Supportive phrases - FOSCE/OSCE

[Jumpstartmy5HT]

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Do you have any standby empathetic/supportive/understanding/emotion-eliciting phrases for your FOSCE/OSCE performances?

These are the ones I usually use:
- I can certainly understand why you would feel that way. Has [illness/problem] caused any additional problems in your life?
- I am sorry to hear that. Please tell me more.
- I am sorry for your loss. Were you close?
- How did that make you feel?

I would like to add a bit of variety to my phrasing, but I am horrible at coming up with these types of touchy feely phrases. So please help!

 

[JP2740]

lol it's not hard bro don't overthink it.

"What brought you in today?"
"Doc I've been coughing like crazy for 5 days"
"I'm sorry to hear that. Could you tell me more about that?" = automatic empathy point at the beginning of every h and p encounter

Family history:
"Any family hx of diseases? How's mom and dad?"
"Dad died a year ago from a heart attack"
"I'm really sorry to hear that Mr. Doe. How old was he when that happened?"

**** like that. It's not about variety. It's about checking a box.

 

[Jumpstartmy5HT]

lol it's not hard bro don't overthink it.

"What brought you in today?"
"Doc I've been coughing like crazy for 5 days"
"I'm sorry to hear that. Could you tell me more about that?" = automatic empathy point at the beginning of every h and p encounter

Family history:
"Any family hx of diseases? How's mom and dad?"
"Dad died a year ago from a heart attack"
"I'm really sorry to hear that Mr. Doe. How old was he when that happened?"

**** like that. It's not about variety. It's about checking a box.

I've been doing that, and I've been graded low on the MIRS communications stuff by the SPs.

 

[JP2740]

**** your SPs. I did that on my Step 2 CS and was not close to borderline in any section. Idk what MIRS stands for though. Does that include summarizing/providing closure and your thoughts?

In terms of empathy, if you're worried about CS that's all you really need to do.

 

[Jumpstartmy5HT]

**** your SPs. I did that on my Step 2 CS and was not close to borderline in any section. Idk what MIRS stands for though. Does that include summarizing/providing closure and your thoughts?

In terms of empathy, if you're worried about CS that's all you really need to do.

Well, thanks for your reassurance. Ultimately Step 2 CS is what this whole thing is practice for. But in the mean time, I need to pass my OSCEs because I'm still a lowly M1! Hah.

 

[JP2740]

Well, thanks for your reassurance. Ultimately Step 2 CS is what this whole thing is practice for. But in the mean time, I need to pass my OSCEs because I'm still a lowly M1! Hah.

lol. IMO besides providing empathy in the open statement, it can just make sense from there. Family member died, they're depressed, etc... just acknowledge it. You will do just fine on step 2 cs. As for your OSCEs now, looks like you're passing them. Wear that low grade as a badge of honor.

 

[colbgw02]

As for your OSCEs now, looks like you're passing them. Wear that low grade as a badge of honor.

This. OSCEs should be pass/fail. The idea that empathy can be quantified in order to provide a grade is so mind-numbingly, next-level stupid that it makes me want to club a baby seal.

 

[Psai]

It's unbelievable how they are trying to make us do what they want to do by taking away points off of a meaningless, so obviously contrived situation. Hmm you want empathy? Here's an idea. Why not do these exams with actual patients so we don't have to pretend that we care about these fake problems? All it's teaching is how to play the game and how to try to display sympathy.

But say anything about standardized patients and simulations and these *****s in administrations eat that shot right up. It's sad that we will have to do it as attendings in those "continuing education" sessions. What a farce.

 

[TooMuchResearch]

Instead of "I'm sorry" statements, try "I wish" statements when they fit in.

Disclaimer: I suck at standardized patient stuff. The phrasing I suggested is what I use with real patients and families.

 

[CherryRedDracul]

It's unbelievable how they are trying to make us do what they want to do by taking away points off of a meaningless, so obviously contrived situation. Hmm you want empathy? Here's an idea. Why not do these exams with actual patients so we don't have to pretend that we care about these fake problems? All it's teaching is how to play the game and how to try to display sympathy.

But say anything about standardized patients and simulations and these *****s in administrations eat that shot right up. It's sad that we will have to do it as attendings in those "continuing education" sessions. What a farce.

QFT.

 

[DH410]

Do you have any standby empathetic/supportive/understanding/emotion-eliciting phrases for your FOSCE/OSCE performances?

