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Communication Skills Examiners Look for in Clinical Assessments |…
Communication Skills Examiners Look for in Clinical Assessments | OSCE Success
Discover the top communication skills that help you excel in clinical assessments like OSCEs and NCA. Learn how to build rapport, show empathy, explain clearly, and stay professional under pressure.
Introduction
Clinical assessments such as OSCEs, PRES, PLAB, AMC, and NCA are not just memory tests. They are designed to evaluate whether you can communicate like a safe and trustworthy doctor.
Examiners expect you to know the medical facts — but what really separates a good candidate from an outstanding one is how you interact with patients. Do you listen attentively? Do you explain clearly? Do you show empathy and respect?
In this blog, we’ll explore the communication skills examiners love to see, with real examples you can use to make your performance stand out.
1. First Impressions & Rapport-Building
The first 30 seconds of any encounter set the tone. Examiners and simulated patients immediately notice how you present yourself.
- Smile warmly and greet confidently.
- Introduce yourself clearly. “Hello, my name is Dr. Patel. I’ll be speaking with you today.”
- Use the patient’s name. “Good morning, Mr. Khan.”
- Body language matters. Avoid crossed arms or fidgeting.
Example (Good) : “Hello, Mrs. Brown, my name is Dr. Singh. I’ll be asking you a few questions today about your health. How are you feeling right now?”
Example (Poor) : “So, what’s the problem?” (no greeting, no name, no introduction).
Examiners love candidates who establish trust quickly and make the patient feel respected.
2. Active Listening: More Than a Checklist
History-taking isn’t about racing through questions — it’s about hearing what the patient is really saying.
Techniques :
- Use encouragers: “I see,” “Please go on.”
- Paraphrase: “So the pain started yesterday and has been constant since?”
- Allow silence.
- Respond to emotions.
Example : Patient: “The chest pain comes and goes, but last night it was really bad.”
Candidate: “So it’s been coming and going, but it was particularly severe last night — that sounds concerning.”
This shows you’re not only collecting facts but also acknowledging the patient’s experience.
3. Empathy: The Golden Thread
Empathy earns marks because it reflects genuine patient care. It’s about acknowledging emotions, not just delivering facts.
- “That must have been difficult for you.”
- “I can understand why you’d be worried.”
- “It doesn’t seem urgent, but I’ll make sure we check carefully.”
Example : Patient: “I’m worried this lump might be cancer.”
Candidate: “I can see why that would make you anxious. Let’s talk through what we can do to investigate this further.”
Examiners love to see candidates who balance professionalism with humanity.
4. Explaining Clearly Without Jargon
Patients shouldn’t feel like they need a medical degree to understand you. Examiners reward those who simplify without patronizing.
Tips :
- Use analogies: “Think of cholesterol like fat blocking a pipe.”
- Short sentences.
- Teach-back: “Could you explain back what you’ve understood, just so I’m sure I was clear?”
Bad example : “Your ECG shows supraventricular tachycardia due to an aberrant conduction pathway.”
Good example : “Your heart is beating faster than normal because of an extra electrical pathway. It’s treatable and not uncommon.”
Clear, jargon-free explanations prove you’re safe and patient-centered.
5. Structure and Flow
A scattered consultation makes you look unprepared. Examiners love logical flow.
History-taking flow :
- Open question
- Symptom timeline
- Systems review
- Past/family history
- ICE (Ideas, Concerns, Expectations).
Counseling flow :
- Start with what the patient knows
- Add information
- Risks/benefits
- Summarize
Example : Patient: “I have headaches every week.”
Candidate: “I’d like to ask a few questions about your headaches, then we’ll cover your past medical history, and finally we’ll discuss what you think might be causing them.”
This structure reassures examiners that you’re methodical and safe.
6. Shared Decision-Making
Examiners value patient-centered care. Instead of telling patients what to do, involve them in decisions.
- Present options: “There are two approaches — lifestyle changes or starting medication.”
- Respect autonomy: “I’d recommend medication, but I want to hear what feels right for you.”
- Summarize together: “So we’ll try lifestyle changes first and review in three months — does that work for you?”
Example : Patient: “Do I really need tablets?”
Candidate: “Not necessarily — we can start with changes in diet and exercise. Tablets are an option if that doesn’t help. Which would you prefer to try first?”
Shared decision-making shows maturity and respect.
7. Handling Difficult Conversations
Clinical exams often test your ability to stay calm in challenging scenarios.
Breaking Bad News (SPIKES) :
- “I’m afraid the results show that the lump is cancerous. I know this is difficult news. Let’s take a moment, then I’ll explain the next steps and support available.”
Angry Patient :
- “I can see you’re upset, and I want to understand what happened so we can sort it out together.”
Unrealistic Expectations :
- “I understand you’d like antibiotics, but in this case, they wouldn’t help. Let me explain why and what else we can do.”
Examiners reward calmness, empathy, and structure in these moments.
8. Non-Verbal Communication
Your body often speaks louder than your words.
- Sit at the patient’s level.
- Maintain natural eye contact.
- Keep hands open, avoid folding arms.
- Mirror posture subtly.
Contrast : Sitting back with arms crossed, staring at the checklist.
Leaning forward slightly, nodding, maintaining soft eye contact.
Examiners often mark candidates down for poor non-verbal cues, even when the content is correct.
9. Time Management in Stations
OSCEs and NCA stations are time-limited. Examiners admire candidates who prioritize well.
- Focus on essentials first.
- Keep an eye on time.
- Summarize if running short: “We’re nearly out of time, but I’d like to quickly check a few important points.”
Example : Instead of spending 6 minutes on the patient’s lifestyle, cover it briefly and move to management so you finish safely.
10. Professionalism Always
Professionalism is scored throughout every station.
- Respectful language, no slang.
- Confidentiality: “This stays between us.”
- Always seek consent.
- Stay neutral, especially with lifestyle questions.
Contrast : “You smoke 20 a day? That’s terrible.”
“I understand smoking is part of your routine. Would you be open to discussing ways to reduce the risks?”
These small touches signal maturity and safety.
11. Reflection and Closing the Loop
A strong closing demonstrates completeness.
- Summarize: “So today we discussed your chest pain and planned tests.”
- Invite questions: “Is there anything you’d like me to go over again?”
- End positively: “We’ll work through this step by step together.”
Example : Instead of: “That’s all, thanks.”
Say: “Thank you for sharing this with me. I’ll make sure you get the tests we discussed, and we’ll review the results together soon.”
Examiners love candidates who don’t leave patients hanging but provide reassurance at the end.
12. The Examiner’s Perspective
Examiners aren’t just ticking boxes. They’re asking:
- Would I trust this doctor with my patients?
- Does this candidate communicate clearly and respectfully?
- Would I feel safe if my family member saw this doctor?
Every smile, empathetic phrase, and clear explanation pushes the examiner toward “yes.”
Practical Tips to Sharpen Communication
- Roleplay with peers or mentors regularly.
- Record yourself to spot filler words or awkward body language.
- Use checklists for structured stations.
- Practice under timed conditions.
- Seek feedback from seniors or colleagues — what felt genuine, what felt rushed?
Conclusion
Clinical assessments are not only about testing knowledge — they’re about testing the doctor within you.
From making a great first impression to closing the loop, every interaction demonstrates whether you can balance science with humanity. Examiners love to see candidates who combine clarity, empathy, professionalism, and structure.
So as you prepare, remember this simple formula :
- Connect like a human.
- Explain like a teacher.
- Decide like a partner.
- Care like a doctor.
That’s the communication examiners love to see.