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Preservice Health Training: Project Objectives

  1. Initiating the Visit
  2. The medical professional:

    1. Verbally greets the patient with an appropriate salutation.
    2. Calls the patient by name.
    3. Introduces self (or reminds the patient of their name if they have seen the patient before) and clarifies role with the patient.
    4. Engages the patient in personal talk; shows interest in the patient as an individual.


  3. Determining Communication Mode
  4. The medical professional:

    1. Identifies and addresses communication issues.
    2. Demonstrates knowledge of communication differences when working with individuals with a variety of communication modes (e.g., for an individual with an interpreter, looks at and addresses the patient NOT exclusively the interpreter, uses language directed to the patient not the interpreter)
    3. Determines the patient's primary mode of communication and makes adjustments in own communication style as required.
    4. Summarizes to verify his or her interpretation of the appropriate communication mode.

  5. Eliciting Information and Exploring Problems
  6. The medical professional:

    1. Prepares the patient for examination in a professional manner and with care.
    2. Determines the reason for the visit.
    3. Encourages the patient to tell the story of problem(s) from when first started to present in their own words (clarifies and probes appropriately).

  7. Wrapping up the Visit
  8. The medical professional:

    1. Assures understanding about follow-up and prescription regimen.

  9. Objectives Addressed Throughout the Case (These objectives are tracked/tested in all case segments.)
  10. The medical professional:

    1. Establishes and maintains an appropriate level of eye contact.
    2. Uses person first language throughout the visit.
    3. Maintains a respectful tone and appropriate non-verbal responses.
    4. Uses appropriate communication methods adapted to the individual's communication mode. Might include silence while waiting for a response.
    5. Adapts communication and interaction to the patient's level of understanding. Might include paraphrasing, repetition and encouragement to elicit responses.
    6. Checks for understanding with appropriate persons.
    7. Provides ample time for questions and responses.
    8. Listens attentively, allowing the patient to complete statements without interruption, leaving space for the patient to think before answering or going on after pausing.

  11. Additional Objectives Not Specific to Individuals with Disabilities

  12. These ARE relevant objectives important in all patient-medical professional interactions, and thus were not a major focus of the Standardized Virtual Patient Project.

    The medical professional:

    1. Negotiates an agenda for the visit.
    2. Demonstrates discretion, privacy and confidentiality, making the patient feel safe and comfortable.
    3. Skillfully uses open ended questions, and then moves to close ended probes.
    4. Explores physical as well as social and emotional factors.
    5. Acknowledges the patient's waiting time.
    6. Acknowledges the patient's accomplishments.
    7. Demonstrates caring, concern, empathy.
    8. Encourages the patient to express emotions.
    9. Moves from one section to the next using transitional statements, supplying a rationale for moving ahead..
    10. Structures the interview in a logical sequence.
    11. Avoids the use of jargon and if used explains.
    12. Uses concise, easily understood questions and comments.
    13. Determines and acknowledges the patient's ideas (i.e., beliefs about cause and therapy).
    14. Explores concerns (including worries) regarding each problem and the patient's expectations.
    15. Summarizes at the end of a specific line of enquiry (e.g., present hx, past hx) to verify his or her own interpretation of what the patient was saying and to assure no important information was omitted.
    16. Explains procedures and provides a rationale for using specific diagnostic procedures or therapies.
    17. Summarizes follow-up steps.

    References:

    Association of American Medical Colleges (1999). Report III: Contemporary Issues in Medicine: Communication in Medicine. Medical School Objectives Project.

    Queens University Faculty of Health Sciences School of Medicine (2002). Phase IIB. Clinical Skills. Online at: http://meds.queensu.ca/~webskill/Phase2B_02_Manual.pdf [Requires Acrobat Reader to access document.]