Patient Communication Skills Flashcards

A patient with severe ARDS is conscious but unable to speak due to an endotracheal tube. She appears to be trying to write something. The correct action is:

Answer: Provide a pen and pad or whiteboard and allow her to write her message

Providing writing materials is a validated, low-tech AAC method that preserves patient autonomy and addresses immediate communication needs.

Surrogates of critically ill patients are most prone to which cognitive bias that can impair shared decision-making?

Answer: Optimism bias overestimating survival probability

Surrogates consistently overestimate survival probabilities, which is an optimism bias that clinicians must gently address with clear prognostic information.

During a family meeting, the intensivist is speaking for 10 uninterrupted minutes about organ dysfunction. According to best-practice communication research, this approach is problematic because:

Answer: Family members retain information poorly when clinicians dominate speaking time

Research shows families recall only a fraction of information when clinicians speak at length; the VALUE framework recommends families speak more than clinicians.

A patient recovering from ICU delirium expresses shame about hallucinations they experienced. The most therapeutic response from the intensivist is:

Answer: Reassure them the hallucinations were caused by medications and are not a sign of mental illness

Normalizing ICU delirium by explaining its physiological basis reduces stigma and psychological distress in recovering patients.

Which statement best reflects the principle of 'prognostic disclosure calibration' in ICU communication?

Answer: Tailor the amount and detail of prognostic information to what the family wants to know

Calibrated disclosure involves first assessing the family's information preferences and then providing prognostic detail accordingly, respecting individual autonomy.

A family requests that the team not tell their elderly relative that she is dying. The most appropriate intensivist response is:

Answer: Explore the family's concerns while affirming the patient's right to information if she wishes to know

While cultural sensitivity is essential, clinicians have a duty to explore the patient's own wishes and cannot routinely withhold information the patient wants.

In the context of ICU communication, the 'ask-tell-ask' technique is primarily used to:

Answer: Check understanding, provide information in chunks, and verify comprehension iteratively

Ask-Tell-Ask is a teach-back-derived technique that ensures information is understood before progressing, reducing miscommunication in high-stakes family discussions.