Delivering difficult news to a Veteran is never easy —especially in matters of life and death. Many providers may not have been taught how to handle these delicate conversations. Learning a strategy on how to have such a conversation can help deliver information accurately and compassionately. This training demonstrates how to deliver difficult news with compassion. We recommend using an approach that follows the acronym: SPIKES., which stands for “Setting”, “Perception”, “Invitation”, “Knowledge”, “Empathy” and “Strategy”. In this program, you will watch a physician use the SPIKES protocol with a Veteran nearing the end of her life. The health care information provided in these materials is for educational purposes only. It does not replace the role of a medical practitioner for advice on care and treatment