Synopsis
Conduct person-centred, accessible and clinically precise conversations that support shared decisions, respond to emotion, preserve confidentiality and confirm understanding and follow-up.
- Begin by confirming identity, preferred name, role, privacy, communication needs and the patient’s agenda before supplying information.
- Use open questions to hear the account, then focused clarification; summarise and signpost so the patient can correct your understanding.
- Explore ideas, concerns, expectations, values and practical constraints because the same medical options can have different consequences for different people.
Reasoning priorities
Ask what the patient wants addressed and agree priorities for the available time.
Early agenda setting reduces late surprises and makes deferral explicit rather than silently ignoring concerns.
Elicit current knowledge, desired detail, values and preferred role in decisions.
Tailor explanation without assuming that education, age or previous illness predicts what this individual understands or wants.
Worked reasoning
A patient is told a scan shows an indeterminate lung nodule. They hear the word cancer, become silent and ask whether they will die.
- Pause the technical explanation, acknowledge the fear and ask what the patient understood; confirm whether they want a support person and what information they need now.
- Give a clear headline: the finding is real but indeterminate, so it neither diagnoses nor excludes cancer; explain the proposed next step, timeframe and what that test can resolve.
- Describe plausible outcomes using plain language and consistent absolute frequencies only if reliable data fit this patient, checking values and preferences rather than offering false reassurance.
- Use teach-back to confirm the plan and safety net, provide an accessible contact route, and document uncertainty, questions, agreed follow-up and responsibility for the result.