Communication

In an open-ended question interview, who is in control of the conversation?

Equally shared control, passing back and forth between doctor and client

What was the main finding of the study regarding the use of open-ended questions in medical interviews?

They were positively associated with the amount of information obtained

Which of the following are benefits of using open-ended questions during medical history-taking interviews?

A) They allow clients to express concerns in their own words

B) They eliminate the need for follow-up questions

C) They minimize assumptions made by the clinician about the patient's condition

D) They help uncover associated symptoms and contextual details

E) They reduce the need for physical examinations

F) They improve the efficiency of the interview by prioritizing client concerns early

A, C, D, F

Which of the following best describes a telling prompt or directed open-ended question?

A question that invites a story but focuses on a specific topic

Select all that are correct regarding use of closed-ended questions during a medical interview

A) Help confirm specific details or clarify information

B) Help gather rapid, binary answers during emergency situations

C) Replace the need for open-ended questions

D) Encourages client to share the full story

F) Allow the clinician to more efficiently move through an appointment

A, B

Select all open-ended questions/statements:

A) What did Fluffy's vomit look like?

B) Was Fluffy's vomit yellow, like bile?

C) Please describe Fluffy's vomit.

D) Tell me more about Fluffy's vomit.

E) How long has Fluffy been vomiting for?

A, C, D

Select all open-ended questions/statements:

A) Tell me about how Lennie responded to treatment?

B) How quickly did Lennie respond to treatment?

C) Did Lennie respond well to treatment?

D) Do you think Lennie respond to treatment?

A

Select all closed-ended questions/statements:

A) Do you feed any treats or people food?

B) Do you feed any supplements?

C) What else do you feed Fluffy?

D) Walk me through your feeding regimen.

A, B

Which of the following would NOT be considered OBJECTIVE information as pertains to medical records.

A) Mucous Membranes light pink

B) Picky Appetite

C) Temp 102.2

D) Respiratory Rate 32

B

What percentage of diagnoses are based on information obtained from the history?

60%

first impressions are...

formed rapidly and they can significantly influence how clients perceive your competence, empathy, and trustworthiness

what does recognizing your Dr persona as a construct do?

gives you permission to question it, reshape it, and make it your own

Which of the following occurs when preparing for the conversation? (select all that apply)

A) Prepare for the Case

B) Prepare the Patient

C) Prepare the Client

D) Prepare the Doctor (Yourself)

A, D

Which of the following are goals of the conversation introduction? (Select all that apply)

A) Elicit client concerns

B) Use open ended questions to determine the purpose of the conversation

C) Elicit client perspectives

D) Establish who is involved in the conversation

E) Use reflective listening to clarify/confirm the clients concerns

A, B, C, D

At what point during the conversation would you set an agenda? (Select all that apply)

A) Once you've confirmed that the client is on board with your plan

B) While initiating the conversation.

C) Once you've elicited and confirmed the clients main concerns

B, C

Why is it important to "set the agenda" early in a veterinary consultation?

To clarify expectations and invite collaboration

Which of the follow is a reason that creativity is a useful skill for veterinarians? (Select all that apply)

A) Can enhance mental flexibility which improves resiliency and adaptability

B) Can help improve client comprehension and retention of medical information

C) Can enhance their ability to analyze, evaluate, and solve complex problems

D) Can help integrate different perspectives and foster successful teams

A, B, C, D

The following is an example of which heuristic?

A client immediately trusts the competency of the doctor due to the doctors physical appearance of mature age.

representative

Which of the follow is most accurate regarding the difference between an agenda, a to-do list, and a schedule?

An agenda takes into consideration the tasks as well as a timeframe for the tasks

In which of the following situations could it be acceptable to use more closed-ended questions then open-ended?

At an emergency visit with a critical patient

Which of the following is true for signposting? (Select all that apply)

A) Helps keep the conversation on track

B) Allows the client to direct the conversation

C) Gives structure to the conversation

D) Notifies the client of transitions to new topics

A, C, D

Which of the following is a major difference between agenda setting and signposting? (Select all that apply)

A) Agenda setting is used to identify and prioritize issues, while signposting helps transition between those issues

B) Agenda setting is typically done throughout the conversation, while signposting happens at the beginning

C) Signposting occurs throughout the conversation, while agenda setting typically occurs at the beginning

D) Agenda setting is used to confirm the clinician recognizes/understands the clients concerns

E) Signposting ensures the clinician understands the flow of the conversation

A, C, D

signposting is used by the _______ to make sure the ________ understands the flow of conversation

vet, client

what are the 3 flavors of feedback

Which of the 3 flavors of feedback is the following an example of?

"Although that procedure went as planned, I suggest that you work on efficiency with your suturing. Grab your practice board and we can go over some mechanics that might help."

coaching

Which of the following are important for giving effective feedback?

A) Permission was asked & granted

B) Provided in a timely manner

C) Uses specific, concrete, factual information

D) Provided in a quiet, public location

E) Provided in written format

A, B, C

What does H.A.L.T stand for?

Hungry, angry, lonely, tired

What is the feedback framework used at the OSU-CVM?

what went well, even better yet

Which of the following is true of window gazing vs mirror holding?

