Study sheet: Establishing the Consultation

📋 Course Outline

1. Purpose and Consultation Structure
2. Consultation Across Different Formats
3. Patient-Centred Communication
4. Rapport and Professional Communication
5. Cultural Safety and Health Literacy
6. Managing Expectations
7. Shared Decisions and Professional Boundaries

📖 1. Purpose and Consultation Structure

🔑 Key Concepts & Definitions

• Professional consultation : A structured, patient-centred interaction that establishes trust and rapport, facilitates accurate information gathering, manages expectations realistically, and supports shared decision-making.

📝 Essential Points

• 🔄 A professional consultation moves through five signposted stages:
  1. Opening
  2. Information gathering
  3. Discussion
  4. Planning
  5. Closing

💡 Memory Hook

Open → gather → discuss → plan → close

📖 2. Consultation Across Different Formats

★ Must-know

📌 The five-stage consultation structure applies across phone, screening, and tele-health formats, but the communication cues and adaptations differ by channel.

Further detail

📌 In phone consultations, clinicians should slow their pace, use clearer diction, and check understanding verbally more often because there are no visual cues.

📌 In tele-health consultations, clinicians should check framing, lighting, and audio first, confirm identity and privacy, and expect slight transmission lag.

💡 Memory Hook

Phone relies on verbal cues, video relies on visual and technical cues

📖 3. Patient-Centred Communication

🔑 Key Concepts & Definitions

• Patient-centred communication : Treats the patient as a partner rather than a passive recipient by starting from the patient’s concerns, goals, and understanding.

📝 Essential Points

• Patient-centred communication involves: using plain language, checking understanding, inviting questions, respecting preferences, sharing information so the patient can participate in decisions

💡 Memory Hook

Patient as partner, not passive recipient

📖 4. Rapport and Professional Communication

📝 Essential Points

• Rapport is built through: a warm professional greeting using the patient’s name, attentiveness through eye contact, open posture and active listening, genuineness and respect without judgement, empathy that acknowledges feelings and concerns

📌 Professional communication should be assertive rather than passive or aggressive, with pace, language, and tone adapted to the patient.

💡 Memory Hook

GARE: Greeting, Attentiveness, Respect, Empathy

📖 5. Cultural Safety and Health Literacy

🔑 Key Concepts & Definitions

• Health literacy : A patient’s ability to access, understand, and use health information.

★ Must-know

• To support health literacy, clinicians should: use plain language, explain one thing at a time, use teach-back by asking the patient to explain information in their own words, provide written or visual aids

📌 Culturally safe and inclusive communication requires respecting cultural, religious, and social differences without assumptions and checking what matters to the individual patient.

Further detail

📌 When an interpreter is needed, clinicians should use a professional interpreter rather than a family member.

💡 Memory Hook

Check the patient’s preferences rather than assuming them

📖 6. Managing Expectations

📝 Essential Points

• Honest expectation-setting requires: explaining what is realistically achievable and what is not, being honest about timeframes, being honest about the number of treatments, addressing unrealistic social-media-driven expectations, documenting the expectations discussed

💡 Memory Hook

Honest expectations → realistic outcomes and reduced dissatisfaction

📖 7. Shared Decisions and Professional Boundaries

🔑 Key Concepts & Definitions

• Shared decision-making : Combines the clinician’s knowledge with the patient’s values and preferences to reach a decision together.

📝 Essential Points

• 🔄 Shared decision-making involves: presenting options, benefits, risks, and alternatives clearly, exploring what matters to the patient, supporting rather than pressuring the patient’s choice, confirming the agreed plan and understanding

• When declining a patient request, the clinician should: acknowledge what the patient wants, explain the clinical reasoning, offer a genuine alternative where one exists, document the request and advice, refer appropriately when the request is outside the clinician’s scope

💡 Memory Hook

Present → explore → support → confirm

📊 Synthesis Tables

Consultation Formats

Format	Key adaptation	Essential checks
Phone	Slow pace, clear diction, frequent verbal understanding checks	Verbal cues
Screening appointment	Shorter and more transactional interaction	Genuine opening and closing
Tele-health/video	Check framing, lighting, audio, identity, privacy, and lag	Technical and privacy checks