The following provides an insight into the three scenarios that we are testing in VR-TALKS, two of which were developed specifically for the project.
SPIKES Scenario
Nora is a 45-year-old woman. She has advanced breast cancer. Her disease dates back over three years and she has undergone multiple lines of therapy. Recent investigations confirmed extensive and progressive disease burden. Nora is currently receiving radiotherapy to the brain due to brain metastasis. As a result, she has alopecia (total hair loss) and severe headaches. Nora is profoundly fatigued. Her prognosis is limited to weeks/few months.
Nora coped with her illness by “being positive.” She actively researched her disease and all treatment options. She views “negativity” as a failing and despite her massive burden of disease, continues to express a desire for more treatment – “what have I got to lose?”
Nora coped with her illness by “being positive.” She actively researched her disease and all treatment options. She views “negativity” as a failing and despite her massive burden of disease, continues to express a desire for more treatment – “what have I got to lose?”
She is married to Hussein but prefers not to bring her husband to consultations since he is busy with work and the kids.
You asked to see Nora in your clinic/consultation room to discuss the situation and to advise her that there are no further treatment options other than pain and symptom management (i.e., no more radiotherapy to the brain since the tumour is not responding).
Nurse scenario
Mr Steward, is the husband of a patient Mrs Steward. His wife was due to be discharged from the hospital today, but unfortunately the latest examinations have shown that Mrs. Steward must remain in hospital for a few more days. The husband got the news directly from his wife in the hospital room, and now he enters the nurses’ station and confronts you with the situation.
Mr Steward becomes very silent and disappointed. He is saying: “But noone told me about it”.
Then Mr Steward will say that this weekend it will be a 55 year anniversary for them, the family arranged a big celebration and relatives are coming from abroad. Mr Steward looks desperate.I n a moment you will meet the husband of Mrs. Steward husband, whom you are familiar with already know from his previous visits.
angry patient scenario
Mr. John Gardner is a 40-year-old man working as a manager. Recently, he has experienced a significant decline in his health, marked by persistent nausea, increasing weakness, abdominal and back pain, and noticeable weight loss over the past month. These symptoms have led to his hospitalization, where further medical examination revealed that he is suffering from advanced pancreatic cancer, categorized as stage 3-4.
You are meeting Mr. Gardener for the very first time. His biopsy results came back this morning. Your job is to tell him he has advanced pancreatic cancer with no further curative treatment.
Emotionally, Mr. Gardner is understandably anxious and nervous, particularly as he awaits the results of his biopsy. His initial reaction upon receiving the news is a mix of disbelief and forced composure, indicative of someone grappling with the sudden, life-altering information. As the conversation progresses, he demonstrates typical stages of emotional response, including denial, hope for a miracle, and deep concern for his family, especially his children. This emotional journey underscores the severity of his diagnosis and the impact it has on his mental state, reflecting a man facing a profoundly challenging and uncertain future.