Communications Checklist

ELSIE SMITH COMMUNICATIONS CHECKLIST

This student’s profession is (check one): __ Dentistry __ Medicine __ Nursing __ Nutrition __ Pharmacy __ Physical Therapy __Social Work

The student:

1. made a personal connection during the visit (e.g., 0 went beyond medical issues at hand, conversed about personal background, interests, job, etc.). YES NO

2. gave me an opportunity/time to talk (e.g., didn't interrupt). YES NO

3. listened. Gave me undivided attention (e.g., eye contact, verbal acknowledgment, non-verbal feedback). YES NO

4. checked/clarified information (e.g., recapped, paraphrased, echoed, summarized, asked for clarification when not certain about what I described). YES NO

5. encouraged me to ask questions/checked my understanding of information provided. YES NO

6. adapted to my level of understanding, using appropriate language (e.g., avoided or explained jargon; avoided child-like slang). YES NO

7. expressed empathy (e.g., demonstrated care and concern for me, acknowledged my feelings, expressed understanding of my feelings / respect for my situation / willingness to support me). YES NO

8. maintained a respectful tone (e.g., did not belittle me; did not use humor inappropriately, did not talk down to me). YES NO

9. involved me in deciding upon a plan (e.g., presented me with options [if any], provided rationale for their assessment). YES NO

10. elicited and addressed any concerns I have about the plan. YES NO OVERALL SATISFACTION

11. Based on my level of satisfaction with this encounter, I would return to see this student provider again. o Strongly Agree: the student provider was so exceptional that you would recommend to a friend or relative. o Agree; your experience with the student provider was overall a positive one. o Disagree: you are dissatisfied with the encounter and you would not come back to see this student provider. o Red Flag: the experience was bad enough for you to want to report the student provider to his/her supervisor.

COMMENTS

If you chose "Disagree" or "Red Flag" on Overall Satisfaction, please explain why:

SUMMARY You are Elsie Smith, a 75 year old retired hotel laundry worker. You previously got your healthcare from a community physician, but you stopped going to see her a year ago because her office was too far from your home. You are taking a complex medication regimen, and want to figure out if you really need all these medications. Your top priority today is to figure out how to keep from falling again, and to fix your jaw pain. This summary is provided only as a reminder for you as to “where you are coming from” as the patient. Keep this in mind while you are writing your comments.

As Elsie Smith, I felt: CHECKLIST TRAINING:

1. made a personal connection during the visit (e.g., went beyond medical issues). o YES: Made an effort to get to know me as a person. o NO: Made no effort to know me as a person. Gave me the impression he/she was solely interested in my disease or a symptom.

2. gave me an opportunity/time to talk (e.g., didn't interrupt). o YES: Gave me an opportunity to speak without interruption. Didn’t rush me. Used open ended questions. Used silence appropriately. o NO: Student talked over me/interrupted me. Used mainly closed ended or leading questions.

3. listened. Gave me undivided attention (non verbal and/or verbal acknowledgments). o YES: Paid attention to me. Used eye contact, body language, etc…to let me know I was the student’s focus. o NO: Was unable to focus on me: Asked same question several times. Long pauses made me feel uncomfortable. Positioned too close or too far away. Used closed body language. Focused solely on clipboard or notes.

4. checked/clarified information (e.g., recapped, paraphrased, echoed, summarized, asked for clarification when not certain about what I described). [NOTE: This is about the student understanding you.] o YES: Followed up on some of my answers, summarized and allowed me to clarify; I was sure the student understood my story. o NO: Never verified what I was saying.

5. encouraged me to ask questions/checked my understanding of information provided. [ NOTE: This is about you understanding the student.]

o YES: Checked in with me during the encounter to make sure I understood what the student said. o NO: Didn’t ask me if I had any questions or if I understood him/her. Only asked me if I had questions at the very end.

6. adapted to my level of understanding, using appropriate language (e.g., avoided or explained jargon; avoided child-like slang). o YES: Spoke clearly in a way I could understand. Used jargon, but explained it clearly. o NO: Used jargon, but didn’t explain at all, or explanations were not clear.

7. verbally expressed empathy (e.g., acknowledged my feelings, expressed understanding of my feelings / respect for my situation / willingness to support me). o YES: Offered comments to validate my feelings and concerns. o NO: Glossed over symptoms or concerns that should have elicited empathy.

