Chapter 2: Interviewing, Communication, & Interpersonal Skills

Interviewing, Communication, & Interpersonal Skills details core skills such as active listening to fully grasp the patient's emotional state, and the use of guided questioning, which utilizes a cone-like approach moving from open-ended inquiries to focused questions without restricting the patient's narrative. The text underscores the necessity of empathic responses, validation, and partnering to empower patients, while cautioning against premature reassurance that may inhibit full disclosure. A significant portion of the chapter focuses on verbal communication, advocating for plain language and the teach-back method to ensure patient understanding, alongside the adoption of non-stigmatizing, "people-first" language to avoid defining patients by their conditions. It also explores the critical role of nonverbal communication—such as posture, eye contact, and haptics—in conveying empathy and reading behavioral cues. The guide addresses specific clinical challenges, including the ethical requirements for informed consent based on decisional capacity, the nuances of discussing sensitive topics, and the importance of using trained medical interpreters rather than family members to navigate language barriers. Advanced communication protocols are introduced, including the SPIKES protocol for disclosing serious news, the SBAR framework for interprofessional patient safety, and motivational interviewing techniques to facilitate behavioral change. The chapter also outlines strategies for managing difficult patient behaviors, such as anger, silence, or discrimination, and adapting care for vulnerable populations with sensory impairments, low health literacy, or terminal illness. Finally, it reviews methods for maintaining patient-centeredness while using the electronic health record (EHR) and the value of standardized patients in medical education.