OET: Workplace Communication Situations & Tools
OET Test Preparation Specialists
The way in which you are expected to communicate in Britain – or in America, or elsewhere – may be very different to what you are used to. With this in mind, here are three common situations and some tips on dealing with them.
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Handing over to another Healthcare Professional
There is a particular method for handovers that is used widely across healthcare in English speaking countries. It’s called SBAR, which stands for Situation, Background, Assessment, Recommendation. It’s easy to remember and frames conversations in a way that information can be conveyed quickly and efficiently, especially in difficult situations. It therefore helps patient safety, and allows teams to work together more easily.
SBAR might be of use to you in day-to-day communications, emails, handovers, when speaking to senior figures in the hospital, or if you need to urgently escalate a patient. It could even be of use in the OET itself, where it may provide a useful structure for a letter.
Situation: identify yourself and ensure that you describe where you are calling from. Identify the patient, their consultant and describe why you are calling. Provide the patient’s vital signs and Resus status.
‘This is Vinh, an FY1 on Ward 24. I’m calling because Mrs Doolittle in room 8A has become suddenly hypoxic. Her oxygen sats are 88% breathing room air, her respiration rate is 22 and her heart rate is 104. Her BP is 90/58. Her consultant is Dr Lane and her Resus status is DNR.’
Background: explain why the patient was admitted, and explain any significant past medical history. Describe their date of admissions, current medications, allergies, and any pertinent results.
‘Mrs Doolittle is a 78 year old woman who was admitted from home two days ago, on Wednesday the 1st October with pneumonia. X-ray showed patchy opacities. She was prescribed oral amoxicillin and had been doing well until this point. She is on no other medications and has no known drug allergies.’
Assessment: here you should provide your clinical impressions and concerns. In this situation, Vinh might say:
‘I’m really worried that her condition is worsening so quickly and I’m not sure why. I’ve commenced high-flow oxygen 15L/min, but her O2 sats has not improved.’
Recommendation: clearly outline what you think needs to happen next, and why. This could be anything from the treatment that you think should be initiated to the type of help that you are requesting.
‘I urgently need senior help with this patient, as I’m concerned about her condition. Please could you provide a recommendation on how to proceed now, and come and see the patient as soon as you are able to?’
Delivering Bad News
You must be aware of how bad news is delivered in the UK (or where you are planning on moving to). First, you should prepare the patient that bad news is coming. This means using phrases like ‘I’m afraid I have bad news’ or ‘I’m afraid that the results aren’t good.’ You must be honest and sensitive to the patient’s level of understanding – that means delivering news in a way that can be interpreted easily. Therefore, say ‘I’m afraid she has had a heart attack’ rather than ‘the results are indicative of an MI.’ Acknowledge the patient’s emotion – either verbally or through an action like providing a tissue if they are crying. Be empathetic, and show that you are considering their feelings. Be prepared to deal with difficult questions. If you don’t know something, admit that – lying or obfuscating is unacceptable.
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Providing Patient-Centred Care
Models of healthcare will be different from one country to another. In the UK, and across other English-speaking countries, healthcare is generally ‘patient-centred’ or ‘person-centred’ rather than paternalistic. That means that you must consider the patient to be an equal partner in the planning of their care. You will need to involve them at each step of their treatment, and ensure that the information you convey to them can be understood and allow for informed decision making. The doctor’s role is not to make decisions for the patient, but rather to provide them with the information that they need in order to make the decision. You should be focused on each individual and see them as a person rather than as their disease.