Patient Centered Skills Form (PCSF)

Resident: / Observer: / Date:

Directions:Track behaviours in the left column. Then, mark one box per row: Not observed, Attempted, Good or Excellent. Record important provider/patient comments and verbal/non-verbal cues in the notes.

Residents:Use form to enhance your learning, vocabulary, and self-awareness. Ratings can be for individual interviews or to summarize several interactions. If requested, use this form to guide verbal feedback to someone you observe.

Not Observed / Attempted / Good / Excellent / Notes
Behaviours, skill sets, and elements
Check only what you see or hear. Avoid giving benefit of the doubt.
Established rapport
Introduces self, role and nature of interview
Greets patient by name
Acknowledges all in the room by name
Demonstrates respect
Uses eye contact
Humour or non-medical interaction
Strong verbal and / or non-verbal empathy
Demonstrates mindfulness through curiosity, self-reflection or presence
Established reason for consult
Asks – “What are the issues you’d like to discuss in today’s visit?” and “is there anything else?” Until the patient states there are no other issues.
Listens to patients’ list of concerns (polite interruption = eye contact. Lean in, hand gesture, apologize, reflect, explain)
Summarizes list and confirms what is most important to patient (negotiates agenda)
Sets an agenda (negotiates agenda)
Acknowledges agenda items from other team member (e.g. nurse, MOA or EMR)
Gathering information - disease
Asks patient to tell ‘The Whole Story’
Starts with open-ended and moves to close-ended questions
Facilitates responses by using verbal, paraverbal and nonverbals, silence, repetition, paraphrasing, interpretation
Actively and attentively LISTENS without excessive interruptions, leaving patients time to think & speak
Picks up on info via patient’s non-verbal cues / behaviours
Uses summary statements (potential for ‘type & talk’)
Uses clarifying statements
Uses easily understood questions – No jargon
Establishes a timeline
Gathering information – illness experience
Explores patient feelings
Explores patient beliefs
Explores impact of illness experience on patient’s functioning
Elicits patient’s expectations for the visit
Explores contextual influences: family, cultural, spiritual
Electronic Medical Record use
Signposts and describes use of EMR to patient
Maintains eye contact with patient during majority of time while using EMR (opportunity for ‘type and talk’)
Positions monitor to be viewed by patient (or positions patient to have better access to the clinician and the monitor)
Points to screen using hand to point / not mouse or cursor
Makes organization overt
About visit organization, problem priorities, problem-solving (admits not-knowing &/or explores info with patient)
Summarizes at the end of specific lines of inquiry to confirm resident understanding
Progresses from one section to another using signposting / transition statements
Structures the interview in a logical sequence
Takes responsibility for efficient time management
Physical Exam
Prepares patient before physical exam actions anddescribes exam findings during the exam
(“I am going to ____” then “your lungs sound healthy”)
Providing the correct amount and type of information
Assesses patient’s prior knowledge (APK)
Chunks & checks information
Asks what information the patient would like to know
Saves explanation and treatment planning until the end
Aiding accurate recall
Organizes information
Categorizes information (using labels i.e. “1, 2, 3” / “a, b, c”)
Uses repetition and summarizing to reinforce information
Avoids or explains medical jargon
Uses visual aids / handouts
Uses Teachback = Asking the patient to explain his/her understanding of the plan / Explicitly Checks pt understanding
Co-creating a plan
Achieving a shared understanding
FIFE’s it back to the patient (creates connections between the patient’s illness experience and the explanation / treatment plan)
  • “So you have been concerned about . . . and these are our options . . .”

  • “You checked with Google – and were wondering whether it was . . . ”,

  • “We know that this is affecting your parenting, so . . .”,

  • or “You were hoping that we would be able to . .”)

Provides opportunities for patient to contribute his / her opinion
Responds to verbal and nonverbal signs of agreement, curiosity , engagement, disagreement, displeasure, etc
Elicits patient’s beliefs about info and plan (does the patient feel you both are “on the right track?”) (‘Scales’ confidence or importance – i.e. on a scale from 0 – 10, how confident . . . )
Shared decision making
Shares own opinion (based on evidence behind recommendations - when available)
Involves patient / makes suggestions / uses inclusive language
Offers choices
Negotiates a mutually acceptable plan
Checks with patient – if plan is acceptable / if concerns have been addressed
Closure and follow-up
Contracts with patient (Dr’s job, patient’s job, clinic’s job, etc.)
Discusses red-flags / safety nets
Summarizes the session
Final Check - Asks for questions about today’s topics (does NOT end with an open “Is there anything else you would like to discuss with the doctor, today”)