction.
  • SPIKES is a protocol to use when you must break bad news.
  • CONES is a variation of the SPIKES protocol that is useful for error disclosure.

You can then explore each of these strategies in depth. We have included explanations of what they are and how they work, as well as video vignettes that show a physician (Dr. Robert Buckman) actually using them in clinical scenarios. The patients in these encounters are professional "standardized patient" actors, but the vignettes are unscripted and depict situations that arise not uncommonly in the practice of oncology.

This video will provide you with a brief overview of fundamental communication techniques.

Introduction to Basic Principles: CLASS-EVE-SPIKES-CONES (11:44)
In depth: These videos will provide you with an expanded discussion and illustration of both fundamental principles (CLASS) and strategies for giving bad news (SPIKES) and error disclosure (CONES).

The Foundation      CLASS - In Depth (5 videos - 57 minutes)
       SPIKES - In Depth (5 videos - 33 minutes)
       CONES - In Depth (2 videos - 11 minutes)

Non-Verbal Communication    Top of Page

Dr. Robert Buckman discusses techniques for effectively using non-verbal communication. You will find this video illustrates in greater detail how paying attention to non-verbal behavior in the clinical encounter can help you with the messages that you send to others.

Non-Verbal Communication - In Depth (22:52)

“Crossroads”    Top of Page

CrossroadsHow do you know when you have reached a point in an interaction where these techniques are needed? View "Crossroads."




Did They Get It? Strategies for Making Sure Patients and Families Understand Your Message    Top of Page

This video demonstrates key communication strategies that are essential when talking with patients and families and ensuring that they understand important information about their treatment plan. Presented by: Daniel Epner, M.D., Associate Professor, Department of General Oncology, Medical Director, International Center, The University of Texas MD Anderson Cancer Center.

Did They Get It? Strategies for Making Sure Patients and Families
        Understand Your Message (55:46)
        Presentation slides (pdf)

The Crisis of Cancer    Top of Page

The Crisis of CancerIn this video you'll see actual patients and family members who talk about aspects of their relationship with their physicians, and how effective communication helped reduce their anxiety. They found that five strategies practiced by these clinicians were particularly helpful. Paying attention to how we communicate can benefit patients and families as they deal with the crisis of cancer.

The Crisis of Cancer (12:47)


Next: We recommend you advance to the next modules in our series "Managing Difficult Communications." There, you will be able to view these techniques in use in various patient-physician interactions that are difficult but common in oncology.

Managing Difficult Communications   » 

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Certain material on this site is available for Risk Management Education Credit (only for physicians enrolled in the The University of Texas Professional Liability Insurance Plan). 

The RME Credit link is for those who only want to obtain RME.  CME credit is not awarded through this link.

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NOTE:  RME is only available to physicians enrolled in The University of Texas UT Professional Liability Insurance Plan.

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