Effective Communication

Question 1

Attributes of CAGE

Answer 1

Cutting down
Annoyance when criticized
Guilty feelings
Eye opener

Question 2

Name cues of Sexual Abuse

Answer 2

• Physical exam inconsistent with hx of injury or injury concealed
• Delayed treatment
• Frequent “accidents” or “clumsy”
• Partner really unwilling to leave exam room, does all the talking
• Fear of pelvic or close contact; genital/rectal trauma or pain
• Hx repeated vaginal infection or STDs
• Young age 1st coitus or 1st IUP
• Young age 1st coitus & multiple partners
• ETOH or substance dependence

Question 3

How does the clinician prepare for the therapeutic interview?

Answer 3

• Review overall daily schedule
• Review each record prior to entering room
• Mindset based on CC

Question 4

How does the patient prepare for therapeutic interview?

Answer 4

List concerns

Question 5

How does admin prepare for the interview?

Answer 5

• Policy
• Guidelines
• Protocols

Question 6

Types of questions NOT to ask

Answer 6

• Yes/No questions
• Jargon questions
• Leading questions

Question 7

What 3 things impact the general therapeutic interview sequence?

Answer 7

• Perspectives
• Expectations
• Preparation

Question 8

What are expectations of a Clinician?

Answer 8

• Obtain attributes & relevant hx about symptoms
• Perform appropriate PE
• Formulate DDX
• Devise treatment plan & do so in timely fashion, flow of the visit

Question 9

What are exceptions of a Patient?

Answer 9

• See some one who is knowledgeable
• Makes feel comfortable, heard & validated tend to the immediate concern
• Respect their time schedule

Question 10

What are exceptions of the Admin?

Answer 10

• No disgruntled pt

- No complaints/legal issues/malpractice, maintain volume with little schedule flexibility

Question 11

Components for a successful therapeutic interview

Answer 11

• Verbiage
• Flip the order of expectations
• Clinician skills: process with skilled questioning, rapport and empowerment, and partner/facilitator relationship

Question 12

Attributes of Skilled Questioning

Answer 12

• Active listening, empathetic responses, guided questioning
• Stigmatization
• Transitions
• Non-verbal language

Question 13

Attributes of Patient rapport and empowerment

Answer 13

• Validation
• Reassurance
• Partnering
• Cultural humility

Question 14

Name the types of Guided questioning

Answer 14

• Open ended questions
• Elicit graded response
• Series, Multiple Choice option
• Clarification, continues
• Echoing

Question 15

Give an example of an Open ended question

Answer 15

“How can I help you today?”

“What brings you into the clinic today?”

Question 16

Give an example of an Elicit graded response?

Answer 16

“How many steps can you take before you need to rest?”

“How long can you — before fatigue?”

Question 17

Give example of a multiple choice question?

Answer 17

Is the pain aching, sharp, shooting?

Question 17

Example of a Clarification question?

Answer 17

“What do you mean by flu? By cold?”

Question 18

Contunuers

Answer 18

Non-intrusive encouragement for pt to continue talking; “Go on”; “Uh huh”

Question 19

Echoing

Answer 19

Repeat pt’s last few words = reflective technique

Question 20

Non-verbal

Answer 20

• Eye
• Facial expression
• Neutral or at ease (posture, head position, movement).

Question 21

Summarization

Answer 21

Recap of the facts by the clinician

“Let em make sure I’ve got this right”

Question 22

Transitions

Answer 22

• Explains purpose of ROS
• Can allay pt fears of being singled out
• Allow for pt to defer or opt out

Question 23

What are components of sensitive topics?

Answer 23

Sexual habits
Behavioral health or addiction
IPV, domestic violence, sexual assault
Terminal disease

Question 24

Attributes of clinician etiquette for sensitive topics?

Answer 24

Non judgmental
Transition technique to explain need to know
Do not act embarrassed - use correct terms