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THE SEVEN ELEMENTS OF MEDICAL COMMUNICATION

Consensus on the essential elements of physician-patient communication was reachedby using the three goals outlined above to guide and ground discussion. The group'sperspective on essential elements is consistent with the task approach, a concept that

has been well supported in communication skills teaching since the early 19!s."snoted by #akoul and $chofield,2focusing on tasks provides a sense of purpose forlearning communication skills. The task approach also preserves the individuality of%learners& by encouraging them to develop a repertoire of strategies and skills, andrespond to patients in a fleible way.

(y identifying specific communication tasks, the group worked to highlight behaviors thatare embedded in eisting consensus statements, guidelines, and standards. )hile thelist is by no means ehaustive, the intent was to make it easier for people working in thisarea to identify not only the key tasks, but the relevant knowledge, skills, and attitudes

as well. *eferences for the supporting research are listed and discussed in a number oftets.

1. (uild a *elationship+ The undamental Communication Task

" strong, therapeutic, and effective relationship is the sine ua non of physician-patientcommunication. The group endorses a patient-centered, or relationship-centered,approach to care, which emphasies both the patient's disease and his or her illnesseperience. This reuires eliciting the patient's story of illness while guiding the interview

through a process of diagnostic reasoning. /t also reuires an awareness that the ideas,feelings, and values of both the patient and the physician influence the relationship.urther, this approach regards the physician-patient relationship as a partnership, andrespects patients' active participation in decision making. The task of building arelationship is also relevant for work with patients' families and support networks. /nessence, building a relationship is an ongoing task within and across encounters+ itundergirds the more seuentially ordered sets of tasks identified below.

0. pen the 2iscussion

3 "llow the patient to complete his or her opening statement

3 4licit the patient's full set of concerns

3 4stablish5maintain a personal connection

6. 7ather /nformation

3 8se open-ended and closed-ended uestions appropriately

http://journals.lww.com/academicmedicine/Fulltext/2001/04000/Essential_Elements_of_Communication_in_Medical.21.aspx#P70http://journals.lww.com/academicmedicine/Fulltext/2001/04000/Essential_Elements_of_Communication_in_Medical.21.aspx#P70

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This outline of essential elements in effective physician-patient communication providesa coherent framework for teaching and assessing communication skills, determiningrelevant knowledge and attitudes, and evaluating educational programs. /n addition, theoutline can inform the development of specific standards in this domain. #ost of theelements included in this document are present in each of the five models eaminedduring the process of consensus building. " ma@or strength of the outline is that itrepresents the collaboration and consensus of individuals with a variety of backgroundsand interests in medical education. urther, the basic outline can be tailored to meet theneeds of different specialties, settings, and health problems. Conscientious efforts toaddress these essential elements across practice settings will help increase theefficiency and effectiveness of physician-patient communication, enhance patient andphysician satisfaction, and improve health outcomes.