3. Now a little about you. Name, position, length of time teaching, type of learners (students, residents, etc) What were you hoping to get out of this session?
28. Physician presents the issue or decision to be made with choices/alternatives Physician gives rationale for patient participating in decision “ I’d like us to make this decision together.” “It helps me to know how you feel about this.” “Two different people might choose to do it differently.” Physician discusses the risks and benefits of alternative #1 Avoid adjectives (unlikely, likely, rare) Frame both positively & negatively. Use absolute (not relative) risk and patient oriented outcomes. Describe proportions (one in 10) rather than probability (10% chance). Physician discusses the risks and benefits of alternative #2 Language patient can understand in digestible pieces. Physician includes discussion of clinical uncertainties “ Most people with your condition respond well to this medication but not all.” “The chance that X will help is X.” Physician surveys and helps the patient clarify their experience, values, and priorities among the alternatives “ How do you feel about taking this medicine/having this test/the possible consequences of doing X?” Does patient desire input from family/friends/others? Physician assesses patient’s understanding of above and the level of participation in decision making desired “ So tell me what you have understood so far about the information I’ve given so I can know if I explained it correctly.” “How would you like us to decide?” Physician allows patient to voice a preference (decide), makes a recommendation, and they come to common agreement Physician documents conversation and decision in chart
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Editor's Notes
Communication skills are teachable just as other skills
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