Table 4.

Examples of Resident Communication Cues in Case Presentations and Supervisor Reactions

Cues to which Supervisors Responded	Supervisor Response
“Yep he hated Carnation instant breakfast. I told him to put like, just make a milkshake and stuff but he couldn’t’ He didn’t like it. So he’s having pizza, hot dogs…”	Supervisor elicited: “So are you having him do extra food?”
“Mom has one concern, do we think his circumcision is done properly?... and I offered to have someone else take a look. And so that’s what Mom wanted”	“We’ll go ahead and see him.”
“We talked about mammograms not being an awesome test.”	“She’ll probably benefit from some written instructions at the next time.”
“Patient did not know if she had tetanus”	Supervisor suggests how to get the information.
Cues to which Supervisors did not Respond	Potential Supervisor Response
“No and he doesn’t seem very concerned. I mean he’s more concerned about the big picture”	Supervisor could provide skills where resident could get the patient to share ideas, concerns, expectations
“I kind of had trouble getting him to open up about his diet”	Supervisor could discuss open ended questions and ways to get more of the patient story
“I might try and give her some home videos and exercise…”	Opportunity to discuss educating the patient with chunks and checks and teach back
“And I told him he needs to talk to the urologist and oncologist. He’s just worried…”	Supervisor could address the patient worry and help the resident see how this affects the plan

^•Bold lettering delineates the potential communication issues/skills that could be addressed in response to the cues given in the resident statement