As Communicators, physicians form relationships with patients and their families* that facilitate the gathering and sharing of essential information for effective health care.†
Physicians enable patient-centred therapeutic communication by exploring the patient’s symptoms, which may be suggestive of disease, and by actively listening to the patient’s experience of his or her illness. Physicians explore the patient’s perspective, including his or her fears, ideas about the illness, feelings about the impact of the illness, and expectations of health care and health care professionals. The physician integrates this knowledge with an understanding of the patient’s context, including socio-economic status, medical history, family history, stage of life, living situation, work or school setting, and other relevant psychological and social issues. Central to a patient-centred approach is shared decision-making: finding common ground with the patient in developing a plan to address his or her medical problems and health goals in a manner that reflects the patient’s needs, values, and preferences. This plan should be informed by evidence and guidelines.
Because illness affects not only patients but also their families, physicians must be able to communicate effectively with everyone involved in the patient’s care.
- Accuracy: 2.1, 3.1, 4.2, 5.1
- Active listening: 1.1, 1.3, 1.4, 1.5, 2.1, 2.2, 2.3, 4.1, 4.3
- Appropriate documentation: 2.1, 5.1, 5.2, 5.3
- Attention to the psychosocial aspects of illness: 1.6, 2.1, 2.2, 4.1
- Breaking bad news: 1.5, 3.1
- Concordance of goals and expectations: 1.6, 2.2, 3.1, 4.3
- Disclosure of harmful patient safety incidents: 3.2
- Effective oral and written information for patient care across different media: 5.1, 5.2, 5.3
- Efficiency: 2.3, 4.2, 5.2
- Eliciting and synthesizing information for patient care: 2.1, 2.2, 2.3
- Empathy: 1.1, 1.2, 1.3
- Ethics in the physician–patient encounter: 3.2, 5.1
- Expert verbal and non-verbal communication: 1.1, 1.4
- Informed consent: 2.2
- Mutual understanding: 1.6, 3.1, 4.1
- Patient-centred approach to communication: 1.1, 1.6, 2.1, 3.1
- Privacy and confidentiality: 1.2, 5.1
- Rapport: 1.4
- Relational competence in interactions: 1.5
- Respect for diversity: 1.1, 1.6, 2.2, 4.1
- Shared decision-making: 1.6, 4.1, 4.3
- Therapeutic relationships with patients and their families: 1.2, 1.3, 1.4, 1.5, 1.6
- Transition in care: 5.1, 5.2, 5.3
- Trust in the physician–patient relationship: 1.1, 5.2, 5.3
|Key competencies||Enabling competencies|
|Physicians are able to:|
* Throughout the CanMEDS 2015 Framework and Milestones Guide, references to the patient’s family are intended to include all those who are personally significant to the patient and are concerned with his or her care, including, according to the patient’s circumstances, family members, partners, caregivers, legal guardian, and substitute decision-makers.
† Note that the Communicator Role describes the abilities related to a physician–patient encounter. Other communication skills are found elsewhere in the framework, including health care team communication (Collaborator) and academic presentations (Scholar).