ECFMG Communication & Interpersonal Skills 2 — Questions and Answers
Question 1: A patient from a non-English-speaking background nods repeatedly during your explanation but cannot repeat back the instructions. What is the best next step?
- Assume understanding and proceed
- Request a trained medical interpreter (Correct answer)
- Ask a family member to translate
- Provide written instructions only
Correct answer: Request a trained medical interpreter
A trained medical interpreter ensures accurate communication and protects patient safety when language barriers exist.
Question 2: During a clinical encounter, a patient says, 'I don't think my medication is working.' Which response best demonstrates active listening?
- I'll order a different medication right away.
- Tell me more about what you've been experiencing. (Correct answer)
- How long have you been taking it?
- Have you been taking it as prescribed?
Correct answer: Tell me more about what you've been experiencing.
Open-ended prompts invite the patient to elaborate and signal that the physician is engaged and curious about their experience.
Question 3: A patient refuses a recommended surgical procedure. After explaining the risks of refusal, what is the physician's ethical obligation?
- Override the refusal if the risk is life-threatening
- Document the refusal and respect the patient's decision (Correct answer)
- Consult the patient's family to obtain consent
- Discharge the patient from the practice
Correct answer: Document the refusal and respect the patient's decision
Competent adults have the right to refuse treatment; the physician must document the informed refusal and continue to offer appropriate care.
Question 4: Which nonverbal behavior most effectively communicates empathy during a patient interview?
- Maintaining eye contact and leaning slightly forward (Correct answer)
- Taking detailed notes throughout the encounter
- Standing at the doorway to appear approachable
- Nodding rapidly to signal agreement
Correct answer: Maintaining eye contact and leaning slightly forward
Eye contact and a forward lean convey attentiveness and genuine interest in the patient's concerns.
Question 5: A patient discloses domestic violence. Beyond ensuring immediate safety, what communication step is most important?
- Immediately report to law enforcement
- Ask the patient what kind of support would be most helpful (Correct answer)
- Advise the patient to leave the relationship
- Document the disclosure and move on
Correct answer: Ask the patient what kind of support would be most helpful
Asking survivors what support they need respects their autonomy and increases the likelihood they will engage with resources.
Question 6: When delivering a serious diagnosis, which communication technique helps patients process the information most effectively?
- Provide all details rapidly to minimize distress
- Use a 'warning shot' before stating the diagnosis (Correct answer)
- Hand the patient written materials and leave the room
- Ask a nurse to deliver the diagnosis to reduce tension
Correct answer: Use a 'warning shot' before stating the diagnosis
A preparatory statement such as 'I have some serious news' allows the patient to mentally prepare before receiving the diagnosis.
Question 7: A colleague interrupts patients frequently during rounds. How should you address this using a professional communication approach?
- Report the colleague to the department chair immediately
- Speak privately with the colleague and describe the observed behavior (Correct answer)
- Ignore it as patient interruptions are common in clinical settings
- Interrupt the colleague during rounds to model correct behavior
Correct answer: Speak privately with the colleague and describe the observed behavior
Addressing concerns privately and specifically is a constructive, professional approach that avoids public embarrassment.
ECFMG Communication & Interpersonal Skills 2
A patient from a non-English-speaking background nods repeatedly during your explanation but cannot repeat back the instructions.
What is the best next step?