Interpersonal and Communication Skills in the Practice of Osteopathic Medicine
Core concepts
Communication questions test patient-centered interviewing: open-ended questions, active listening, empathy, and shared decision making. Use plain language, chunk information, and teach-back to confirm understanding. For bad news, use SPIKES: setting, perception, invitation, knowledge, empathy, strategy and summary. Motivational interviewing uses open questions, affirmations, reflections, and summaries to explore ambivalence without confrontation. Know how to work with interpreters-use a trained interpreter, not a family member, and speak directly to the patient. Address health literacy, cultural humility, and family dynamics. Traps include premature reassurance, jargon, leading questions, interrupting, ignoring emotional cues, and obtaining consent without checking understanding. Documentation should be accurate, respectful, and free of judgmental language. When conflict arises, name the emotion, clarify goals, and negotiate a plan. Also ask about the patient’s beliefs, concerns, and preferences before recommending a plan.
Worked example
A patient nods after instructions but cannot repeat the dosing. Use teach-back: I want to make sure I explained clearly; can you tell me how you will take this? Rule of thumb: ask-tell-ask, then document understanding.