A) Mirror holding fosters self reflection by allowing others to "see for themselves"

B) Window gazing aims to help the receiver see through the window to appreciate the givers perspective

C) Window gazing assumes that only the view of the receiver matters

D) Mirror holding assumes that only the view of the mirror holder matters

A

what are the 3 main reasons why feedback?

truth trigger, relationship trigger, identity trigger

extrinsic motivation

External factors dictate motivation

Not meeting extrinsic expectation → Unintentionally reinforce fixed mindset

Success is focused on proving you're "smart enough"

intrinsic motivation

Internal factors dictate motivation

• Curiosity, interest, desire to improve

More likely

• Embrace challenges

• Learn from mistakes

• Persist through setbacks

Success focused:

• Developing deeper understanding

• Developing stronger clinical reasoning

• → more resilience over time

• → greater academic and personal success

with intrinsic motivation you are more likely too...

embrace challenges, learn from mistakes, persist thru setbacks

which is more success focused extrinsic or intrinsic motivation?

intrinsic

T or F: perfectionism is compatible with growth

False

negative effects of perfectionism

reinforces a fixed mindset, avoidance of risk/feedback

how to receive feedback effectively?

active listening, emotional awareness, gratitude

feedback as a GIFT

given with permission

intent for growth

for the person

targeted for success

what does proxemics involve

personal space

what does paralanguage involve

vocalics

what does autonomic shifts involve

physiological responses

what does active listening involve

kinesics

Boundries

making clear what's okay, what's not, and why

reliability

you do what you say you will do

Accountability

you own your mistakes, apologize, and make amends

vault

you don't share what's not yours to share

integrity

choosing what's right over what's fun, fast, or easy

Which of the following best describes Kinesics?

A) Body position and posture

B) Physical distance between you

C) Rate, pitch, and tone of speech

D) Sweating, rapid breathing, facial flush

A

Which of the following demonstrates mirroring?

A) Sitting down to put yourself on the same level as a seated client.

B) Standing over a seated client to demonstrate dominance.

C) Moving rapidly with large hand gestures when talking with a quiet, reserved client.

D) Speaking softly and slowly to a loud, animated client.

A

Dealing with mixed messages - When non-verbal and verbal messages are not aligned, we often trust the _______.

non-verbal

7 sets of behaviors in Brene Brown's braving framework

boundaries, reliability, accountability, confidentiality, integrity, non-judgment, and generosity

4 types of non-verbal communication

body language, tone, personal space, and physiological cues

4 skills to facilitate rapport building

Establishing partnership

Eliciting the client's perspective

Asking for the client's permission

Assessing the client's knowledge

ways to establish rapport with client

1. Remember to greet the client AND Pet

2. Ask open ended questions

3. Listen without judgement

4. Empathy & partnership

5. Note nonverbal cues

6. Be honest, sometimes you don't know what's going on

6 components of listening

hearing, understanding, interpreting, remembering, evaluating, responding

what is a conversation gap?

gap btwn what is said and what is heard

how do you mitigate a conversation gap?

by being clear in your intentions by stating the purpose of sharing information from the beginning (ex. agenda setting, sign posting)

T or F: It's not what our message does to the listener, but what the listener does with our message that determines our success as communicators

True

active listening

fully engaging with the speaker, seeking to understand their message, and providing feedback through nodding, asking questions, or summarizing points.

passive listening

hearing the speaker without actively participating or responding

how can we be better active listeners?

reduce distractions, be present and mindful, avoid interrupting, use verbal and non-verbal cues, be patient and ask clarifying Qs, paraphrase and summarize, empathy, withhold judgement, give thoughtful responses, listen to yourself

Which of the following is not a listed basic component of listening?

A) Judging

B) Responding

C) Evaluating

D) Interpreting

A

Which of the following best explains the "conversation gap"?

A) The gap between what is said and what is perceived

B) The gap between what is intended and what is said

C) The gap between what is said and what is heard

D) The gap between what is intended and what is heard

C

Listeners translate what they hear through unconscious filters. Select all answers below that could be part of these unconscious filters.

A) Beliefs

B) Prior experiences

C) World view

D) Bias

A, B, C, D

Which of the following best explains the difference between active and passive listening?

A) Passive listening involves asking questions

B) Passive listening involves engaging with the speaker to understand their message

C) Active listening involves fully engaging with the speaker

D) Active listening involves hearing the speaker without participating

C

Select all that are true about multitasking:

A) Multitasking improves learning and results in higher overall grades.

B) Around 95% of people multitask effectively.

C) Frequent "media multitasking" results in less ability to focus attention even when performing only one task

D) Constantly switching between tasks makes us less efficient and more likely to make mistakes.

C, D

what is jargon?

Terms, expressions, and acronyms that are unique to a specific industry or profession (pretentious)

what are the 3 main relationships systems that vets deal with?

vet-client-patient, vet-team, vet-self

what does emotional intelligence begin with?

emotional self-awareness

what is emotional intelligence?

ability to recognize, understand, manage, and influence emotions—both in yourself and in others

4 main skills of emotional intelligence?

self-awareness, self-management/self-regulation, social awareness, relationship mgt

Why are we afraid to feel/recognize/or otherwise interact with our emotions or those of others?

