Communication and Interpersonal Skills
Relationship-centered communication
The evidence-based core is often summarized as the Four Habits: invest in the beginning (greet, orient, set agenda), elicit the patient's perspective (what matters, concerns, goals), demonstrate empathy (nonverbal plus explicit acknowledgment), and invest in the end (summarize, plan, check understanding). Recognize structured tools and what each is for: AIDET for introductions and expectation-setting; NURSE (Name, Understand, Respect, Support, Explore) for responding to emotion; SPIKES for breaking bad news; teach-back for confirming understanding; motivational interviewing (OARS) for behavior change.
Empathy versus sympathy
Empathy is recognizing and articulating the other person's experience (“that sounds frightening”). Sympathy is sharing the feeling (“I feel terrible for you”). Empathy statements come before explanations and solutions.
Service recovery and disclosure
Acknowledge, apologize, and act - an apology for the experience is not an admission of legal liability in most jurisdictions, though scope varies. Error disclosure follows organizational policy and includes what happened, what is being done, and what happens next. Service recovery done well is a loyalty event; done poorly it becomes a grievance.
Health literacy and equity
Use plain language, chunk information, avoid jargon, use pictures, and offer professional interpreters - never a family member for clinical content. Teach-back is the standard check: “I want to make sure I explained this clearly. Can you tell me in your own words how you'll take this at home?” “Do you understand?” is not teach-back; it invites a yes.
Traps
Confusing empathy with sympathy; treating AIDET as a complete communication program; assuming slower and louder equals plain language; believing apology creates liability; accepting a nod as confirmation of understanding.
Rule of thumb
If an answer option asks patients to demonstrate understanding in their own words, it is almost always the best answer in a communication item.