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Clinical Communication Development Report: Dr. Emily Carter
A comprehensive assessment of communication strengths and development opportunities for enhanced patient-centered care

Week of September 22 - 28. 22 Patient Visits. 15 Complex Patients.
Executive Summary
Overall Performance: Warm, patient-centered communicator who explains clearly and listens well.
Key Strengths: Consistently builds rapport/empathy and uses clear, jargon-free explanations with effective summaries.
Priority Development: Early, collaborative agenda setting and stronger co-creation/closure (teach-back + AVS) to ensure shared decisions and patient understanding; more consistent exam/vitals consent and findings communication.
Context: Cases span chronic disease follow-up, vaccine counseling, hypertension, depression/anxiety, and acute back pain—often with education and behavior change needs.
Strengths
What you're doing well consistently across visits
Supporting Evidence:
  • "Think of them like a training exercise for her body." (Vaccines) (T27 01:58)
  • "You're a 45-year-old accountant with three weeks of constant lower-back ache… Is that about right?" (T39 04:35)
Focus Areas for Growth
Agenda Setting
Start visits with collaborative agenda sweep: "What brings you in today?" followed by "What else?" and "What's most important to you?"
Decision Making
Present options with pros/cons, ask for patient ideas/hopes, and create shared decisions rather than single-path plans
Exam Communication
Ask permission before exams/vitals, narrate findings immediately, and distinguish between exam results vs. lab results
Closure & Teach-back
Use "scribe-back" method: have patients recount the plan while you document, co-create AVS together
Deep Dive:
Note on Recognizing Patient Cues
Probe vague statements about adherence, side effects, or stress before moving on to ensure complete understanding and address underlying concerns.
Supporting Evidence
  • Late/limited agenda setting: "My goal today is to…" (T26 01:30; T28 01:39) and "Is there anything else…?" at end (T26 11:00)
  • Single-path plans: "Let's stick with this plan." (T26 10:34)
  • Consent/finding gaps: "Let's get that blood pressure reading now" (no permission) (T30 09:07); then "your blood pressure today is a little higher…" (T30 09:25)
PCOF Performance Snapshot
Complex Case Performance
Key Elements for Complex Cases:
Agenda Setting with Patient Input
Ensuring the patient's priorities and concerns are at the forefront of the discussion.
Team Integration
Seamlessly bringing together different healthcare professionals for comprehensive care.
Skillful Listening
Attentively processing multiple issues and subtle cues from the patient.
Transparent Problem-Solving
Openly discussing challenges and developing clear, actionable solutions.
Appropriate Empathy
Connecting with the patient's emotional state and providing compassionate support.
Your Pattern with Complex Cases:
Strength: Consistent Support
Your transparent problem-solving and empathic listening are consistent and highly effective. For example, in a discussion about depression, you responded with:
"That's a lot to carry…" (T29 05:22)
and provided a clear, stepwise plan with contingencies for back pain (T39 08:35).
Growth Opportunity: Prioritization & Teach-Back
There's an opportunity for upfront prioritization and end-of-visit teach-back, especially when multiple action items are assigned. For instance, an anxiety plan had many steps but lacked a teach-back to ensure understanding (T40 11:00–12:15).
Team Utilization: Strategic Collaboration
You effectively utilize the team when case complexity increases. Examples include involving the nurse for vaccines (T27 07:40), the MA to teach home BP monitoring (T28 10:44), and the front desk for follow-up scheduling (T39 10:45).
Note: Team makeup aligns well; add "scribe-back" with AVS creation to optimize shared understanding across conditions.
Next Steps
01
Immediate Focus
Start every visit with a 60–90 second agenda sweep and end with a 60-second teach-back "scribe-back."
02
Practice Opportunity
Use these in your next 10 routine follow-ups (HTN, diabetes, mood/anxiety). Add explicit exam/vitals consent in those visits.
03
Success Indicator
  • Fewer "by-the-way" concerns at the end; patient names top priorities early.
  • Patients can accurately recount the plan while you type.
  • Documented exam/vitals permissions and immediate findings statements appear regularly in your notes.