These are the ones I usually use:
- I can certainly understand why you would feel that way. Has [illness/problem] caused any additional problems in your life?
- I am sorry to hear that. Please tell me more.
- I am sorry for your loss. Were you close?
- How did that make you feel?

I would like to add a bit of variety to my phrasing, but I am horrible at coming up with these types of touchy feely phrases. So please help!

 

[NontradCA]

.

 

[JP2740]

.

A nurse? What was the nurse doing?

 

[NontradCA]

A nurse? What was the nurse doing?

Preaching.

 

[JP2740]

Preaching.

Actually teaching you guys?

 

[NontradCA]

Actually teaching you guys?

No. Physicians were. Nurse was just there.

 

[touchpause13]

Don't forget eye contact and body language. If the pt tells you a family member died put down your pencil and look at them and tell them you are sorry for their loss

 

[jakeislove]

Much as I don't want to get hit by WS' ban-shoe: Does it really take a script to treat people how you'd like to be treated when sick or dealing with a loss?

 

[Jumpstartmy5HT]

It's not. I feel like I'm naturally empathetic, but it's not the same with SPs. Some of them also try to be ornery as their character.

 

[Priapism4tooLong]

This. OSCEs should be pass/fail. The idea that empathy can be quantified in order to provide a grade is so mind-numbingly, next-level stupid that it makes me want to club a baby seal.

I once started crying and got a A+

 

[Jumpstartmy5HT]

I'm also beginning to really loathe some of the SPs my program uses because they really lack the guts to provide face to face feedback that is helpful. Instead they tell me I'm awesome and then rates me really low for stuff I actually covered.

A few of the clinical faculty reviewed my videos, and they all agreed that the SPs graded weird.

Has this happened to anyone?

 

[Priapism4tooLong]

I'm also beginning to really loathe some of the SPs my program uses because they really lack the guts to provide face to face feedback that is helpful. Instead they tell me I'm awesome and then rates me really low for stuff I actually covered.

A few of the clinical faculty reviewed my videos, and they all agreed that the SPs graded weird.

Has this happened to anyone?

yeah it happened to me, some one told me they look for minute stupid things like how you greet the patient.

How do you greet them normally?

 

[Jumpstartmy5HT]

yeah it happened to me, some one told me they look for minute stupid things like how you greet the patient.

How do you greet them normally?

I actually usually get 100% for the greeting and HPI elements. The stuff that gets me are the arbitrary things like understanding, supporting, etc. I also never get full marks for empathy, transitional phrases. Stuff like that. I always pause when the SPs tell me about something tragic. But I never get full points. The most recent SP revealed to me as a part of his fake family history that his father died. I asked about the circumstances of the death, how he dealt with it emotionally, offered him support and understanding while expressing my condolences, and asked how he's coping with it now. Did I get full points for empathy? Nope. Did he tell me how empathetic I was during feedback? Yep. Was I annoyed completely when I saw how he actually graded me? Fuming.

 

[Priapism4tooLong]

I actually usually get 100% for the greeting and HPI elements. The stuff that gets me are the arbitrary things like understanding, supporting, etc. I also never get full marks for empathy, transitional phrases. Stuff like that. I always pause when the SPs tell me about something tragic. But I never get full points. The most recent SP revealed to me as a part of his fake family history that his father died. I asked about the circumstances of the death, how he dealt with it emotionally, offered him support and understanding while expressing my condolences, and asked how he's coping with it now. Did I get full points for empathy? Nope. Did he tell me how empathetic I was during feedback? Yep. Was I annoyed completely when I saw how he actually graded me? Fuming.

did you add a physical aspect to it like pat him on the back and say I'm so sorry to hear that sir? They love that

 

[Jumpstartmy5HT]

Well when I interview them I am usually sitting and talking to them at the same physical level to remove barriers from the conversation and to put them at ease. So I can't do that. I also hope you aren't serious because I am not patting anyone regardless. Lol. If it ain't a part of the physical exam, I have no interests in making physical contact at this point of my career.

 

[Priapism4tooLong]

Well when I interview them I am usually sitting and talking to them at the same physical level to remove barriers from the conversation and to put them at ease. So I can't do that. I also hope you aren't serious because I am not patting anyone regardless. Lol. If it ain't a part of the physical exam, I have no interests in making physical contact at this point of my career.

with this kind of attitude you aren't going to score high. You have to go above and beyond the call of duty.

