PCS EXAM 1 QUESTIONS & ANSWERS
Why are Good Communication Skills Important - Answers -Positive impact on patient
outcomes
-Greater patient satisfaction
-Improved psychological symptoms and ability to cope
-Improved physical symptoms
-Greater recall and adherence to treatment plan
-Positive health behavior change
-Reduced length of hospital stay
Positive impact on physicians
-More information available for medical decision-making
-Greater satisfaction with the patient encounter
-Increased comfort discussing difficult or sensitive issues
Common Communication Deficiencies in Clinical Medicine - Answers -Interruption of
patients early in the encounter
Failure to identify and prioritize patient concerns
Missed opportunities to understand and acknowledge the patient's ideas and feelings
Failure to give bad news concisely and adequately
Minimizing patient's role in his/her health care
Failure to obtain adequate informed consent
Poor Physician Communication Skill Consequences - Answers -Decreased patient
satisfaction
Poorer health outcomes
Decreased patient compliance with treatment recommendations
Greater disenrollment from care
,More malpractice suits
Why Medical Interview Important - Answers --About two-thirds of diagnoses can be
made on the basis of the history alone despite modern technological advances.
-An accurate history also provides focus to the physical examination, making it more
productive and time efficient.
Why learn the skill of medical interviewing - Answers -The most cost-effective
diagnostic tool
The most frequently performed medical procedure (>100,000 interviews/physician
career)
Provides the opportunity to develop meaningful and caring relationships with patients
Create a therapeutic alliance (facilitates healing)
Gives direction to the physical exam
Provides the foundation for the formulation of an accurate differential diagnosis (clinical
reasoning
Why is the PE important? - Answers -Contributes significantly to accurate diagnosis
and management of disease
-Efficient and cost-effective
Some diseases can only be diagnosed by physical exam
-Cellulitis, herpes zoster, Bell's palsy, pericarditis, Parkinson's disease
Many diagnoses require correlation between diagnostic studies and physical exam
findings
Evidence-based data to support the validity and reliability of physical exam findings
Fundamental Qualities of Mindful Physicians - Answers -1-Observation
2-Curosity
3-Beginner's Mind
4-Presence
, Becoming Mindful - Answers -1-Priming
2-Being available
3-Reflective Questions
4-Active Engagement
5-Thinking aloud
6-Practice
7-Self-Monitoring
8-Assesment
It's late on a Friday afternoon and you are tired. Your 15th and last patient, a 62 year old
recent widower, is particularly challenging because he has come in frequently during the
last three months, each time complaining of a new ache or pain. You have been unable
to find a physical cause for his complaints, and come to the conclusion that his
symptoms are part of his grieving process. Your offers to refer him to a support group
were rejected, and he seems to have no insight at all. Which of the following questions
represents mindfulness, and is most important to contemplate in order to make this
encounter more successful, for you and for the patient?
A. How do I feel about patients with psychosomatic illness?
B. To whom can I refer this patient?
C. How do I feel about the fact that he has rejected my efforts to help him with his real
problem, the recent loss of his wife?
D. Can I help him see that his problem - Answers -C. is correct because it explores the
clinician's own emotions at a specific point in time. Mindfulness is always a useful
strategy when you seem stuck with a patient. A (an example of self-awareness) might
also be useful since it addresses general beliefs regarding patients who suffer from
psychosomatic conditions. Options B and E may provide temporary relief, but will not
help you work with similar patients who will inevitably appear in the future (and B and E
could even diminish both your effectiveness and your well-being in the future!)
One of your colleagues made a serious mistake and administered the wrong antibiotic
to a patient. Now it is 3am and you are trying to stabilize the patient, with mixed results
so far. In the light of day you will have to talk with the family and reveal the error to
them. Which of the following questions are most important to contemplate to make that
encounter more successful, for yourself and for the patient's family?
Why are Good Communication Skills Important - Answers -Positive impact on patient
outcomes
-Greater patient satisfaction
-Improved psychological symptoms and ability to cope
-Improved physical symptoms
-Greater recall and adherence to treatment plan
-Positive health behavior change
-Reduced length of hospital stay
Positive impact on physicians
-More information available for medical decision-making
-Greater satisfaction with the patient encounter
-Increased comfort discussing difficult or sensitive issues
Common Communication Deficiencies in Clinical Medicine - Answers -Interruption of
patients early in the encounter
Failure to identify and prioritize patient concerns
Missed opportunities to understand and acknowledge the patient's ideas and feelings
Failure to give bad news concisely and adequately
Minimizing patient's role in his/her health care
Failure to obtain adequate informed consent
Poor Physician Communication Skill Consequences - Answers -Decreased patient
satisfaction
Poorer health outcomes
Decreased patient compliance with treatment recommendations
Greater disenrollment from care
,More malpractice suits
Why Medical Interview Important - Answers --About two-thirds of diagnoses can be
made on the basis of the history alone despite modern technological advances.
-An accurate history also provides focus to the physical examination, making it more
productive and time efficient.
Why learn the skill of medical interviewing - Answers -The most cost-effective
diagnostic tool
The most frequently performed medical procedure (>100,000 interviews/physician
career)
Provides the opportunity to develop meaningful and caring relationships with patients
Create a therapeutic alliance (facilitates healing)
Gives direction to the physical exam
Provides the foundation for the formulation of an accurate differential diagnosis (clinical
reasoning
Why is the PE important? - Answers -Contributes significantly to accurate diagnosis
and management of disease
-Efficient and cost-effective
Some diseases can only be diagnosed by physical exam
-Cellulitis, herpes zoster, Bell's palsy, pericarditis, Parkinson's disease
Many diagnoses require correlation between diagnostic studies and physical exam
findings
Evidence-based data to support the validity and reliability of physical exam findings
Fundamental Qualities of Mindful Physicians - Answers -1-Observation
2-Curosity
3-Beginner's Mind
4-Presence
, Becoming Mindful - Answers -1-Priming
2-Being available
3-Reflective Questions
4-Active Engagement
5-Thinking aloud
6-Practice
7-Self-Monitoring
8-Assesment
It's late on a Friday afternoon and you are tired. Your 15th and last patient, a 62 year old
recent widower, is particularly challenging because he has come in frequently during the
last three months, each time complaining of a new ache or pain. You have been unable
to find a physical cause for his complaints, and come to the conclusion that his
symptoms are part of his grieving process. Your offers to refer him to a support group
were rejected, and he seems to have no insight at all. Which of the following questions
represents mindfulness, and is most important to contemplate in order to make this
encounter more successful, for you and for the patient?
A. How do I feel about patients with psychosomatic illness?
B. To whom can I refer this patient?
C. How do I feel about the fact that he has rejected my efforts to help him with his real
problem, the recent loss of his wife?
D. Can I help him see that his problem - Answers -C. is correct because it explores the
clinician's own emotions at a specific point in time. Mindfulness is always a useful
strategy when you seem stuck with a patient. A (an example of self-awareness) might
also be useful since it addresses general beliefs regarding patients who suffer from
psychosomatic conditions. Options B and E may provide temporary relief, but will not
help you work with similar patients who will inevitably appear in the future (and B and E
could even diminish both your effectiveness and your well-being in the future!)
One of your colleagues made a serious mistake and administered the wrong antibiotic
to a patient. Now it is 3am and you are trying to stabilize the patient, with mixed results
so far. In the light of day you will have to talk with the family and reveal the error to
them. Which of the following questions are most important to contemplate to make that
encounter more successful, for yourself and for the patient's family?
