SPIKES
A six-step protocol for delivering serious news — Setting, Perception, Invitation, Knowledge, Empathy, Strategy — the most widely adopted framework in oncology and palliative care globally.
Baile et al., 2000 · The Oncologist ↗THE EVIDENCE BASE
Built on evidence. Evaluated beyond it.
empathium's scenarios and evaluation model draw from a broad body of peer-reviewed clinical communication research — spanning healthcare, behavioral health, social services, medical education, and organizational practice. What follows is a curated window into that evidence base.
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FRAMEWORKS
4
DOMAINS
THE EVALUATION MODELBOTH LAYERS REQUIRED
empathium draws on published frameworks — and adds its own relational intelligence model. The output is developmentally actionable feedback that neither layer can produce alone.
FRAMEWORK FIDELITY
Validated clinical communication standards
SPIKES, MI, SDM, and the evidence base below.
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RELATIONAL INTELLIGENCE
empathium's adaptive evaluation model
Emotional attunement, pacing, and presence in the moment.
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RELATIONAL COMPETENCY
Feedback neither layer achieves alone
Select a domain to explore a curated sample of the frameworks behind empathium's scenarios and evaluation model.
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CURATED SAMPLE
Healthcare & Serious Illness
NURSE
An empathic response framework — Name, Understand, Respect, Support, Explore — for responding to patient emotion in serious illness and end-of-life conversations.
Back, Arnold et al. · VitalTalk / serious illness communication ↗Ask–Tell–Ask
A patient-centered technique for assessing understanding, sharing information, and checking comprehension collaboratively rather than directively.
Health communication / teach-back literature ↗Shared Decision-Making (SDM)
An evidence-based model in which clinicians and patients jointly participate in healthcare decisions, driving adherence, satisfaction, and outcomes.
Elwyn et al., 2012 · Journal of General Internal Medicine ↗Advance Care Planning (ACP) Communication
Frameworks for facilitating goals-of-care conversations with seriously ill patients and families, including values clarification and prognostic disclosure.
Serious illness communication literature ↗Informed Consent Communication
Evidence-based standards for communicating risk, benefit, and alternatives in ways that support genuine patient understanding and autonomous decision-making.
Bioethics and medical education literature ↗Frameworks are referenced for educational purposes. empathium does not claim endorsement by framework authors or originating institutions.
The frameworks shown are a curated sample — not a complete inventory. empathium's evaluation model draws from a substantially broader body of clinical and behavioral communication research.
HOW WE EVALUATE
Beyond the framework. Into the conversation.
Published frameworks define what good looks like. empathium's own relational intelligence model measures how you show up in the conversation — assessing framework fidelity and emotional intelligence together. Neither layer alone produces feedback that is specific, developmental, and actionable.
Framework fidelity + relational intelligence = relational competency.
Not a grade. A read.
TWO LAYERS · ONE OUTPUT
Framework fidelity
How closely the conversation follows validated clinical communication standards from the published literature.
Relational intelligence
empathium's own model — emotional attunement, pacing, and human presence in the moment itself.
= Relational competency — impossible without both.
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