Communication Skills

[Patches]

Did you know in October 2020, the USMLE increased the number of items assessing communication skills on the USMLE Step1? To some, that is a dream come true and to others, their worst nightmare. How are you preparing? Come back later this week and we’ll post the best tips from this forum and some of our own advice!

[Patches]

Here are a few tips we suggest for approaching USMLE questions that asses communication skills and ethics:

1. Don’t assume you are a conversational expert. It is okay to practice these types of questions in your q-banks so that you not only have a good understanding of how to speak to patient’s on exam day but also in your clinical practices.

2. Lead with empathy and compassion. Often, patient’s are scared, need reassurance, and expect further guidance. After hearing your patient’s concerns (or after reading the vignette), find an answer option (or respond) in a manner that affirms you understand how the patient is feeling. For example you can note, “Thank you for sharing those details with me. I understand how scared/stressed/frustrated you feel.” From there you can guide the patient history to address their concerns.

3. Remember to respect patient privacy. Brush up on times when it is acceptable to ask parents to leave the room or when to ask elderly questions outside the presence of their care takers.

4. For decision making and consent scenarios, understand the concepts of “power of attorney” and “living will.” It is important in every situation to asses the patient’s decision making capacity before they give their consent.

5. Familiarize yourself with the definitions to these words: autonomy, beneficence, nonmaleficence, and justice. Be sure the response you are selecting follows each of these values.

6. Remember to follow HIPAA.

7. Understand when to utilize your hospital ethics team’s reporting system.

8. Direct patient’s who have complaints about other medical professional to speaking directly with the professional in question.

9. Brush up on your knowledge of STD reporting and testing. Understand what STDs must be reported to partners and if testing of a minor needs to be reported to parents or guardians

10. Utilize SPIKES when discussing bad news and long term patient care.

Good Luck!