Novice medical students' perception about bad news training with simulation and spikes strategy.

Objective: To analyze the medical students' perception about simulated consultations before and after training using the SPIKES protocol. Methods: Quasi-experimental study, with a qualitative approach. It counted with the participation of 20 students as Simulated Physicians (SF), and 20 students as Simulated Patients (SP), all belonging to a medical course. Data were obtained from the responses given to a reflective question, applied before and after training with the SPIKES. The treatment and the analysis of the data were guided by the stages of thematic analysis. Results: In the category "Simulated Medical Student's Self-Perception", the subcategories "Nervousness and Insecurity" were predominant after the first consultation, while "Tranquility and Security" after the second consultation after training. In the category "Simulated Medical Student's Perception about the Educational Process", the subcategory "Reflective Learning" emerged in the students' speeches, especially after the second consultation. In the speeches of SP, it was evidenced the improvement of the care provided by SF after training. Conclusion: The strategy used for the development of communication skills showed evidence of short-term effectiveness. Innovation: The research resulted in a teaching protocol for students in pre-clinical stages that involves four stages: simulation, self-assessment, feedback and new simulations.