ECFMG Communication & Interpersonal Skills 3 — Questions and Answers
Question 1: A patient with limited health literacy asks you to explain their hypertension diagnosis. Which strategy is most appropriate?
- Use precise medical terminology to maintain accuracy
- Use simple language and the teach-back method (Correct answer)
- Refer the patient to a health educator instead
- Provide a detailed pamphlet and schedule a follow-up
Correct answer: Use simple language and the teach-back method
Plain language combined with teach-back confirms comprehension and is the gold standard for low-literacy patients.
Question 2: During a pediatric visit, the parent repeatedly answers questions directed at the 12-year-old patient. What is the best response?
- Continue addressing the parent as they are the legal guardian
- Redirect questions to the child while acknowledging the parent's role (Correct answer)
- Ask the parent to wait outside
- Skip the interview and proceed to physical examination
Correct answer: Redirect questions to the child while acknowledging the parent's role
Engaging the adolescent directly respects their developing autonomy while maintaining the parent as a collaborative partner.
Question 3: A patient appears tearful when you enter the room. What is the most therapeutic opening statement?
- Let's go over your chief complaint.
- You seem upset — would you like to tell me what's going on? (Correct answer)
- I see you have a lot on your mind; we'll get to that later.
- I only have 15 minutes, so let's focus on your main issue.
Correct answer: You seem upset — would you like to tell me what's going on?
Acknowledging observable emotional cues and inviting the patient to share creates psychological safety early in the encounter.
Question 4: Which element of the Calgary-Cambridge model focuses most directly on understanding the patient's perspective?
- Physical examination findings
- Exploring the patient's ideas, concerns, and expectations (Correct answer)
- Writing clear clinical notes
- Closing the consultation with a safety net
Correct answer: Exploring the patient's ideas, concerns, and expectations
Eliciting the patient's ideas, concerns, and expectations (ICE) is central to the Calgary-Cambridge communication framework.
Question 5: A patient admits to not taking prescribed medications due to cost. What is the most appropriate response?
- Emphasize that non-adherence is dangerous and document accordingly
- Explore the barrier, express understanding, and discuss affordable alternatives (Correct answer)
- Refer to social work and close the encounter
- Prescribe the same medication and hope the patient finds a way
Correct answer: Explore the barrier, express understanding, and discuss affordable alternatives
Acknowledging the financial barrier without judgment and collaboratively problem-solving improves adherence and the therapeutic relationship.
Question 6: A patient's family demands that a terminal diagnosis be withheld from the patient. What is the most appropriate action?
- Honor the family's request to avoid conflict
- Determine the patient's own preference regarding disclosure first (Correct answer)
- Disclose the diagnosis immediately regardless of family wishes
- Ask the ethics committee to make the final decision
Correct answer: Determine the patient's own preference regarding disclosure first
The patient's preference for information disclosure takes precedence over the family's wishes unless the patient lacks decision-making capacity.
Question 7: Which approach best manages disagreement between two team members during patient handoff?
- Defer entirely to the senior physician's view
- Raise the concern respectfully using 'I' statements and focus on patient safety (Correct answer)
- Wait until the patient is discharged to discuss the disagreement
- Document the disagreement in the medical record immediately
Correct answer: Raise the concern respectfully using 'I' statements and focus on patient safety
Assertive yet respectful communication focused on patient safety outcomes is the standard for interprofessional conflict resolution.
ECFMG Communication & Interpersonal Skills 3
A patient with limited health literacy asks you to explain their hypertension diagnosis.
Which strategy is most appropriate?