Communicator- Key and Enabling Competencies[RCPSC]

Definition: As Communicators, physicians effectively facilitate the doctor-patient relationship and the dynamic exchanges that occur before, during, and after the medical encounter.

Description: Physicians enable patient-centered therapeutic communication through shared decision-making and effective dynamic interactions with patients, families, caregivers, other professionals, and important other individuals.  The competencies of this Role are essential for establishing rapport and trust, formulating a diagnosis, delivering information, striving for mutual understanding, and facilitating a shared plan of care.  Poor communication can lead to undesired outcomes, and effective communication is critical for optimal patient outcomes.  The application of these communication competencies and the nature of the doctor-patient relationship vary for different specialties and forms of medical practice.

Key Competencies:  Physicians are able to...

1. Develop rapport, trust and ethical therapeutic relationships with patients and families;

2. Accurately elicit and synthesize relevant information and perspectives of patients and families, colleagues and other professionals;

3. Accurately convey relevant information and explanations to patients and families, colleagues and other professionals;

4. Develop a common understanding on issues, problems and plans with patients and families, colleagues and other professionals to develop a shared plan of care;

5. Convey effective oral and written information about a medical encounter.

Enabling Competencies:  Physicians are able to...  

1. Develop rapport, trust, and ethical therapeutic relationships with patients and families

1.1. Recognize that being a good communicator is a core clinical skill for physicians, and that effective physician-patient communication can foster patient satisfaction, physician satisfaction, adherence and improved clinical outcomes

1.2. Establish positive therapeutic relationships with patients and their families that are characterized by understanding, trust, respect, honesty and empathy

1.3. Respect patient confidentiality, privacy and autonomy  

1.4. Listen effectively

1.5. Be aware and responsive to nonverbal cues

1.6. Effectively facilitate a structured clinical encounter

2. Accurately elicit and synthesize relevant information and perspectives of patients and families, colleagues, and other professionals

2.1. Gather information about a disease, but also about a patient’s beliefs, concerns, expectations and illness experience

2.2. Seek out and synthesize relevant information from other sources, such as a patient’s family, caregivers and other professionals

3. Accurately convey relevant information and explanations to patients and families, colleagues and other professionals

3.1. Deliver information to a patient and family, colleagues and other professionals in a humane manner and in such a way that it is understandable, encourages discussion and participation in decision-making

4. Develop a common understanding on issues, problems and plans with patients, families, and other professionals to develop a shared plan of care

4.1. Effectively identify and explore problems to be addressed from a patient encounter, including the patient’s context, responses, concerns, and preferences

4.2. Respect diversity and difference, including but not limited to the impact of gender, religion and cultural beliefs on decision-making

4.3. Encourage discussion, questions, and interaction in the encounter

4.4. Engage patients, families, and relevant health professionals in shared decision-making to develop a plan of care

4.5. Effectively address challenging communication issues such as obtaining informed consent, delivering bad news, and addressing anger, confusion and misunderstanding

5. Convey effective oral and written information about a medical encounter

5.1. Maintain clear, accurate, and appropriate records (e.g., written or electronic) of clinical encounter and plans

5.2. Effectively present verbal reports of clinical encounters and plans

5.3. When appropriate, effectively present medical information to the public or media about a medical issue