FACEM Patient Communication Skills 3 — Questions and Answers
Question 1: During a resuscitation attempt, how should the emergency team communicate with a family member present in the room?
- Ask the family member to leave immediately
- Assign a dedicated team member to provide ongoing explanation and emotional support to the family (Correct answer)
- Continue resuscitation without acknowledging the family member
- Allow the family to direct resuscitation efforts
Correct answer: Assign a dedicated team member to provide ongoing explanation and emotional support to the family
Family presence during resuscitation is supported by evidence, and assigning a dedicated support person improves family outcomes and communication.
Question 2: When documenting a difficult conversation with a patient in the medical record, what should be included?
- Only the clinical decisions made
- The content of the discussion, patient's understanding, questions asked, and who was present (Correct answer)
- A brief note that 'the patient was counselled'
- Only the patient's verbal consent
Correct answer: The content of the discussion, patient's understanding, questions asked, and who was present
Comprehensive documentation of difficult conversations provides medicolegal protection and ensures continuity of care.
Question 3: A 16-year-old presents alone with a suspected sexually transmitted infection and requests confidentiality from their parents. What is the best approach?
- Inform the parents regardless, as the patient is a minor
- Assess the patient's Gillick competence and, if competent, maintain confidentiality (Correct answer)
- Refuse to treat without parental consent
- Contact child protective services immediately
Correct answer: Assess the patient's Gillick competence and, if competent, maintain confidentiality
Gillick competence allows mature minors to consent to and have confidential treatment when they demonstrate sufficient understanding.
Question 4: Which non-verbal communication behaviour is most likely to build rapport with a patient during history-taking?
- Maintaining sustained eye contact without breaks
- Sitting at the same level as the patient and using appropriate nodding (Correct answer)
- Standing at the end of the bed while taking notes
- Crossing arms while listening to demonstrate attentiveness
Correct answer: Sitting at the same level as the patient and using appropriate nodding
Sitting at the patient's level with open body language and affirmative nodding signals engagement and builds trust.
Question 5: A patient with intellectual disability is brought to the ED by a carer. How should communication be adjusted?
- Direct all communication to the carer, as the patient cannot participate
- Use simple language, speak directly to the patient, and involve them in decisions to the extent possible (Correct answer)
- Assume the carer has full legal authority to make all decisions
- Avoid asking the patient questions to prevent confusion
Correct answer: Use simple language, speak directly to the patient, and involve them in decisions to the extent possible
Patients with intellectual disability retain communication rights; simple, direct language and inclusion in decision-making respects their autonomy.
Question 6: What is the most appropriate response when a patient says 'No one has told me anything about what's happening'?
- Apologise on behalf of other staff and blame them for the communication failure
- Acknowledge the patient's frustration, apologise for the gap, and provide a clear update (Correct answer)
- Tell the patient to ask the attending physician when they arrive
- Explain that the ED is busy and information sharing takes time
Correct answer: Acknowledge the patient's frustration, apologise for the gap, and provide a clear update
Acknowledging the breakdown, apologising sincerely, and providing immediate information addresses the patient's core concern effectively.
Question 7: A patient is being discharged but appears confused about their follow-up instructions. Which method best confirms comprehension?
- Asking 'Do you understand?'
- Using teach-back: asking the patient to explain the instructions in their own words (Correct answer)
- Providing a written information sheet
- Calling the patient's GP to relay the instructions
Correct answer: Using teach-back: asking the patient to explain the instructions in their own words
Teach-back is the gold standard for verifying patient comprehension, as it requires active recall rather than passive acknowledgement.
FACEM Patient Communication Skills 3
During a resuscitation attempt, how should the emergency team communicate with a family member present in the room?