How to Ace Relating to Others Domain of the MRCGP SCA Exam
This domain is tested throughout the entire SCA consultation. To excel in the Relating to Others domain of the MRCGP SCA exam, you must demonstrate empathy, cultural sensitivity, and person-centred communication. You must also respect patient autonomy and work collaboratively with patients and colleagues.
Ethical Awareness and Cultural Sensitivity
Strategy: Recognize and respect cultural and personal differences while making non-judgmental decisions in the patient’s best interest. Be aware of ethical concepts like informed consent and mental capacity.
Tip: Always check the patient’s understanding and preferences, adapting your communication to their needs and values.
Example:
- “Thank you for telling me that, Nadia. I know you have told me in your culture, this issue is sensitive. Can you share your thoughts with me about your treatment.
- “I want to ensure you fully understand the available treatment options. Do any of these options conflict with your beliefs Nadia?”
- “It’s important that you feel comfortable with the plan. Is there anything you’d like me to clarify or adjust to fit your needs?”
Person-Centred Communication
Strategy: Actively listen, explore the patient’s ideas, concerns, and expectations (ICE), and respond to verbal and non-verbal cues. Tailor your communication style to suit the individual patient.
Tip: Use precise language, avoid jargon, and check for understanding throughout the consultation.
Example:
- “Thank you for coming in. Can you explain what’s been going on in your own words?”
- “I want to make sure I understand—do you think this might be related to something specific, or has anything like this happened before?”
- “I hear this is worrying you. Let’s talk about your main concerns and what you’re hoping we can address today.”
Shared Decision-Making and Respecting Autonomy
Strategy: Involve the patient in the decision-making process, respecting their autonomy while guiding them to make informed choices about their care.
Tip: Work collaboratively with the patient, discussing their options, preferences, and any concerns they may have.
Example:
- “We’ve discussed a few treatment options for your condition. It’s essential that we decide together on a plan that suits you best. How do you feel about the choices we’ve talked about so far, Khalid?
- “I’ll guide you through the pros and cons of each option, but ultimately, the decision is yours, Khalid. Is there a particular option that you prefer or are concerned about?”
- “Let’s make sure we choose something that aligns with your preferences and fits your lifestyle, Khalid.”
Showing Empathy and Compassion
Strategy: Demonstrate genuine empathy by acknowledging the emotional impact of the patient’s situation and offering reassurance and emotional support.
Tip: To show that you care, use empathetic body language, maintain eye contact, and provide verbal reassurance.
Example:
- “I can see this has been really tough for you. It’s okay to feel overwhelmed, and we’re here to support you through this.”
- “I can see that this has been really difficult for you, and it’s completely understandable to feel overwhelmed by everything you’ve been dealing with.”
- “You’re not alone in this; I’m here to help you through it. We’ll work together to find a solution that makes things a little easier for you.”
- “It’s okay to feel the way you do. Let’s take things step by step, and I’ll be with you throughout the process.”
Collaborating with Colleagues and Coordinating Care
Strategy: Collaborate with colleagues and other services to ensure the patient’s care is well-coordinated. Respect the roles and opinions of other team members.
Tip: Engage with multidisciplinary teams when necessary and refer appropriately while maintaining continuity of care.
Example:
- “Given your arthritis and weight issue, I believe it would be beneficial to involve a few other healthcare professionals to provide you with the best care. I’ll refer you to a physiotherapist and a dietitian who can help manage your symptoms and improve your overall well-being.”
- “I’ll share your treatment plan with them to ensure we’re all on the same page, and we’ll keep in touch to coordinate your care. I’ll continue to be your main point of contact, so if anything changes, just let me know.”
Holistic Approach to Care
Strategy: Address not just the medical aspects of the patient’s condition but also consider its impact on their family, social circumstances, and emotional well-being.
Tip: Use a holistic approach, recognising the broader context of the patient’s life, and incorporate this into their care plan.
Example:
- “I understand that your back pain affects more than just your physical health. How has it impacted your work, daily activities, and family life, Philip?”
- “It’s important that we address not only the pain but also how it’s affecting your mood and relationships. Would you like some support with managing stress or coping with these challenges at home?”
- “It sounds like the breathlessness is not only physically exhausting but is also affecting your mood. Have you noticed it causing stress or anxiety, especially when managing things at work or home?”
- “Let’s create a plan that helps you manage the pain while also ensuring you have the support you need at work and home.”
Conclusion:
The Relating to Others domain focuses on patient-centred communication, cultural sensitivity, empathy, and collaboration. Respect patient autonomy while providing ethical, non-judgmental care. Adapt your approach to meet individual patient needs and work closely with colleagues to ensure holistic and coordinated care.
Dr Sakaria Farah
PassCME SCA Tutor
