Interpersonal and Communication Skills
Core concepts
Communication in hematology is high-stakes: delivering a new diagnosis of leukemia, discussing prognosis, obtaining informed consent for chemotherapy or transplant, and navigating goals of care. Candidates should demonstrate structured approaches-ask-tell-ask, SPIKES for breaking bad news, and shared decision-making. Cultural humility, health literacy assessment, and interpreter use are essential.
Traps
- Using jargon without checking understanding.
- Presenting prognosis before assessing what the patient wants to know.
- Failing to confirm comprehension with teach-back.
- Ignoring family dynamics or decision-making preferences in collectivist cultures.
- Rushing to treatment options before exploring goals and values.
Worked example
A patient newly diagnosed with AML asks, "Am I going to die?" Use ask-tell-ask: "What is your understanding so far?" Then provide a clear, honest statement aligned with the patient's informational preference, pause, and explore emotion before discussing treatment. Confirm understanding with teach-back.
Rule of thumb
Assess the patient's understanding and information preference before delivering news; close every serious conversation with a teach-back and a plan.