ESPS SP Checklists

Extended Standardized Patient Scenario

ELAINE STUART
Standardized Patient Checklist -Visit #7: 6/12/98
(Enrolled in Hospice, Progressive Symptoms)

Communication Scale Responses	strongly agree	agree	do not agree or disagree	disagree	strongly disagree
1. The physician spoke to me in a direct manner concerning my condition.
2. The physician demonstrated sensitivity about my fears and anxiety at hearing this news.
3. The physician behaved warmly, but professionally throughout the encounter
4. Used words I could understand when discussing my problem.
5. Treated me like I was on the same level, did not talk down to me, or treated me like a child.
6. Encouraged me to ask questions.
7. The physician utilized space well (e.g., maintained a comfortable distance, shoulders at equal level, etc.).
8. The physician was sitting down or standing, attending appropriate distance when we talked.
9. The physician appeared comfortable conducting the interview.
10. The physician maintained appropriate eye contact throughout the interview.
11. The physician seemed genuinely interested as expressed by facial expressions and body posture.
12. I was allowed to "tell my story" without interruption.

Communication Responses	yes	no
1. I was asked how I've been feeling.
2. The resident asked me to elaborate on my medication schedule.
3.I told the resident that I take morphine.
4.I told the resident that the morphine relieves the pain somewhat.
5. I told the resident that the pain is the worst before I take the morphine (9 out of 10).
6. I told the resident that the pain is 4 out of 10 after I take the morphine.
7. I was asked about my bowel movements.
8. I was asked about nausea and vomiting.
9. A rectal exam was performed.
10. The resident recommended an immediate enema or suppository.
11. The resident recommended a long-term treatment schedule using a laxative and stool softener.
12. I was asked about the physical support I was receiving.
13. I was asked about the social support I was receiving.
14. I was asked if counseling has been helpful.
15. I was asked if I had spiritual support.
16. I was asked if I would like to discuss other end of life concerns.
17. I was reassured that my pain can largely be controlled.
18. I was reassured regarding the problems with my bowels.
19.I was told that morphine needs to be given around the clock to control the pain.
20. I was told that long-acting morphine would be best in my situation.
21. Our discussion was summarized.
22. I was asked if I had any more questions.
23. I was reassured about my concerns.
24. An appropriate, polite closure ended the visit.