ROLE PLAY SCENARIOS
OVERCOMING BARRIERS IN THERAPEUTIC COMMUNICATION
The six interviewing techniques are reflecting, paraphrasing, clarification, asking open-ended questions, summarizing, and allowing
silences.
1. Reflecting
Reflecting is repeating what you have heard the patient say, using open-ended statements. With this technique, you do not complete
a sentence but leave it up to the patient to do so. For example, you might say, “Mrs. Rivera, you were saying that when your back
hurts you ….” Reflection encourages the patient to make further comments. It also can help bring the patient back to the subject if the
conversation begins to drift. (Reflecting is a useful tool, but be careful not to overuse it, because some patients find it annoying to
have their words constantly parroted back.)
2. Paraphrasing or Restatement
Paraphrasing or restatement means repeating what you have heard, using your own words or phrases. Paraphrasing can help verify
that you have accurately understood what was said. It also allows patients the opportunity to clarify their thoughts or statements.
Typically, a paraphrased statement begins with “You are saying that …,” or “It sounds as if …,” followed by the rephrased content.
3. Asking for Examples or Clarification
If you are confused about some of the information you have received, ask the patient to give an example of the situation being
described. For instance, “Can you describe one of these dizzy spells?” The patient’s example should help you better understand
what the patient is saying. It also may give you an insight into how the patient perceives the situation.
4. Asking Open-Ended Questions
The best way to obtain specific information is to ask open-ended questions that require the patient to formulate an answer and
elaborate on the response. Open-ended questions usually begin with what, when, or how. For example, “What medications did you
take this morning?” “When did you stop taking your medication?” “How did you get that large bruise on your arm?” Be careful about
asking “why” questions, because they can often sound judgmental or accusing. For example, asking “Why did you do that?” or “Why
didn’t you follow the directions?” may imply to patients that you have already made a negative value judgment about their behavior,
and they could become defensive and uncooperative. Instead, you might ask, “What part of the instructions did you not understand?”
or “How can we help you follow these instructions?” Avoid closed-ended questions that allow the patient to answer with one word,
such as yes or no. For example, suppose you ask the patient, “Are you taking your medications?” The patient can easily say yes but
may not be taking all of them. However, suppose you ask, “What medications do you take every day?” The patient’s answer will give
you a clearer understanding of whether the patient is taking the correct medications.
5. Summarizing
Briefly reviewing the information, you have obtained, or summarizing, gives the patient another chance to clarify statements or
correct misinformation. This technique can also help you organize complex information or events in sequential order. For example, if
the patient has been feeling dizzy and stumbling a lot, you might summarize by saying, “You told me that you have been feeling dizzy
for the past 3 days and that you frequently stumble as you are walking.”
6. Allowing Silences
Periods of silence sometimes occur during the interview. These can be beneficial. Some people are uncomfortable with prolonged
silences and feel a need to break the silence with words in an effort to jump-start a stalled conversation. Silences are natural parts of
conversations and can give patients time to formulate their thoughts, reconstruct events, evaluate their feelings, or assess what has
already been said. During moments of silence, gather your thoughts and formulate any additional questions that you may have.
Case #1: The patient was admitted 2 days ago with a diagnosis of cancer. She was informed by her doctor that a course of radiation and
chemotherapy was her best option. She became very upset and frightened about the proposed treatment and stated that she wasn't sure if
she would go through with it. The MA approaches her to discuss how she is feeling today.
Case #2:
Case #3:
The way a person perceives situations and other people is greatly influenced by cultural, social, and religious beliefs or firmly held convictions. Personal
values (principles or ideals) are commonly developed from these same beliefs. As a medical assistant, you will interact with people from varied ethnic
backgrounds and cultural origins who bring with them beliefs and values that may differ from your own.
Case #4:
The way a person perceives situations and other people is greatly influenced by cultural, social, and religious beliefs or firmly held convictions. Personal
values (principles or ideals) are commonly developed from these same beliefs. As a medical assistant, you will interact with people from varied ethnic
backgrounds and cultural origins who bring with them beliefs and values that may differ from your own.
Case scenario #5:
Case scenario #6:
Case scenario #7:
Consider the following suggestions if you must encounter an angry patient:
 Speak in a calm and even-toned voice. Make gentle eye contact.
 Direct the patient toward a solution regarding his or her problem. Specifically ask, “How may I help resolve this for
you?”
 Use reassuring statements that do not assume blame, such as “I understand you are upset. Let’s see how we can
work this out.”
 If necessary, get assistance from an office manager or physician.

It is important to document all encounters with the patient in the medical record. When documenting, provide specific
facts regarding the situation and the resolution. Never include personal opinions.