p.7
Non-Verbal Communication Techniques
What does remaining silent prompt the patient to do?
Continue talking and signals that the clinician is interested in what they are saying.
p.5
Non-Verbal Communication Techniques
How do emotions contribute to human communication and connection?
Emotions maximize human communication and connection.
p.4
Patient-Centered vs. Clinician-Centered Approach
What is the primary purpose of building a therapeutic relationship with the patient?
To gather information, formulate a diagnosis, determine drug interactions, and formulate a management plan.
p.10
Open-Ended and Closed-Ended Questions
What are closed-ended questions primarily used for?
To confirm or refute specific issues, rather than expand the conversation.
p.22
Shared Decision Making
What are the key steps in conducting shared decision making with the patient?
Involving patient preferences and determining the final plan together.
p.3
Patient-Centered vs. Clinician-Centered Approach
What are the outcomes of a clinician-centered approach?
Poor patient satisfaction, physician frustration, and worse health outcomes.
What should the interviewer do to obtain consent for investigations and procedures?
Clearly explain the investigations and procedures and then obtain consent.
p.3
Sequence of Clinical Encounter
What is the integrated clinical encounter?
An approach that integrates aspects of both patient-centered and clinician-centered approaches.
p.4
Data Gathering and Relationship Building Skills
What do most clinicians rate as having greater diagnostic value?
The patient's medical history.
p.14
Empathy in Clinical Communication
How can the four skills for communicating empathy be used?
They can be used singly or in pairs every time the patient expresses an emotion.
p.11
Data Gathering and Relationship Building Skills
What are the four indirect ways to encourage a patient to express emotion or feelings using the FIFE acronym?
FIFE stands for Intuiting how the patient might be feeling (F), Ideas/beliefs/attributions (I), Functioning (impact) (F), and Expectations (E).
p.10
Data Gathering and Relationship Building Skills
Give an example of a multiple question.
“Do you drink, smoke, use recreational drugs, anything like that?”
p.5
Open-Ended and Closed-Ended Questions
What are open-ended skills in communication?
Skills that allow for expansive and detailed responses, encouraging deeper conversation.
p.9
Non-Verbal Communication Techniques
What is echoing in clinical communication?
A type of reflection accomplished by repeating a word or phrase mentioned by the patient, letting the patient know they are heard and encouraging them to focus, expand, and elaborate.
p.14
Empathy in Clinical Communication
What are the four skills for communicating empathy with patients?
Name, Understand, Respect, Support.
p.16
Patient-Centered vs. Clinician-Centered Approach
Why is it important to inquire about the patient's preferred way of address?
To respect the patient's preference and ensure a patient-centered approach.
p.1
Data Gathering and Relationship Building Skills
What happens if either the patient or health care provider lacks clear understanding of the information conveyed?
The delivery of care is compromised.
p.3
Patient-Centered vs. Clinician-Centered Approach
What is encouraged in a patient-centered approach?
Expression of concerns, feelings, and emotions that encourage relationship-centered care.
p.2
Biopsychosocial Model in Healthcare
What did George Engel critique about the biomedical model?
A biochemical alteration does not equal illness, the presence of a biological derangement does not shed light on the meaning of the symptoms to the patient, psychosocial variables are more important determinants of susceptibility, severity, and course of illness, the success of the most biological of treatments is influenced by psychosocial factors, and the patient-clinician relationship influences medical outcomes.
p.19
Patient-Centered vs. Clinician-Centered Approach
Why is it important to elicit personal context in a patient-centered interview?
To understand how the symptoms affect the patient's daily life and activities.
p.19
Open-Ended and Closed-Ended Questions
What type of questions can a clinician use as continuers in a patient-centered interview?
Open-ended questions to encourage the patient to continue sharing their story.
p.1
Biopsychosocial Model in Healthcare
Why is clinical communication considered a fundamental skill?
To establish a relationship with the patient, paving a way to successful diagnosis and treatment.
p.16
Clinical Communication Definition
What does the acronym SOM - CSI.PCM1.4.FTCM.1.CPD.0002 refer to?
