As a fellow in our program, how would you change your communication style if a patient's family had trouble understanding what you were trying to tell them?
Fellows are often responsible for talking with patients' families and explaining their diagnoses or medication regimen. In cases where a diagnosis is unexpected or the prognosis is not favorable, it's not uncommon for patients' families to struggle to understand information. This can also be the case with undereducated patients and their families. Your interviewers pose this question in hopes of hearing that you are aware you are likely to encounter these circumstances and that you will be willing to take extra time with patients' families when needed.
"If a patient's family didn't understand something I'd explained, I would first try to determine where the breakdown in communication occurred. If necessary, I would offer a simpler explanation. As medical professionals, we are fortunate to understand and grasp the complexities of medical issues, but a majority of the general population simply does not. My goal as a fellow would be to ensure that my patients and their families understand diagnoses and care plans and that all their questions are answered thoroughly."
Let the interview panel know you are always cognizant of your audience when discussing critical medical information. Discuss the importance of asking questions to ensure patients' families understand the information you've given them. Assure them that when patients' families don't understand your explanation, you will attempt to offer the information in a different way that considers the cause of their misunderstanding, whether it was your initial approach or their background.
Community answers are written by other candidates practicing this set. Reading how others frame the same question is one of the fastest ways to sharpen your own.
Anonymous Answer
A family's understanding of a patient's condition is one of my priorities. I would try to identify where the miscommunication is and rephrase my explanation in a more understandable manner, maybe using simpler language. Depending on the topic, I have found that drawings can be helpful to understand conditions and procedures. Being empathic has also proven to help communicate with patients and families.
Jaymie's Feedback
Perfect!
Anonymous Answer
In a multicultural society and serving a cross-section of different cultural, religious, socioeconomic, and educational backgrounds. Communication can be very challenging with the overlay of grief, and distress.
The general principle to follow is, to be honest and empathetic, listen and use silence to allow the emotional impact of a statement to settle, avoiding jargon. I accept in general that many families will not like what I have to say and that I do not expect to be thanked.
An example I find was last week I looked after a Scottish gentleman who had covid exacerbation of end-stage COPD but was in late cardiogenic shock. My bedside TTE found an effusion suggestive of tamponade. He had declined all invasive treatment in ICU and declined an echo when he was well. A comprehensive assessment of capacity had been done. and the decision I came to with the consultant is to transition to palliative treatment and have the family in.
I opened the line with "I'm so sorry to meet you under these circumstances. Unfortunately, your father's condition has worsened." And this Glaswegian gentleman basically said to me "I dun understand ya, cut to the chase." So I said
"I am sorry, your father is dying. There's not much we can do to change this. We will start some medication to make sure he doesn't feel pain and suffering, but he is likely to die tonight."
And as with every other family, there was unequivocal grief, there was a little bit of denial and bargaining, but in the end, acceptance. They spent his final moments with him, said their goodbyes, and gave us their thanks.
Jaymie's Feedback
This is a good example to use. Some prefer direct communication and others discover more of a "fluff" approach, so it's important to be able to accommodate different styles to relay messages and information.
Anonymous Answer
Use simple terms used in day-to-day life (say heart attack instead of MI), and slow down when speaking that helps them process information. Use visual aids, like diagrams or models to illustrate medical concepts. Ask open-ended questions, “What questions do you have?”—active listening, showing empathy, using analogies (like the heart to a pump. Repeat and summarize (like instruction on how to take medication), avoid giving too much information that could be overwhelming focus on the most critical information first, and provide details gradually. Use a medical interpreter when needed, written materials for later referral, and encourage family(support person) to help clarify information and offer emotional support. Follow up as needed, collaborate with other healthcare teams like social workers, and make sure you are culturally sensitive as cultural differences may impact communication and healthcare decisions.
Jaymie's Feedback
Perfect! These are excellent strategies to use when finding the right approach and communication style with patients and/or their families.
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