introduction to clin com s

Question 1

open qns

Answer 1

more open and elaborate response
closed -when need to narrow focus/pt not conscious
be aware of how ask qn - tone
read pt so know how much information they give

Question 2

interruption

Answer 2

let talk at beginning
sometimes need to interrupt - if theyre tense, running out of time, urgency associated, diverging
NVC - hand signal, change position, euye contact, adjust gaze

Question 3

ICE

Answer 3

content
failure = inaccurate diagnosis and reduced satisfaction
in context and contribute to the normal flow - ideas not qns
don’t have to agree - find out baseline and work from there

Question 4

Listen

Answer 4

active listening - skill for recognising and exploring pt cues
expression of feelings
attempts to understand or explain feelings
speech clues that underscore concern for the patient
personal stories - link pt with risk
behaviours suggestive of unresolved concerns or unmet expectations
deeper understanding = increased patient satisfaction and improved outcomes

Question 5

verbal cues

Answer 5

pick up leads abvout concerns

answer qn if in breadth of knowledge

Question 6

probe

Answer 6

not all feel sensitive about everything
I can see difficult - should I go on
normalise
religion - provides comfort

Question 7

survey for other problems

Answer 7

explore more compaints/symptoms
near beginning
might not feel comfortable saying everything at once

Question 8

set agenda

Answer 8

may not solve all problems in 1 meeting

plan what going to discuss with the patient

Question 9

clarify pt terms

Answer 9

pts use colloquial terms - don’t assume you know what they mean

Question 10

interim summaries and signposting

Answer 10

check and clarify understanding 
clarify listening 
time to reflect if lost chain of thought 
link interview together 
make process transparent

Question 11

Silence

Answer 11

helpful
need more time to respond to problems
go ahead signal

Question 12

multiple qns

Answer 12

avoid

increase probability of pt only answering with 1 qn = -ve impact on info gathering

Question 13

leading qns

Answer 13

avoid
biased and judgemental - lead pt to agree with you rather than eliciting useful info
avoid unexplained jargon

Question 14

end summary

Answer 14

check accuracy of info 
leave both parties with a sense of what you thought was important 
lasting impression 
signal about to finish 
restate what done

Question 15

discuss an action plan

Answer 15

eg prep for an operation

Question 16

check further info and ask for qns

Answer 16

ask immediately before end
may not feel comfortable sharing before hand
after summary - might have triggered area of discussion they would like to pursue
then ask if any worries - might have developed in the consultation

Question 17

empathy

Answer 17

walk in someone’s shoes - ‘as if’
imagine what like to be that patient and show it through your behaviour
more likely to develop rapport
recognise what the patient is feeling and relay it to them

Question 18

avoid being judgemental

Answer 18

only share views appropriately - if at all

don’t let judgements get in way of care you provide

Question 19

paralanguage

Answer 19

everything but the content of the language