We practised Communication scenario – 7 day old cyanosed baby, diagnosed with CHD on this admission. Seen the video of the case and discussed management with examiner previously. Today it was to speak with the neonate’s parents.

MF was in the hot seat and the task was completed with excellence. Only a couple of minor points could be identified that could be improved.

Take a pause of a few seconds – up to 5 – 10 after breaking bad news – let the information sink in. Generally you can wait for the Role player to come back and ask a question. Describe the abnormality / pathology in simple words and then offer to draw a diagram – if the Role Player so indicates. Summarise at 6-7 minutes leave and open question after – “Is there anything else you wish to ask / discuss?”

Learning points:

• Be systematic in approach
• Use ‘Pause / Silence’ as a powerful tool in your discussion
• 30 second rule – check for understanding / acknowledgement
• How is the baby? – Be honest, brief but optimistic – “Stable now and has responded to our immediate treatment’.
• Future management after further query from Role player – if appropriate.
• Remember Name of RP & Child – try and not confuse.

Add your comments or any points I may have missed.
Anil Garg