How to Counsel and Explain to Patients

Question 1

What to cover in the beginning

-what would you say

Answer 1

Introduce yourself, patient ID check

• Hello, I’m An Nakamura, a 3rd year medical student. Can I confirm your name and DOB?
• I understand that you were expecting to see XYZ today?
• XYZ has asked me to talk to you before you see her, would that be ok?

Ask patient - lay out their and your own agenda

• why they’ve come today? - what are you expecting from today’s consultation? Is there anything you’d like to discuss in particular?
• understanding of events leading up to test - before I go through your results, I’d like to ask you what led you to have these investigations done?

Brief history - 1min

Question 2

Explanation of a disease

• what would you say
• how would you structure this

Answer 2

Assess prior understanding

• what do you think is causing XYZ
• I’d like to ask, what do you already know about XYZ

Normal body functioning
How does the condition affect body functioning
Causes - genetics, environment, family history
Symptoms => linked to patient’s experiences
Complications - prevent worsening of symptoms
Management
-I recognise that I’ve given you a lot of information in a short time frame. If you’d like, we can arrange for a follow up appointment to discuss management in more detail

Layterms, analogies
Check understanding periodically

Question 3

Explanation of a procedure

• what would you say
• how would you structure this

Answer 3

Assess prior understanding
-what do you currently know about XYZ

Describe the procedure in a sentence
What is it used for
What needs to be done before, during and after
Risks and benefits of procedure
Capacity assessment if we need to gain consent

Layterms, analogies
Check understanding periodically

Question 4

Explanation of a procedure

• what would you say
• how would you structure this

Answer 4

Check CI to treatment
Check patient understanding of condition
Purpose of treatment
How does treatment work
Monitoring needed?
SE

Layterms, analogies
Check understanding periodically

Question 5

How would you end a counselling session

Answer 5

Summarise key points
Check understanding
Offer resources for more info/phone no for questions/follow up appointment for next stage of management.