 

[jakeislove]

Well when I interview them I am usually sitting and talking to them at the same physical level to remove barriers from the conversation and to put them at ease. So I can't do that. I also hope you aren't serious because I am not patting anyone regardless. Lol. If it ain't a part of the physical exam, I have no interests in making physical contact at this point of my career.

Are you afraid they might have cooties?

 

[D4C]

Are you afraid they might have cooties?

Probably ebola! Don't underestimate the usefulness of physical contact OP.

 

[Jumpstartmy5HT]

Are you afraid they might have cooties?

No. I just don't feel comfortable doing that. Maybe I will. Maybe I won't. I think it would also depend on what kind of practice I am in.

Say if I am in a primary care setting, and a patient I know well has experienced something traumatic, I am way more inclined to offer support via through nonverbal means. But in a SP scenario? Highly unlikely.

 

[jakeislove]

No. I just don't feel comfortable doing that. Maybe I will. Maybe I won't. I think it would also depend on what kind of practice I am in.

Say if I am in a primary care setting, and a patient I know well has experienced something traumatic, I am way more inclined to offer support via through nonverbal means. But in a SP scenario? Highly unlikely.

In that scenario, you're a simulated doctor.

Be grateful for the feedback. People can usually tell when someone is just going through the motions. 🙂

 

[Jumpstartmy5HT]

That's the thing. I wish the SPs would give actual feedback. We have face to face feedback after the session, but they're always full of praise. Then I look at my score sheet and note I really shouldn't have been praised as much as I was.

The point isn't the grade itself. I go to a true pass/fail school. I'm well within the range for passing. The point is that I wish they would tell me what I could improve on so I can be better when I'm interacting with real patients. (And I guess so I can steadily improve and make sure I get similar or higher grades for my osces later down the road.)

 

[hallowmann]

Don't forget eye contact and body language. If the pt tells you a family member died put down your pencil and look at them and tell them you are sorry for their loss

This is huge. You really need to make it clear you are looking at them, listening to them, and maybe even try and ask them more about stuff. "I'm so sorry to hear your father passed away, how have you and your family been coping after this loss?" Actually look upset at the news. They should be able to read the concern on your face, not just hear the words.

If you have time, be sure to joke around with the SP, and just be generally friendly as you would with any person.

You get to a point where you can get the job done, but at the same time just joke around and talk along the way. Don't be so focused on the goal of the H&P that you miss acting like a normal person (this happens a lot with people). Even within a time limit, its very possible to do a quick H&P and still throw in a bunch of personal stuff.

It's not. I feel like I'm naturally empathetic, but it's not the same with SPs. Some of them also try to be ornery as their character.

You need to stop viewing them as an SP. When you walk in that door, they are a patient. That's it. They are a random patient that came in, and you need to interview them for your attending. Get used to acting like this now, because when CS comes, you'll need to be that way regardless of how fake the situation feels.

 

[Kahreek]

i give no cheap empathy to my pts, everyone smells cheap empathy a mile away, being professional about it makes them much more comfortable than anything

 

[Kahreek]

lol it's not hard bro don't overthink it.

"What brought you in today?"
"Doc I've been coughing like crazy for 5 days"
"I'm sorry to hear that. Could you tell me more about that?" = automatic empathy point at the beginning of every h and p encounter

Family history:
"Any family hx of diseases? How's mom and dad?"
"Dad died a year ago from a heart attack"
"I'm really sorry to hear that Mr. Doe. How old was he when that happened?"

**** like that. It's not about variety. It's about checking a box.

i am not being sorry for a old man's dad, that died 40 years ago, though

 

[Kahreek]

Much as I don't want to get hit by WS' ban-shoe: Does it really take a script to treat people how you'd like to be treated when sick or dealing with a loss?

lol, yes you need training, you dont have any idea about endless h&p's streaks in the im ward.
My favourite way of condolences is to give a slow and meaningful nod, not very good in yapping american culture though.

 

[hallowmann]

i am not being sorry for a old man's dad, that died 40 years ago, though

Well yeah, obviously feel the room. The point is that you should act the way you'd want someone to treat... your little sister or something. This goes for SPs too.

 

[JP2740]

i am not being sorry for a old man's dad, that died 40 years ago, though

We're talking about OSCEs not real life. You're expected to do this on OSCEs. Your reaction IRL is up to you.

 

[Kahreek]

ohh, lol sp's