OSCEs for MRCOG Part 2 Meenakshi Titoria Sahu
Chapter Notes

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Communication SkillsChapter One

This is an important part of all stations. Candidate would be assessed for communication skills at most stations, like opening and closing remarks, showing sympathy, maintaining calm and friendly attitude, etc. This chapter provides suggestions on some commonly used phrases that are used to provide patient friendly and benevolent gestures during communication, and phrases used to tide over difficult challenging situations.
Before you begin at any station make sure you know:
  • Who you are?
  • Where you are?
  • What has happened?
  • What is your task and what are you supposed to do?
  • Make sure who the role player is and who is the examiner?
After making sure about the above facts, start conversation in the following way:
  1. Greet role player (and/or examiner).
  2. Introduce yourself, your role and nature of task you are supposed to do.
  3. Maintain eye contact—it denotes your interest in the person and your honesty in what you are saying.
  4. Always show interest and respect, establish an attentive and non-judgmental relationship.
  5. Ensure that you have understood the patient's problems and concerns.
  6. Enable patient to understand the problem or situation. Encourage them to ask questions.
  7. Use open and closed questioning technique appropriately.
  8. Reassure appropriately.
  9. Pick-up verbal and nonverbal clues.
  10. Involve patient in management. Respect the patient's autonomy and help them to make a decision based on available information and advice.
  11. Summaries station briefly and clarifies plan of care.
  12. Give them contact number and offer to meet again.
Some commonly used phrases are given below that can be used in different and difficult scenarios.
Breaking bad news
  • Mrs……. I would like to discuss the findings of the biopsy you had last week. Is that ok with you? We were hoping it would be just a polyp, but I am afraid the news is more than that………
  • When breaking bad news, patient (role-player) is shocked and silent. If it goes for long you could say—you seem to be quiet shocked or I guess you need some space to take it all in or this news seems to be hard for you to take in.
  • I am sorry that must be a terrible feeling. Is there anything that I can do to help you with? Is there someone to accompany you?
  • If patient asks—if she is responsible for the condition whereas in reality if it is not so, you can say there is nothing wrong you did. Also there is not anything for sure that you did not do that could have prevented it.
Angry patient
  • Acknowledge the anger by saying I can see that you are angry. People in situation like your will react just the same.
  • This must be difficult for you. Can you tell me how you are feeling?
  • So you feel annoyed that no one explained the situation to you.
Solving conflicts
  • We seem to have a difference of opinion which is unusual. Let us work together to solve it to the best of both of us.
  • Let us have an agreement about…….? How do you think we should approach this problem?
Crying patient
  • Offer glass of water or tissue to wipe tears.
  • Say you are sorry for the situation.
  • Ask if she wants her partner or family member to be with her.
  • Say take as much as time you want, I am in no rush, and if you want we can talk later.
  • It is OK to cry…. It is good to get it out. You have gone through a lot of bad things.
Grieving mother
  • It must be a difficult time for you. How are you coping? Do you have somebody to support you?
  • I care for you. I do not know how you feel but with sharing perhaps I will learn a little and perhaps you will feel comfortable with me, and find your burden has eased.
3Before history and examination
  • I would like to know details of your complaints, perform an examination, arrange necessary investigations and discuss possible management options. Are you comfortable with this plan?
  • Develop habit of summarizing things in the end.