Naturally, when we interview a patient, we always want to show them that we understand what they are saying, that we are actively listening to them. To do so, we commonly and rightfully demonstrate our mutual understanding by politely acknowledging what they've shared, by rephrasing or paraphrasing their thoughts, and also by summarizing the key points of the conversation. Yet, sometimes we can unintentionally alienate and confuse the patient when we apply these listening tools. This typically occurs when we inadvertently substitute the patient's word use for different terms and descriptions from those that they initially used leaving them to feel uncomfortable, unheard and obliged to clarify or contest our statements. This matter is further compounded in the NAC-OSCE where valuable interaction time is lost if the simulated patient must promptly clarify your account or the use of medical jargon.
Here are some common substitutions to avoid:
Low energy -> Substitution: Feeling depressed
Feeling tired -> Substitution: Fatigued
High blood pressure -> Substitution: Hypertension
Miscarriage -> Substitution: Therapeutic abortion
Blue skin -> Substitution: Cyanosis
Swelling -> Substitution: Edema
Poop -> Substitution: Bowel movement or stool
Pee -> Substitution: Urine or Voiding
Belly pain-> Substitution: Abdominal pain
Friends and family -> Substitution: Social supports and resources
In the end, avoid the use of medical jargon and reflect the same language, the same terms the patient used back to the them so they feel heard, understood and comfortable with you. Your interaction will also feel conversational and you'll move through the station in a timely and seamless manner.
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