8. maintained a respectful tone (e.g., did not belittle me; did not use humor inappropriately). o YES: Treated me with respect at all times. Did not talk down to me. I felt my problems were taken seriously by the student. o NO: I felt disrespected, that the student’s agenda was more important than mine, or that my problems were not important.

9. involved me in deciding upon a plan. o YES:  Presented me with several options, and then ask which option I would prefer.  Presented the plan and let me know why s/he thinks the plan is necessary. o NO: Did not involve me in making the plan and did not check with me. Made it clear that I had to do things in the way s/he suggested and my opinion about it did not matter.

10. elicited and addressed any concerns I have about the plan. [NOTE : This is about you understanding “the PLAN”.] o YES:  Asked me if the plan was okay (e.g., "how does that sound?", “Are you willing to go through with the plan?”, “Do you think you can implement the plan?)  Specifically asked if I had any concerns or questions about the plan AND then addressed them. o NO: Did not ask if I have any concerns/questions about the plan OR did not address the concerns/questions.

SP COMMENTS for Elsie Smith

Your comments are the patient’s subjective personal feelings about the interpersonal skills of the student. Write about what the student did, not about who s/he is. Never judge the person. Simply respond honestly, about how you as the patient felt.

How to Write Comments: 1. Use the “sandwich technique” when writing your comments: a. Start and end with comments about what the student did skillfully (positive comments). b. The “meat of the sandwich” (or constructive criticism), should be written in the middle. (Limit your constructive criticism to 3 or 4 items at most.) c. If you have no constructive criticism, then just write positive comments. 2. Be specific and describe concrete student actions that affected you either positively or negatively. The format of each comment should contain this simple linkage: What you felt was brought on by what the student did : 1. “…listened to because you repeated back things I said.” 2. “…belittled, because you seemed to lecture me about not meeting your expectations about how I should take my medications

3. Write your comments as if you were talking to the student : As Elsie, I felt…[Elsie’s feeling] because you… [student’s behavior].

What to Write Comments about: 1. Communication Checklist Comments: Be sure to write constructive comments for items where you answered “No.” Similarly, you can write about the specific, positive student behaviors for any of the items where you answered, “Yes.”

2. Comments on other Clinical Behavior Issues : You may also comment on items such as these: a. Draping (being exposed unnecessarily) b. Washing his/her hands (safety concerns) c. Warning you before touching you d. Explaining the reason performing a maneuver or asking a highly personal question e. Explaining the results of at least one maneuver f. Speaking in a way that makes it hard to understand what is being said(too fast or too slow) g. Rambling or run-on sentences. h. Behaviors that appear to demonstrate nervousness i. Body odor, unprofessional attire, bad breath

Sample Comments: As Elsie Smith I felt… o …connected to you by the way you shook my hand and looked directly in my eyes when you introduced yourself. o …overwhelmed because you rambled on for a long time about my condition/treatment so I lost track of what you were talking about. o …unheard when you quickly followed up your saying you were sorry about my husband’s death with an unrelated question. o …cared for because you retied my gown after examining my lungs o …anxious as if I was taking up your time when you kept firing questions at me o …really cared for when you asked if I was OK to get home by myself.

5. Things NOT to write comments on: a. Never comment about a student’s lack of medical knowledge: “…distressed because you didn’t know anything about diabetes.”

b. Never write vague compliments, such as, “You were professional” OR “You had good bed-side manner” because they don’t include a specific student action or patient feeling.

c. Never comment on things a student cannot change or anything that might culturally sensitive.

GUIDE FOR COMMUNICATION SKILLS USING “I” MESSAGES I FELT ______as a result of a specific behavior, i.e., POSITIVE something the student did or said. NEGATIVE Empowere Hopeless d Examples: I felt… Connected connected because you gave such good eye contact. Pressured Encouraged unimportant because you kept looking at your watch. Alarmed grateful when you said you were sorry for what I was going Focused Exposed through vulnerable because you left me lying on the exam table without Grateful Awkward draping me appropriately. Hopeful safe when you told me our conversation was confidential. Distressed distracted by the repetitive gesture you made, throwing your Important Distracted hair back hopeful that I could make changes in my lifestyle when you gave Optimistic me small but workable suggestions to incorporate into my Vulnerable routine.

NOTE: For this exercise, you should keep the student’s profession in mind. A pharmacy student may not suggest a diagnosis and a dental student would not focus on your arthritis pain, for example. For example, do not say:  “ …ignored because you (the pharmacy student) didn’t talk to me about my jaw pain.”  “…upset because you (the dental student) didn’t address whether I need all these prescriptions.”