Professional Documents
Culture Documents
Gathering information
Exploration of problems
Narrative thread: encourages patient to tell the story of the problems from when first started to the present in own
words clarifies reason for presenting now
Question style: uses open-ended and closed questions, appropriately moves from open-ended to closed
Listening: listens attentively, allowing patient to complete statements without interruption and leaving space for
patient to think before answering or go on after pausing
Clarity: uses concise, easily understood questions and comments, avoids or adequately explains jargon
Feelings and thoughts: encourages expression of the patients feelings and thoughts
Cues: picks up verbal and non-verbal cues (body language, speech, facial expression); checks out and acknowledges as
appropriate
Providing structure to the consultation
Summary
At the end of a specific line of enquiry, summarises, to verify own interpretation of what patient was saying and assures
no important information was omitted; demonstrates understanding to patient
Signposting: progresses from one section to another using transitional statements; includes rationale for next section
Sequencing: structures interview in logical sequence
Timing: attends to timing and keeps interview on task
Building the relationship
Developing rapport
Non-verbal behaviour: demonstrates appropriate non-verbal behavior: eye contact, posture and position, movement,
facial expression, use of voice.
Use of notes: if reading/writing notes or using a computer, does in a manner that does not interfere with dialogue or
rapport
Acceptance: acknowledges patients views and feelings: accepts legitimacy, is not judgmental
Empathy and support: expresses concern, understanding, willingness to help; acknowledges coping efforts and
appropriate self-care
Sensitivity: deals sensitively with embarrassing and disturbing topics as well as physical pain especially when associated
with physical examination
Communication Tip
Say you ask a series of closed questions early on in the consultation about one specific content area. This apparent
efficient way of obtaining answers to your own questions can lead to problems in effective diagnosis by preventing you
from considering the wider picture. Questioning skills used inappropriately can lead to poor hypothesis.
Workshop activity
Lets examine the questioning skills of the doctor in the following interactions:
Compare:
Patient: Ive been having to get up in the night to pass water lately.
Doctor: Yes
Patient: And Ive been drinking a lot.
Doctor: Ah ha.
Patient: My mothers diabetic. Do you think I could be?