Communication Checklist
-
(Blank Evaluation)
COMMUNICATION SKILLS CHECKLIST
1. Introduction
Does not introduce self and does not indicate student status or purpose of the encounter
Introduced self and either student status or purpose of encounter
Introduced self by full name, student status, and purpose of encounter.
2. Open ended questions are utilized to explore the presenting complaint (after initial opening question)
Questions are generally close ended.
Utilized two or three open ended questions.
Utilized multiple open ended questions allowing the patient to tell their story.
3. Allowing to speak
Student interrupts patient
Does not interrupt patient but encounter may feel rushed
Does not interrupt patient and allows for silence when appropriate.
4. Medical jargon
Frequently uses medical jargon.
Occasionally uses medical jargon.
Rarely or never uses medical jargon.
5. Nonverbal skills
Body language, eye contact and facial expressions do not demonstrate engagement.
Some skills in utilizing body language, eye contact, and facial expressions to show engagement.
Body language, eye contact and facial expressions project listening and engagement.
6. Organization
History was disorganized AND hard to follow without any transition statements.
Either disorganized OR no transition statements were utilized.
History was obtained in an organized fashion utilizing transition statements. (e.g. We will now do the physical exam)
7. Listening skills
Follow up questions are not based on patient answers, questions are repeated which indicate not fully listening to patients answers earlier in the
conversation.
Demonstrates some careful listening skills.
Follow up questions are directed by patients answers, does not repeat questions or ask about things they have already been told, and may
occasionally summarizes what they have heard so far.
8. Clarity of question style
Examples: Leading - you don't smoke do you? Stringing - multiple symptoms in a row (nasuea, vomiting, diarrhea or constipation?)
Questions are leading and stringing together
Either leading or stringing
Questions are neither leading or stringing
9. Responding to nonverbal communication
Does not accurately read or respond to nonverbal communication.
Responds to some of patients nonverbal cues.
Active responses to all/most of patients nonverbal cues.
10. Emotional Support
Avoids emotions and steers away from difficult conversations.
Responds to emotions but does not reassure or provide comfort to patients.
Explores emotions and engages in difficult conversations, possesses skills to provide reassurance/comfort to patients in these situations.
Page 1
Communication Checklist
-
(Blank Evaluation)
11. Closure - End of the encounter
Neither summarizes issues nor discusses next step in care.
Either summarizes possible causes of symptoms/illness (at least 2) or instructs in the specific next steps in care.
Summarized the possible cause of illness (at least 2) and explains the specific next steps in care.
12. Answering questions - End of the encounter
Does not ask for questions or respond to questions asked.
Asks for questions but does not adequately address concerns.
Asks for patients questions and addresses concerns.
Page 2
