A map for introducing aspects of ‘communicating with patients’ into the curriculum

Further analysis of our survey of clinical educators and academic staff provide insight as to consider introducing specific skills into a curriculum.

Results for Domain 1: Communication with patients

PRECLINICAL

The student:

A1:  adapts own communication to the level of understanding and language of the patient, avoiding jargon.
A2: builds and maintains rapport and an empathetic relationship and ensures that the patient feels attended and listened to.
A3: relates to the patient respectfully including ensuring confidentiality, privacy and autonomy and recognizing the patient as a partner in shaping a relationship.
A7: uses techniques of active listening (e.g. reflection, picking up patient’s cues, paraphrasing, summarizing, verbal and non-verbal techniques)
A8: recognizes difficult situations and communication challenges (e.g. crying, strong emotional feelings, interruptions, aggression, anger, anxiety, embarrassing or sensitive issues, cognitive impairment, delivering bad news) and deals with them sensitively and constructively.
A9: shows awareness of the non-verbal communication of both the patient and the healthcare professional
A15: considers somatic, mental, social, gender, cultural, ethical and spiritual elements in the care and assessment of the Patient and perceives divergences between own values and norms and the patient’s.

A18: provides information in a patient-centered way and shares it with the patient’s consent (e.g. colleagues, family and others.) A25: discusses with the patient the likely advantages, disadvantages and expected outcomes

A26: The student encourages active participation by the patient in decision-making and explains choices or rights to the patient in a patient-centered manner.

A27: clarifies own role in decision-making process.

MID CLINICAL

The student:

A12: identifies patient expectations with respect to the role of health care professional.

A14: elicits the needs and capabilities of the patient (e.g. information, autonomy, truth and responsibility) and adapts the plan/intervention to patient’s resources and strengths.

A17: finds out how much information the patient requires and gives the appropriate amount of information

A23: seeks out and synthesizes relevant information from other sources (e.g. patient’s family, caregivers and other professionals), if necessary and available
A24: ascertains how much involvement and responsibility the patient is willing and able to take for decision-making.
A31: discusses decisions with colleagues, patients and their relatives as appropriate and regularly reassesses own decisions and revises them if necessary.
A32: identifies own opinion clearly to the patient if asked.
LATE CLINICAL

The student:

A33: talks openly to the patient about uncertainty and formulates ways of dealing with it.
A34: explains to the patient which information is needed to minimize uncertainty in the decision-making process.
INDETERMINATE (PRECLINICAL/MIDCLINICAL)I.E. NO CLEAR DIFFERENCES IN NUMBER OF RESPONSES ACROSS THESE CATEGORIES

The student:

A5: encourages the patient to express own ideas, concerns, expectations and feelings and accepts legitimacy of patient’s views and feelings.
A6: gives information to the patient (oral, written, electronic and over the phone) in a timely, comprehensive and meaningful manner.
A7: uses techniques of active listening (e.g. reflection, picking up patient’s cues, paraphrasing, summarizing, verbal and non-verbal techniques).
A8: recognizes difficult situations and communication challenges (e.g. crying, strong emotional feelings, interruptions, aggression, anger, anxiety, embarrassing or sensitive issues, cognitive impairment, delivering bad news) and deals with them sensitively and constructively.
A10: shapes a conversation from beginning to end with regard to structure (e.g. introduction, initiating the conversation, gathering and giving information, planning, closing interview, setting up next meeting; time management).
A11: uses different types of questions (e.g. open, closed and focused) according to the situation.
A19: elicits and synthesizes information for patient care.
A20: inquires about the patient’s level of knowledge about the illness
A21: considers different elements of a patient history (history of the illness, history of the health care professional–patient relationship, history of the patient).
A22: knows about the importance of supplementing verbal information with diagrams, models, written information and instructions and applies the information appropriately.
A23: seeks out and synthesizes relevant information from other sources (e.g. patient’s family, caregivers and other professionals), if necessary and available
INDETERMINATE (MID CLINICAL/LATE CLINICAL) I.E. NO CLEAR DIFFERENCES IN NUMBER OF RESPONSES ACROSS THESE CATEGORIES

The student:

A16: responds to the patient’s health beliefs and theories of illness and contrasts and integrates these into own theories of illness as a health care professional.

A28: discusses with patient the spectrum of possible consequences of a decision and explains to the patient the likely consequences of not choosing diagnostic and therapeutic measures.
A29: inquires about the relevant psychological and social resources the patient has available for making a decision.
A30: offers the patient the option to include other people in the decision- making process and clarifies with the patient how and when a decision must be made.
INDETERMINATE (PRE CLINICAL/MID CLINICAL/LATE CLINICAL) I.E. NO CLEAR DIFFERENCES IN NUMBER OF RESPONSES ACROSS THESE CATEGORIES

The student:

A13: uses adequate strategies to solve conflicts (e.g. feedback on perception, impact, wishes).