communication skills

Question 1

what happens in consultation?

Answer 1

1. confirm correct patient
2. open question - why patient attended & what they hope to gain
3. ask right questions to gather more info
4. apply clinical knowledge to work out what’s going on
5. discuss with patient and agree a plan

Question 2

what is important about communication skills?

Answer 2

• patient safety = ensure understood and accurate info
• patient trust = form rapport, what matters to them
• teamwork

Question 3

what happens in calgary cambridge guide?

Answer 3

• initiating the session
• gathering info (enquire & listen)
• physical examination
• explanation & planning (negotiation)
• closing the session (recall & safety net)

Question 4

what are cardio problem questions?

Answer 4

• chest pain
• palpitations
• breathlessness
• ankle swelling
• calf pain
• lightheadedness/loss of consciousness

Question 5

what are respiratory problem questions?

Answer 5

• cough
• sputum
• breathlessness
• hoarseness
• chest pain
• haemoptysis (coughing up blood)

Question 6

what are gastro-intestinal problem questions?

Answer 6

• Change in appetite
• Heartburn
• Problems with swallowing
• Nausea or vomiting
• Vomiting blood ( haematemesis)
• Yellowing of skin or eyes
• Change in weight
• Abdominal pain
• Change in bowel habit
• Change in bowel movement ( stool)
• Blood from back passage

Question 7

what acronym should be used for PAIN history?

Answer 7

S - site of pain
O - onset
C - character
R - radiation
A - associated symptoms
T - timing/duration
E - exacerbating or relieving factors
S - severity (often 1-10 scale)

Question 8

what else do we want to know about our patient?

Answer 8

Have they had any serious health
issues ( past medical history)?

Are they taking any medications or
are they allergic to any?

Is there any relevant family history?

How is their home life, what is their
occupation, do they smoke or drink
alcohol/ use illicit drugs?

Question 9

how should you ensure that you are understood?

Answer 9

• Avoid speaking too quickly
• Observe for verbal & non-verbal cues
• Avoid raising your voice
• Use inclusive language – avoid local dialect if the other person is likely to be unfamiliar with it
• Encourage patient to ask questions

Question 10

how should you ensure that you have understood the patient?

Answer 10

• Avoid making assumptions
• Clarify the information eg belly …….where are they referring to
• If necessary ask them to repeat themselves or slow down their speech
• Observe & respond to verbal and non verbal cues
• Summarise

Question 11

how to form rapport?

Answer 11

• attentive listening
• positive body language
• being caring & empathetic

Question 12

what should you do for attentive listening?

Answer 12

• Effective eye contact
• Using both your ears & eyes
• Think about body language – posture, position of arms, facial
  expressions
• Listen for clues/ hints from your patient about what is
  particularly on their mind ( we call them ‘cues’). Respond to
  these
• Use facilitation - ah ha, go on, I see or head nodding
• Repeat back what the patient has said to confirm you have
  picked them up correctly
• Being culturally sensitive and non judgemental

Question 13

what are 3 different parts of how we speak for effective communication?

Answer 13

Verbal = the words & phrases we use, as well as how we structure our sentences

para-verbal = how say those words (tone, pitch or pace)

non-verbal = that is our body language

Question 14

how do you start the consultation - saying hello?

Answer 14

• who are you?
• who is your patient? do you have the right person? = confirm name & DOB
• introduce yourself, role, nature of interview
• how would you like to be addressed? (e.g. first name)
• opening question e.g. what brings you in today? what can i do for you? how can i help you?
• how will you find out more? e.g. can you tell me more? how has this been affecting you?

Question 15

how should you end a consultation?

Answer 15

• signposting
• summarising