In the Australian GP context, effective verbal and written communication skills, patient-centred consultation approaches, and adaptability in consultations are fundamental for delivering high-quality care. GPs must navigate diverse sociocultural landscapes, rural challenges, and the unique health perspectives of Aboriginal and Torres Strait Islander peoples. This guide outlines the key criteria for excellence in communication and consultation, aligned with the standards of the GP Institute.

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Core Criteria for Communication Skills

Patient-Centred Communication

1. Contextually Appropriate Communication
   • Adapt language and communication style to match the patient’s sociocultural background, health literacy, and preferences.
   • Address occupational factors influencing the patient’s condition, especially in rural or remote areas where specific roles may have unique health implications.
2. Engagement with Patients
   • Gather comprehensive information about symptoms, ideas, concerns, and expectations (ICE), as highlighted by the GP Institute.
   • Understand the broader impact of the patient’s health issues on their daily life, fostering empathy and respect.
3. Effective Communication Techniques
   • Use clear, concise, and jargon-free language. Provide explanations that align with the patient’s understanding.
   • Apply tools such as diagrams, written materials, or digital aids to support communication.
4. Adaptation to Patient Needs
   • Use varied techniques to motivate health behaviours, including collaborative goal setting.
   • Tailor communication strategies to build rapport, particularly in challenging scenarios, such as delivering bad news or de-escalating conflict.
5. Active Listening
   • Demonstrate attentive listening without interruptions.
   • Periodically summarise patient statements to confirm understanding.

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Consultation Skills for Australian GPs

1. Adapting to Patient Needs
   • Flexibility in timing and structure of consultations, particularly for patients presenting complex or multiple issues.
   • Accommodate the inclusion of family members or carers when necessary, fostering collaborative decision-making.
2. Focused Consultation Structure
   • Balance the patient’s agenda with medical priorities to ensure optimal care delivery within standard consultation time frames.
3. Safety-Netting and Follow-Up
   • Provide clear, culturally sensitive follow-up instructions, including signs of deterioration and when to seek further care.
   • Address barriers to accessing care, such as logistical issues in rural areas or cultural misunderstandings for Aboriginal and Torres Strait Islander patients.

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Performance Standards for Fellowship-Level Competence

To consistently perform at a fellowship standard, GPs must:

• Show empathy and respect, considering both verbal and non-verbal cues during interactions.
• Explain diagnoses and treatment options in manageable “chunks,” ensuring the patient understands each step.
• Balance open and closed questioning techniques to thoroughly explore concerns while maintaining focus.

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Special Contexts

Aboriginal and Torres Strait Islander Health

• Use culturally safe communication methods, incorporating Indigenous perspectives on health and wellbeing.
• Address barriers to effective therapeutic relationships, such as mistrust of healthcare systems.
• Provide holistic care that respects cultural beliefs and practices.

Rural and Remote Health

• Adapt to the unique communication demands of remote practice, such as using telehealth tools or navigating limited local resources.
• Ensure effective strategies for long-distance collaboration with other health professionals.

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Practical Applications

Example 1: Managing ICE

In consultations, use the ICE framework to understand a patient’s unique perspective:

• Ideas: “What do you think might be causing your symptoms?”
• Concerns: “Is there something specific worrying you about this condition?”
• Expectations: “What were you hoping I could do for you today?”

Refer to GP Institute’s detailed ICE resources for additional guidance on integrating this into daily practice.

Example 2: Breaking Bad News

Employ frameworks like SPIKES for difficult conversations, ensuring the patient feels supported throughout.

Example 3: Rural Contexts

Use clear communication plans and infrastructure to accommodate the challenges of remote practice. For example, setting up telehealth check-ins for follow-up care.

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Conclusion

Achieving excellence in communication and consultation requires both technical and interpersonal mastery. The GP Institute provides a wealth of resources for Australian GPs to enhance these skills and deliver truly patient-centred care in diverse clinical contexts. By focusing on active listening, cultural sensitivity, and adaptive communication, GPs can meet the unique challenges of general practice in Australia.