Emotional Exhaustion and Compassion Fatigue, Evidence of "Weakness", Lack of Emotional Intelligence Training, Cultural and Generational Stigma & Fear of Vulnerability

what is conflict?

disagreement, misunderstanding, or clash of interests, values, needs, or expectations

Interpersonal conflict

this occurs between individuals, often due to personality clashes, miscommunications, or differing values

Internal conflict

this is a struggle within an individual when faced with a difficult decision or moral dilemma

Task conflict

disagreements over work-related goals, strategies, or responsibilities

Relationship conflict

this stems from personality clashes, emotional tensions, or miscommunications

Process conflict

this stems from disputes over how work should be done, including decision-making authority and workflows

causes of conflict

poor comm, differing values or priorities, resource scarcity, emotional reactions, power struggles

5Fs initial responses to perceived threats

fight (aggressive), flight (avoidance), freeze (shut down), fawn (people pleasing), fib (deception)

According to the Thomas-Kilmann conflict mode model, what are the 2 conflict mgt modes?

assertiveness (satisfy own concerns) and cooperativeness (satisfy concerns of others)

According to the Thomas-Kilmann conflict mode model, what are the 4 conflict mgt styles?

competing, collaborating, compromising, avoiding, accommodating

competing

High Assertiveness, Low Cooperativeness

collaborating

High Assertiveness, High Cooperativeness

compromising

Moderate Assertiveness, Moderate Cooperativeness

avoiding

Low Assertiveness, Low Cooperativeness

accommodating

Low Assertiveness, High Cooperativeness

WHY DOES EMOTIONAL RECOGNITION AND MANAGEMENT MATTER IN VET MED?

• PATIENT OUTCOMES OFTEN TIED TO CLIENT EMOTIONS

• CLINICIANS AVOID EMOTIONAL SITUATIONS

• ABILITY TO UNDERSTAND AND EMPATHIZE IMPROVES OUTCOMES

what does agenda setting allow the vet to do?

clarify priorities, manage time efficiently and prevent door handle conversations, reduce miscomm, enhance clients satisfaction and improve decision making

what does signposting allow the vet to do?

mark transitions between different parts of the conversation, essentially laying out the roadmap for your client to follow so they can understand the structure of the discussion

3 key diffs btwn agenda setting and signposting

Timing:

Agenda setting --> beginning of a consultation

Signposting --> throughout the conversation.

Focus:

Agenda setting --> identifying and prioritizing issues

Signposting --> transitioning smoothly between issues

Goal:

Agenda setting --> ensures clinician understands the client's concerns

Signposting --> ensures client understands the flow of the consultation

Signposting can be used in a variety of manners throughout the conversation, including:

To transition from the introduction to history taking phase

To transition from one topic to another

To explain a certain line of questioning

To ask permission

To redirect the conversation

To warn about sensitive questioning or topics

To prepare the owner for potentially bad or upsetting news

To begin the closure of the conversation

A client brings their new puppy in for a wellness appointment. The technician notes the visit reason as "exam and vaccines." Early in the consultation, the client adds that the dog has had trouble settling into the new house and regularly has accidents in the house. The veterinarian acknowledges these concerns but proceeds directly into a full physical exam and vaccine discussion without revisiting the client's input.

Which of the following best describes the primary communication breakdown in this scenario?

A) Failure to use open-ended questions during history taking

B) Overuse of closed-ended questions leading to incomplete data collection

C) Failure to reset the agenda after eliciting additional concerns

D) Inappropriate use of signposting during the introduction

C

Midway through a consultation, a veterinarian says: "Now that we've talked about Fluffy's diet and activity level, I'd like to shift gears and focus on what might be causing the sneezing you've noticed, and then we'll talk about next steps."

This statement is best characterized as which of the following?

A) Signposting, because it marks a transition and clarifies the flow of the conversation

B) Agenda setting, because it establishes the topics to be discussed

C Agenda setting, because it prioritizes medical concerns over client concerns

D) Reflective listening, because it restates the client's concerns

A

Which statement best describes deliberate practice as it applies to communication skills?

A) Intentionally practicing specific communication skills with focused attention and feedback

B) Watching experienced communicators and modeling their style

C) Practicing complete conversations without interruption or correction

D) Repeating conversations frequently until they feel comfortable

A

Why is timely external feedback especially important when practicing communication skills?

It prevents incorrect habits from being reinforced before they become automatic

In our flipped classroom model focused on communication skills, what is the primary purpose of peer-to-peer practice?

To create real-time opportunities for feedback and adjustment

funnel technique

start broad with an open-ended question, then narrow down our line of questioning to get to specific details once the client has given us the broad information

Ask Tell Ask

we start by asking the client to give us some information, then we tell them some additional information, then we ask/check in to see if the information we provided helped them understand the situation/condition or what else they need to know

Chunk and Check

strategy to break down large amounts of information into smaller sections, which promotes understanding and recall of information. Only move on to the next chunk when you are sure the client has understood the current chunk.