Advanced communication OSCE- station 1

Open questions definition and key words

Open questions are questions that cannot be answered with a simple "yes," "no," or one-word response.

key words include:

How, what, tell me about, describe, in what way, can you explain,

Reflective statements

Reflective questions encourage a person to think more deeply about their experiences, feelings, motivations, and behaviours.

use open questions to encourage this.

Affirmations

statements that recognise peoples strengths, efforts, values or positive behaviours.

Normalisations

Normalisation is a communication technique used to reassure patients that their experiences, feelings, concerns, or reactions are common and understandable.

eg. Many people... Its totally understandable….

Shared agenda setting

patient-centred communication strategy where the clinician and patient collaboratively decide what topics or goals will be discussed during the consultation.

eg. what would oyu like to focus on today

Elicit patients goals

ability to determine patients goals collaboratively and safely

barrier

communication technique used to identify obstacles that may prevent a patient from achieving their goals, following a treatment plan, or making a behaviour change.

Facilitators

Factors that make it easier for a person to achieve a goal, engage in a behaviour, or follow a treatment plan.

Elements of safe communications

• Emotional/cultural safety 

• Rapport/trust building 

• Non-judgemental language 

• Tone, body language, eye contact 

• Whether the clinician rushed, interrupted, blamed or dismissed patient 

Patient centred communications

What matters to patient

The patients goal

Their beliefs/concerns

Home/work/family context

Barriers/facilitators

Consent before asking sensitive questions

Whether the patient led the direction of the conversation

Identify main approach

Directive or motivational

Motivational

• Open questions 

• Affirmations 

• Reflective listening 

• Summaries 

• Exploring readiness/confidence 

• Eliciting change talk 

• Responding to sustain talk without arguing 

Directive

• You need to… 

• Lots of education 

• Close questions 

• Little reflection 

• Clinician choosing the goal 

• Limited exploration of motivation 

change talk

Patient gives reason for change 

Sustain talk

Patient gives reasons not to change

Importance 

How much change matters to them 

Confidence 

How able they feel to change 

Engaging 

Building rapport first 

Focusing 

collaboratively Agreeing what to talk about 

Evoking 

Drawing out motivation 

Planning 

Agreeing on next steps 

criteria for collaboration and suggest improvements

• Shared decision-making 

• Whether patient chose the goal 

• Whether the plan was SMART 

• Whether barriers discussed 

• Plan was achievable? 

• Review/adaption was included? 

Criteria for whether the clinician communicated in a way the patient could understand and follow?” 

• Plain language 

• Avoiding jargon 

• Logical sequencing 

• Chunking info 

• Checking understanding 

• Teach-back 

• Not overwhelming the patient 

• Tailoring education to the patient’s knowledge level