Communication and Interpersonal Skills: Person-Centred and Safe Communication
What you must understand
Communication questions test active listening, open vs closed questions, reflection, summarising, clarifying and empathy. Know SBAR (Situation, Background, Assessment, Recommendation) for structured handover and escalation, and closed-loop communication for safety-critical instructions (repeat back and confirm). Understand health literacy, interpreters (never use a family member as interpreter for consent or sensitive matters), capacity and consent, breaking bad news, and record-keeping of communication (what was said, by whom, to whom, when). Recognise barriers: sensory impairment, cognitive impairment, language, anxiety, pain, environment, and power imbalance.
Traps in questions
- Choosing closed questions when the aim is to explore feelings or concerns; closed questions are for facts and consent.
- Using reassurance or false hope ('don't worry') instead of acknowledgement; this blocks disclosure.
- Assuming a patient lacks capacity because they disagree with you - capacity is decision-specific and presumed.
- Using a relative to interpret; this breaches confidentiality and risks inaccuracy.
- Forgetting to document the conversation, or documenting opinions rather than facts.
Rule of thumb
Explore before you explain. Use open questions and reflection to understand the patient's concern, then give clear, jargon-free information and check understanding with teach-back ('Can you tell me what you'll do when you get home?').
Worked example
A patient says, 'I don't think I want the operation.' The best response is an open, non-judgemental exploration: 'Tell me more about what's worrying you.' This gathers information, respects autonomy and supports informed consent, rather than persuading or dismissing.