Communication skills overview

Introduction

Takes place in same hospital as clinical examination
Exercise with actor playing patient / relative
Based on
- Information giving
- Information gathering followed by presentation to a consultant
Expected to give accurate clinical information as well as possess good communication skills

Objectives

Competent performance within time given
Skill / insight to recognise situations or knowledge outside personal experience but ability to act appropriately
- Ask consultant to provide further details
- Assistance from other members of the team
Assessment of communication skills in a clinical situation

General skills

Introduction
- Name
- Explain role
- Checks patients name
- Appropriate greetings
- Non-verbal behaviour appropriate to culture
Establishes purpose of interview
- Clarify why interview is taking place (patient perspective, own perspective)
- Check patient happy to proceed
- Establish outcome of interview
Establish baseline knowledge / understanding
- Open questions
- Listens
- Confirms what learned
- Signals to move to information giving at the end

*General Manner*	*Questioning style*	*Information giving*	*Control of interview*	*Summarising*	*Recognition and responding to cues*
Picks up and responds to cues Listens actively Uses empathy Offers support Presents information non-judgementally Uses language patient understands Uses appropriate body language	Open/closed questions used appropriately	Conveys information and understanding	Allows control of interiew to alternate between doctor and patient Signposts change of direction	Summaries / next steps	Recognises and responds to patients concerns, anxieties and doubts

	Information Gathering	Information Giving
Presentation Skills	Appropriate language Methodical approach Comprehensive Succinct (keep to 5 minute limit) Emphasis and significance - leep appropriate to surigcal context Interpretation of ideas and concerns
Format	Given time to read brief information sheet explainin scenario (who you are, patient, place, time, aim of particular task) Onus on candidate to introduce , check identity and explain role 10 minutes to complete task May rearrange chairs to reduce "barrier" between you and patient	Given time to read brief information sheet explaining scenario (who you are, place, time, details, particular task) Take history from actor playing patient / relative Present history to examiner playing consultant Onus on candidate to introduce , check identity and explain role
Core elements	2 aspects to the task (1) specific clinical task - explain operation (2) particular communication skill - distressed / withdrawn patient Scenario may go deliberately beyond scope of junior professional experience - must recognise you should refer matter upwards Should deal with aspects of situation of patients condition as they emerge in conversation	Up to 10 minutes to complete task Open Close appropriately (check if has no further questions, and knows what will happen next) Should say you will now speak to your consultant Up to 5 minutes to present patient's history and answer 3 standard questions Systemic review is focused concentrating on relevant points Presentation to the consultant shold be logical, structured, couched in appropriate clinical language
Examiners	Will not intervene during conversation / will not ask questions at the end Mark performance on handling of conversation and accuracy of information given	What differential diagnosis would you suggest at this stage based on the history? What signs would you look for specifically in the examination What investigations would you request for this patient?

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Communication skills overview