It refers to specific guidelines or standards for clinical communication.
p.22
Assessing Patient Understanding
What should the interviewer do to assess patient understanding?
Use the teach-back method.
p.9
Clinical Communication Definition
What are continuers in communication techniques?
Brief, noncommittal statements like 'I see,' 'Uh-huh,' 'Yes,' or 'Mmm' that encourage the patient to talk without directing the conversation.
p.5
Open-Ended and Closed-Ended Questions
What are closed-ended skills in communication?
Skills that elicit specific, concise responses, often used for clarification.
p.9
Setting the Stage for the Interview
What is the purpose of a transitional statement in clinical communication?
To signal the conclusion or addition to an idea and help the clinician direct the flow of the conversation.
p.6
Data Gathering and Relationship Building Skills
When are focusing open-ended skills used?
When the patient's narrative becomes hard to follow, gets off-track, or overwhelming.
p.16
Setting the Stage for the Interview
What are the initial steps in a clinical encounter?
Introducing oneself, inquiring the patient's name and preferred way of address, ensuring patient readiness and privacy, removing communication barriers, ensuring patient comfort and putting them at ease, and sanitizing hands.
p.10
Data Gathering and Relationship Building Skills
What are leading questions?
Questions where the answer is in the question and pushes the patient to respond in a specific manner.
p.5
Data Gathering and Relationship Building Skills
What is data gathering in the clinical context?
The process of extracting information and analyzing the data for decision making.
p.9
Open-Ended and Closed-Ended Questions
How are open-ended requests used in clinical communication?
To focus the patient on an already mentioned area that the clinician wants to expand upon.
p.6
Open-Ended and Closed-Ended Questions
What do open-ended skills encourage the patient to do?
Freely express what is on his/her mind.
p.9
Closing the Clinical Encounter
What is the purpose of a summary in clinical communication?
A brief, concise compilation of pertinent data from the encounter, commonly done at the end of the HPI or end of the encounter.
p.6
Non-Verbal Communication Techniques
What are neutral utterances/continuers in open-ended skills?
Verbal cues to encourage the patient to continue talking.
p.20
Data Gathering and Relationship Building Skills
What are the components of transitional skills used by the physician before the physical examination?
Explaining the techniques, purpose and expectations of the examination, seeking permission, and appropriate draping to avoid over-exposure.
p.15
Sequence of Clinical Encounter
What is the purpose of Review Of Systems in the clinical encounter sequence?
To systematically review the body systems for symptoms.
p.8
Non-Verbal Communication Techniques
What are some non-verbal communication techniques that urge patients to talk freely?
Sympathetic facial expression, eye contact, head nods, body language (leaning forward), and healing touch (with mindfulness).
p.14
Empathy in Clinical Communication
What does the acronym SOM - CSI.PCM1.4.FTCM.1.CPD.0003 stand for?
It stands for the four skills in order: Name, Understand, Respect, Support.
p.3
Patient-Centered vs. Clinician-Centered Approach
What is the characteristic of a clinician-centered approach?
The doctor leads the entire encounter and directs questions and flow of information to acquire data for identifying a disease.
p.11
Empathy in Clinical Communication
Why does the absence of expression of feelings or emotion from a patient not necessarily mean that the patient does not have or want to share them?
Patients do not always express feelings or emotion, but it does not mean they do not have or want to share them.
p.2
Biopsychosocial Model in Healthcare
What does the biomedical model describe the patient in terms of?
Only in terms of disease (physical or psychiatric).
p.5
Patient-Centered vs. Clinician-Centered Approach
What is one of the most important goals in clinical communication?
Forming a therapeutic relationship with the patient to ensure patient understanding, education, and compliance.
p.6
Non-Verbal Communication Techniques
What is the purpose of silence in open-ended skills?
To allow the patient to continue their story or gather their thoughts.
p.19
Sequence of Clinical Encounter
How does a clinician transition to the middle of the interview in a clinician-centered process?
By summarizing the symptom story and providing a transitional statement.
p.15
Sequence of Clinical Encounter
What is the third step in the sequence of clinical encounter?
Opening the History Of Presenting Illness.
p.15
Sequence of Clinical Encounter
What is the purpose of obtaining Social History in the clinical encounter sequence?
