Communication and Interpersonal Skills
Structure and warmth together
Examiners score both content and delivery: eye contact, posture, pace, plain language, and the absence of jargon. A reliable structure is: explore the patient's understanding and concerns, share information in small chunks, check understanding (teach-back), address emotion, and agree next steps. Use the patient's own words for their problem, and reflect emotion explicitly ("That sounds frightening").
Consent as a conversation
Valid consent requires capacity, adequate disclosure, and voluntariness. Disclose the material risks a reasonable person in this patient's position would want to know, plus any risk the clinician knows matters to this individual. Discuss alternatives and the consequences of declining. Document the discussion, not just the signature. Traps include accepting a signed form as proof of consent, obtaining consent from a relative for a competent adult, and glossing over cost or the possibility of a different operator.
Difficult conversations
Breaking bad news, managing anger, and addressing a complaint all reward acknowledging emotion before offering solutions. Avoid defensiveness, premature reassurance, and blaming others. If a patient lacks capacity, act in their best interests, involve those close to them where appropriate, and use the least restrictive option.
Rule of thumb
Before any procedure, ask yourself: "Could I explain this, and its alternatives and material risks, back to the patient in one minute without notes?" If not, the consent discussion is incomplete.
Worked example: A patient asks for "the cheapest filling" for a tooth with irreversible pulpitis. Acknowledge the cost concern, explain that a filling alone will not resolve the pulpal diagnosis, outline extraction versus root canal treatment with realistic prognoses, and document the discussion and the patient's decision.