Clinical Communication I - Patient centered interview - Dealing with emotions and communicating bad news

Code:

OPT64

Acronym:

CC I - ECD

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2017/2018 - 2S

Active?	Yes
Responsible unit:	Clinical Neurosciences and Mental Health Department
Course/CS Responsible:	Integrated Master in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIMED	20	Mestrado Integrado em Medicina- Plano oficial 2013 (Reforma Curricular)	4	-	1,5	14	40,5

Teaching language

Suitable for English-speaking students

Objectives

To promote and consolidate the acquisition of basic skills for Patient-Centered Interviewing

Determine and explore patient’s ideas, concerns, expectations and knowledge.        Acknowledge how each problem affects the patient’s life.

Ability to screen and evaluate patient’s support systems

Applying specific skills – listen attentively, open questions, facilitate response and positive statements, rephrasing and summarize.

To develop emotion-handling skills

Discovering and exploring patient’s feelings.

Demonstrate sensitive, empathy, acceptance and support.

Emotional self-awareness and self-regulation

To acquire and consolidate the ability for breaking bad news – Six steps protocol for disclosing unfavorable information (Buckman R, Baile W 2000).

Encourage students to consider the individual need for receiving medical information and discover patient’s perspectives, gathering information from the patient, transmitting the medical information, providing support to the patient, and eliciting the patient's collaboration in developing a strategy or treatment plan for the future.

Acquire the skills to tailor significant information and use language appropriately.

Enhance the student’s ability to communicate and care of patients in difficult clinical situations.

Learning outcomes and competences

Develop the ability to determine and explore patient’s ideas, concerns, expectations and knowledge. Acknowledge how each problem affects the patient’s life; ability to screen and evaluate patient’s support system and to aply specific skills – listen attentively, open questions, facilitate response and positive statements, rephrasing and summarize.

Encourage students to consider the individual need for receiving medical information and discover patient’s perspectives, gathering information from the patient, transmitting the medical information, providing support to the patient, and eliciting the patient's collaboration in developing a strategy or treatment plan for the future.

Acquire the skills to tailor significant information and use language appropriately.

Enhance the student’s ability to communicate and care of patients in difficult clinical situations.

Detect and explore emotions, professional attitude in the presence of strong emotional reactions.

Foster empathic response (naming, legitimating, respecting, supporting, partnership), and the insight for the personal emotional responses to patients disclosures

The students will be able to use the six steps protocol (SPIKES) including a preparation phase (physical setting, open questioning), finding how much the patient knows an how much wants to know, share information, elicit and respond to patients feelings and planning the follow up including social support systems.

The acquisition of the ability to communicate difficult information in the non verbal component of breaking bad news, the adequate selection of wording, confirming is accuracy and understanding.

Working method

Presencial

Program

Patient centred interview - Strategies and basic skills

Listen attentively and attending behaviour

Discover the patient’s perspective

Specific patient centred skills

Emotion-handling skills

Detect and explore emotions, professional attitude in the presence of strong emotional reactions.

Empathic response (naming, legitimating, respecting, supporting, partnership).

Insight for the personal emotional responses to patients disclosures

Breaking bad news – definition, models and standardized protocols

Six steps protocol (SPIKES) including a preparation phase (physical setting, open questioning), finding how much the patient knows an how much wants to know, share information, elicit and respond to patients feelings and planning the follow up including social support systems.

Other skills - Preserve hope whilst being realistic and to deal with the stress created by patients' unfulfilled expectations.

Non Verbal component of breaking bad news.

Mandatory literature

Jonathan Silverman, Suzanne Kurtz, Juliet Draper; 1. Skills for Communicating With Patients, Third Edition, Radcliffe Publishing, London., 2013
Rui Mota Cardoso et al; Competências de Comunicação Clínica, Fundação Calouste Gulbenkian e FMUP, 2012

Teaching methods and learning activities

Teaching methodologies (including evaluation):

Seminars 1.5 hour week (Total 10.5 hours), including:

Theoretical component – Theoretical background on patient centred interview skills and emotion-handling skills. Acquiring the rational for defining bad news and presentation of a standardized protocol.

Theoretical-practical component – Videotaped clinical examples visualization and discussion, identification and discussion of communication strategies; roll play exercises including breaking bad news, based on real case histories.

Practical component – Interviews with simulated and real patients. Audio and video recording of selected interviews to provide discussion and evaluation of acquired communication skills.

Evaluation (3,5h)

General principles: Formative and summative, providing continuous feedback and addressing specific behaviors

Objective structured examination and integrated clinical skills examination (practical component); Checklist and process grids scored by teachers and observers (students) (90%).

Assiduity, attitudes, professional behavior, problem solving skills (10%).

14 contact hours

27 hours – supervised practice, real and simulated clinical situations observation, bibliographic consultation.

Evaluation Type

Distributed evaluation without final exam

Assessment Components

Designation	Weight (%)
Participação presencial	10,00
Trabalho laboratorial	90,00
Total:	100,00

Calculation formula of final grade

Assiduity, attitudes, professional behavior, problem solving skills 6 values.

Objective structured examination and integrated clinical skills examination (practical component); Checklist and process grids scored by teachers and observers (students) - 14 values


14 + 6