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Giving an Explanation

From Mediwikis

Your technique when explaining topics to patients, on the wards or in an OSCE, can greatly affect their perception and recall of information. A structured approach with appropriate opportunities for the patient to ask questions is vital for a patient to make appropriate choices with regards to their health[1], and will limit any communication and distress over miscommunication.

Introduction

  1. Introduce Self
    1. "Hello, I'm John, a medical student..."
  2. Confirm patient name and date of birth.
  3. Build rapport with the patient. Avoid using platitudes.
  4. Explain purpose
    1. "I've been asked to explain to you..."
  5. Assess how much they have already been told by other staff, and how much they know of the situation
    1. "Has anyone talked to you about this procedure before?"
    2. "Do you know why this procedure is important?"

Throughout the meeting

  • Elicit ICE[2]
    • What would you like to see happen with this procedure?
    • Is there anything that you're worried about?
    • What impact will this have on your life?
  • Maintain open, empathic communication
  • Ensure the patient can always ask questions
  • Don't assume any understanding. Always be ready to explain any part of the procedure.

Explanation

  1. Measure your patient's existing knowledge of the subject
    1. "So how much do you know already about...?"
  2. Set the agenda with the patient
    1. "I'm going to discuss a few details of the procedure, but is there anything in particular you'd like to know about?"
  3. Begin explanation
    1. Consider signposting to set the agenda- "I'm going to give you an overview, then talk about the procedure, then any risks involved"
    2. Avoid Jargon
    3. Chunk and check- give information in small chunks, and then check their understanding.
  4. Check understanding- ask patient a question at this point
    1. "Just so that I can check I've got everything across, can you tell me about this procedure?"
  5. Summarise the discussion- think bullet points.
  6. Give appropriate supporting literature (leaflet). Offer someone the patient can direct any further questions to.

Related Pages

References

  1. http://www.gmc-uk.org/guidance/ethical_guidance/consent_guidance_reasons_for_not_sharing_information.asp
  2. http://www.gp-training.net/training/communication_skills/calgary/guide.htm