Hello fello medics,
I hope we are all keeping well during these testing times.
This blog will look at the principles of an Explanation Station in the OSCE. It is centred around discussing a particular investigation or procedure to a patient. This station is a favourite as it tests your communication skills, knowledge and ability to build rapport.
Some examples may include explanation of a procedure ie: OGD, colonscopy, angiogram. Explanation of a diagnosis ie Diabetes, hypertension.
Some obvious but important steps to remind yourself of:
1) Introduce yourself
2) Ask the patient if they are happy to talk to you
3) Make sure the patient is comfortable
4) Wash your hands (just get into the habit of it!)
General Structure:
Introduce your self
Ask what they know about procedure X
Communicate the information - small junks, stopping to allow patient to digest
Pro
cons
risks associated with procedure X
Summarise
Allow for questions
Follow up/Patient information leaflet
Set the agenda for the consultation
This depends on the information you have been provided with before the station starts. It might be that the patient is aware of reason for consultation “John has been notified they are having an angiogram, please explain” (here the patient knows the point of the consultation) or they have no prior knowledge.
If you are not sure, you might want to start with “Hello Mrs Brown, I am Dr XX, how can I help you today?”. They will then lead you from there.
Allow the patient their “golden 1 minute” to explain why they think they are here and why they are having the scan etc. This saves time and avoids confusion of trying to get the information out of them. Just let them talk and the vital (and hopefully “to the point”!) information will flow out.
Ask the patient what their thoughts are on the procedure
Ask them if they know what the test is? Have they heard of it before? Maybe their neighbour had the same procedure. Again allow the patient to talk about their ideas: they may have zero thoughts on it or know a little bit. If they haven’t heard of it, great! You can now communicate the information from a fresh prospective.
Give information in bite-sized chunks
This station is little about knowledge and more about how you convey the knowledge to the patient. It is no good being the expert on colonoscopy if you continuously speak to the patient without checking their understanding or giving yourself a moment to breathe.
Do not use medical jargon
This point follows on from the above one. You need to be able to explain a medical procedure into lay terms. This is testing your ability to communicate, so practice speaking in in non medical terms. You do want to alienate your patient with jargon. There is nothing worse than a blank or confused face looking back at you
Summarise the points and allow time for questions
Leave time to summarise the important components and ask if the patient has any questions. You may have been answering their questions whilst you were explaining, but a quick “Do you have any further questions?” is a nice gesture.
Provide a patient information leaflet
I love to end the consultation with an information leaflet. I usually suggest patient.co.uk.
Talking of patient.co.uk - this is such a great resource for practicing explaining medical procedures and diseases in a patient friendly tone. They are concise and a great revision aide.
I hope you found the information useful. Remember to keep your knowledge fresh and practice (with friends and family and with yourself in a mirror!) Become comfortable with how you speak, the tone of your voice and how you communicate.
If you need any further information or guidance, please feel free to send me an email/social media message, I am happy to help in anyway.
If you would like to sign up for structured one to one help (or even a few of you want to get together to practice with myself) via virtual modes to improve your communication skills- please sign up or send me an email. We can then have 1 hour (free!) to discuss the areas you would like help with and whether I can help. No pressure, no contracts.
Stay focused and productive x