NAC OSCE Communication Skills

Question 1

A patient has just been diagnosed with cancer. Using the SPIKES protocol, what is the FIRST step before delivering the bad news?

Accepted Answer

Setting up the interview — ensuring privacy, sitting down, making eye contact, and minimizing interruptions

Answer

Immediately tell the patient the diagnosis

Answer

Ask the patient how much they want to know

Answer

Provide a treatment plan

Question 2

When obtaining informed consent for a surgical procedure, which element is MOST commonly omitted by physicians?

Accepted Answer

A discussion of reasonable alternatives to the proposed treatment, including the option of no treatment

Answer

The name of the procedure

Answer

The surgeon's name and qualifications

Answer

The date of the procedure

Question 3

A patient is angry because they waited 3 hours to see you. What is the MOST effective initial response?

Accepted Answer

Acknowledge their frustration empathetically — 'I can see you've been waiting a long time and I understand that's frustrating. I apologize for the delay.'

Answer

Explain that you were busy with other patients

Answer

Ignore the anger and proceed with the medical history

Answer

Tell them they can leave if they are not happy

Question 4

When explaining a complex medical condition to a patient with limited health literacy, which communication technique is MOST effective?

Accepted Answer

Use plain language, the 'teach-back' method (asking the patient to explain what they understood), visual aids, and limit information to 2-3 key points per visit

Answer

Use medical terminology to be precise

Answer

Give the patient a medical textbook to read

Answer

Speak louder and more slowly

Question 5

During a NAC OSCE station, a patient asks you 'Am I going to die, doctor?' How should you respond?

Accepted Answer

Acknowledge the question with empathy, explore what prompted it, provide honest information appropriate to the clinical situation, and address the patient's underlying fears and concerns

Answer

Avoid the question and change the subject

Answer

Say 'Everyone dies eventually' to deflect

Answer

Provide a precise statistical probability of survival

Question 6

What is the role of 'motivational interviewing' techniques in a NAC OSCE encounter?

Accepted Answer

To help the patient explore and resolve ambivalence about behaviour change by using open-ended questions, affirmations, reflections, and summaries (OARS)

Answer

To convince the patient to follow the doctor's recommendations

Answer

To motivate the patient to exercise more

Answer

To interview the patient about their career goals