SPEAKING TEMPLATE

3-min preparation:
- ask for interlocutor’s name
- setting + scenario
- Task: key verb = how to say
- How patient might feels:
o Highlight = they might resist
o Reassure = they might worry
- Replace medical jargon with simple language
A. Relationship building
A1 initiating the interaction (greeting, introductions, nature Unknown: Good afternoon, I’m Dr. Violet, I am... Before we start, can I check how would you
of interview) prefer to be called?
Nice to meet you, Mr… How can I help you today?
Known: Hello, Sally. Good to see you again. I understand that you are worry/ concerned about…
So today we will discuss about… Could you tell me…?
- As a reminder, I’m…, can you remind me of your name?
A2 demonstrating an attentive and respectful attitude - I see, I understand
- I can see we have difference in opinion, but I can assure you I have your best interests at heart
- I want to ensure you get the best possible treatment, and it is for that I will…
- I can see you are understandably upset, but is it okay if I ask you a few more question?
- Many people feel embarrassed about such topic, but it is important for me to ask some more
questions in order to help you, would that be okay?
A3 adopting a non-judgmental approach - I would strongly advise that you…
- It is understandable to think that, however studies have shown that in fact…
- I can see that this is a big decision. Why don’t I give you a leaflet and you can discuss it with your
family. I will make you an appointment to discuss this further in the future.
A4 showing empathy for feelings/predicament/emotional - It sounds like this has been a stressful time for you
state - I can see that you appear to be very upset by this, would you like to talk more about that?
- I’m sorry to hear that
- It is understandable to feel worried in this situation.
- It must be difficult for you but let me reassure you that…
B. Understanding & incorporating the patient’s perspective
B1 eliciting and exploring the patient’s - Have you had any ideas about…
ideas/concerns/expectations - Some people find… what are your thoughts?
- What are you most concerned about?
- What would you like to focus on in this appointment/ consultation?
B2 picking up the patient’s cues Respond to patient’s cues (agree, understand or doubt)
- So I would like to… and if you want, I can… (then patient responds)
That’s good. And also, how about…
- You mentioned that… Can you tell me more about that?
- You said before that… Would you like me to offer some suggestions?
- I can see that you seem understandably frustrated/ disappointed (A2)
B3 relating explanations to elicited - Your thoughts about…, I can see why you would think this but actually..
ideas/concerns/expectations - You were wondering if, I would like to give you some other options to consider
- You mentioned you were particularly worried about…, by…we will be able to know for certain
C. Providing structure
C1 sequencing the interview purposefully and logically - Do you mind if I come back to that after clarifying a few things with you first?
(patient-centered) - We touched on this topic earlier, but before we continue, can I just double check if…
C2 signposting changes in topic: - I would first ask you some questions about…
 Okay/ So/ Now… - Firstly, I need to clarify a few things about…
 Thanks for that… - We’ve spoken about/ You mentioned earlier that…, now I would like to…
 Can we talk about… - Thank you, you have explained everything very clearly. Now I would like to explain how we can
 Is it okay if we move on to… investigate this (when patient talk too much)
- I’m afraid I need to ask you some personal questions relating to…, would that be okay with you?
(sensitive topics)
- I know this must be upsetting for you, but can I go through with you what will happen if this
treatment doesn’t work?
C3 using organising techniques in explanations - We have spoken about a lot of things today, can I briefly summarise the important points?
- chunking: pause - My recommendations include medical options and lifestyle modifications. Firstly, lets discuss
- use: Firstly, then, after that about medication…
- highlight words: critical, important, recommend… - I would strongly recommended that/ It is extremely important that…
D. Information gathering
D1 active listening techniques, minimising interruption - Okay/ I see/ Go on/ Oh dear
- You’re not alone in thinking that
- Okay, I see. Let me explain about it… (topic that patient mentioned)
D2 using initially open questions, moving to closed questions - How are you feeling about my suggestions?
(then) Do you have any questions up until this point?
D3 NOT using compound questions/leading questions - one question at a time
- use “Have you…” instead of “You have…, haven’t you?”
- prefer open question then closed one
D4 clarifying statements which are vague or need - ask for details of patient’s information
amplification
D5 summarising to encourage correction/invite further - From my understanding, …
information - From what you have told me, …
- To summarise what you said, …
- Okay, just so I get this right, …
(then) Is that correct?/ Was there anything else you would like to add?
E. Information giving
E1 establishing initially what the patient already knows - Have you heard about it?
- Have you had any ideas about…
- Can I ask… (patient’s concern related)
E2 pausing periodically, using the response to guide next
steps
E3 encouraging the patient to contribute reactions/feelings - How does it sound?
- How are you feeling about my suggestions?
- Do this sound like a reasonable plan?
E4 checking whether the patient has understood information - Do you have any questions up until this point?
- Does that make sense? Is that clear? Do you get what I mean?
- Can I check your understanding by asking you to summarise what we have disscussed
- You said earlier that you wanted to know more about…, after our discussion, is this clearer for
you?
E5 discovering what further information the patient needs - You mentioned at the start that…, I reassured you that I would run some tests, and we also
discussed…Do you have any questions so far?
- Does that answer all of your questions?
- Why don’t I give you a leaflet and you can discuss it with your family. I will make you an
appointment to discuss this further in the future.
- We’ll stay in touch, and you can always call me if you have more concerns
1. Chief complaint: I understand you’ve been o I understand your concerns, and it’s perfectly
experiencing… normal to feel this way
2. For symptoms: o I’m here to support you and provide what you need
o Can you tell me what bothers you the most? 5. For diagnosis:
o Can you describe your symptoms? Can you tell me o Based on…, we suspect...Have you heard of it?
more about that? o Based on what you’ve described, it sounds like you
o When and how did it start? And you’ve had it for might be experiencing…, which is the medical term
how long? for...
o (Pain) Are you experiencing any pain? If so, where o This can sometimes caused by/ happen after…
and how would you describe it? o It could be caused by…/ It can be triggered by…
o Have you noticed anything that makes it better or 6. What to do next:
worse? Have you noticed if it’s worse in certain o It’s important to/ for…
positions or situations during the day? o It’s important that we investigate further to make
o Have you taken any medications for this? sure there’s no underlying condition, such as...
o Was there a health problem that happened right o But don’t worry, we’ll refer you to a specialist for
before the symptom? further testing, including a procedure called…, to
o (Infection) Have you (noticed/ had contact with) help us figure out the cause.
anyone who has the same problem? o I’m going to refer you to… for…
3. For medical history: Do you have any other medical o This is very reassuring, but we need to investigate further
conditions that we should be aware of? to make sure we’re not missing anything.
4. Show empathy o (Specialist)…will do to decide on the appropriate
o No doubt this has had a major impact on your daily treatment.
life o I’ll also arrange for you to…
o I understand how badly you’ve been affected by 7. Advice – Recommendation:
these symptoms. o There are a few things you can do to … For instance/ We’ll
o I can understand how concerning that must be/ start with…
what you’re suffering o I would recommend…
o I understand that this may be hard to take in. o You should…
o It’s completely understandable to feel nervous, but o In the meantime, continue with...
let me reassure you. 8. Expect: You should start to feel some relief in about a week
or two, but we’ll monitor your progress closely….