Which of the following best describes the purpose of the 'Setting up interview' step in SPIKES?

• A. Arrange a private, quiet setting with sufficient time to discuss.
• B. Begin with a full medical history.
• C. Make the patient wait in the hallway.
• D. Provide the news in a public space.

Answer: (C)

Setting up the interview focuses on creating the right environment before delivering difficult information. The goal is to arrange a private, quiet space with minimal interruptions and to allocate enough time so the discussion isn’t rushed. It also involves deciding who should be present (patient, family members, interpreter) and confirming that everyone who should be included is at the table. This groundwork signals respect, protects confidentiality, and helps the patient feel secure and ready to engage, which sets the stage for a clearer, more compassionate conversation about what comes next.

Delivering news in a public space would breach confidentiality and make the patient uncomfortable. Beginning with a full medical history is something that happens during the information-giving phase, not during the setup. Making the patient wait in the hallway creates distrust and demonstrates a lack of respect for the patient’s time and wellbeing.