To gather information about the patient's social background and habits.
p.1
Clinical Communication Definition
What is the definition of clinical communication?
A structured way for a well-timed, truthful, and deferential exchange of information between patients or their carers, healthcare providers, or different members of health-professional teams.
p.10
Data Gathering and Relationship Building Skills
When are closed-ended questions ideal in an interview?
In the middle of the interview where specific information is required from the patient, especially if there are gaps in the history.
p.11
Non-Verbal Communication Techniques
How can a clinician suspect an emotion like anger from a patient?
By observing the patient's statement, nonverbal behavior, or actions.
p.3
Patient-Centered vs. Clinician-Centered Approach
What is the characteristic of a patient-centered approach?
The patient leads the entire encounter, tells their story, and directs the doctor to a diagnosis.
p.22
Closing the Clinical Encounter
What should the interviewer do to conclude the interview?
Invite the patient to ask any questions or discuss any concerns, agree on the next time of appointment, acknowledge and say goodbye.
p.19
Data Gathering and Relationship Building Skills
What is the purpose of eliciting the symptom story in a clinical interview?
To understand the patient's symptoms from their perspective.
p.2
Biopsychosocial Model in Healthcare
What does the Biopsychosocial (BPS) model describe the patient as?
An integrated mix of biological, psychological, and social components.
p.19
Empathy in Clinical Communication
How can a clinician respond to the patient's emotions during the interview?
By expressing empathy and seeking to understand the patient's feelings.
p.15
Sequence of Clinical Encounter
What is the first step in the sequence of clinical encounter?
Set the stage for the interview.
p.20
Setting the Stage for the Interview
What is the significance of SOM - CSI.PCM1.4.FTCM.1.CPD.0002?
It is a code or reference for a specific clinical procedure or guideline.
p.15
Sequence of Clinical Encounter
When does the closure of the clinical encounter occur?
At the end of the sequence.
p.6
Data Gathering and Relationship Building Skills
What is the purpose of non-focusing open-ended skills at the beginning of the interview?
To allow the patient to express without direction.
p.2
Data Gathering and Relationship Building Skills
What are used to elicit physical, personal, social, and emotional data from the patient in the Biopsychosocial model?
Communication and interpersonal skills.
p.6
Data Gathering and Relationship Building Skills
When is summarizing used in open-ended skills?
To recap and reflect on the patient's narrative.
p.20
Data Gathering and Relationship Building Skills
What does the physician do in Steps 7-10 of the clinical encounter?
Obtain details from the PMHx (Past Medical History), SHx (Social History), FHx (Family History), and ROS (Review of Systems) using closed-ended questions.
p.15
Sequence of Clinical Encounter
What is the purpose of obtaining Past Medical History in the clinical encounter sequence?
To gather information about the patient's medical history.
p.19
Open-Ended and Closed-Ended Questions
How can a clinician expand the symptom story in a patient-centered interview?
By asking open-ended questions and echoing the patient's responses.
p.19
Empathy in Clinical Communication
What is the significance of eliciting emotional context in a patient-centered interview?
To understand the patient's emotional experience related to their symptoms.
p.6
Data Gathering and Relationship Building Skills
What is the purpose of echoing in open-ended skills?
To show understanding and encourage the patient to continue.
p.20
Sequence of Clinical Encounter
What is the focus of Step 11 in the clinical encounter?
Conducting the physical examination.
p.15
Sequence of Clinical Encounter
What is the purpose of obtaining Family History in the clinical encounter sequence?
To gather information about the patient's family medical history.
p.20
Sequence of Clinical Encounter
What is the purpose of Step 6 in the clinical encounter?
To complete the HPI (History of Present Illness).
p.15
Sequence of Clinical Encounter
What is the sixth step in the sequence of clinical encounter?
Obtain a chronological description of HPI.
p.15
Sequence of Clinical Encounter
What is the second step in the sequence of clinical encounter?
Elicit chief concern and set agenda.
p.15
Sequence of Clinical Encounter
What does HPI stand for in the clinical encounter sequence?
History Of Presenting Illness.
