How to counsel/explain to patients

Communication > Explaining

How to counsel

Beginning

Introduce yourself and explain why you are there
Build rapport before launching into the explanation
Ask if the patient knows why they are there. Ask them what has happened up to this point.
Assess their prior knowledge – it is important to find out what they already know
Tell them what you plan to talk about, ask if they would find that useful, and check there isn’t anything else they want to discuss

Middle

Consider using diagrams where appropriate
‘Chunk and check’: this is very important – only give small ‘chunks’ of information at a time, then check their understanding. Pause after each section in case the patient has any questions.
Speak slowly and clearly. Listen to the patient and be alert to their concerns.

Ending

Summarise what you have talked about and make a plan
Check they’ve understood everything
Ideally you should offer something, e.g. a leaflet, website address, specialist nurse contact, follow-up appointment

How to structure explanations

Explaining a disease

Normal anatomy/physiology

What the disease is

Cause

Problems and complications

Management

Explaining a procedure

Explain what it is

Reason for it

Details of procedure (before, during, after)

Risks and benefits

If you are also asked to obtain consent: thoroughly check their understanding, get them to weigh up the pros and cons, and ask them why they chose their answer

Explaining a treatment

Briefly check for contraindications to the treatment (where relevant)

Check patient understanding of condition

How treatment works

Treatment course and how it’s taken

Monitoring required

Side effects

Tips

Let the patient guide the consultation
Follow cues
Ask what they want to know and about their worries
Don’t forget ICE (Ideas, Concerns and Expectations)
Empathise
Be aware that you may be breaking bad news without realising it! A SPIKES approach can help here (see notes on breaking bad news).
Avoid all medical jargon

Now try it out for real!

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How to counsel/explain to patients | OSCEstop - Solutons Lounge says:

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8 August 2024 at 16:32

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