TABLE V.

Sample prompts and questions for clinical practice to address and assess disease-based clinical competency: a nonexhaustive, noncomprehensive list of sample prompts and questions that can be used in a clinical setting with patients

Racism/bias	(Opening statement) I would like to ask you some questions that will help me to get a sense of your life outside of the hospital/clinic.64 How often, if ever, have you ever experienced discrimination, been prevented from doing something, or made to feel inferior while receiving care because of your race, ethnicity, or skin color? In terms of race and ethnicity, how do you identify? How often, if ever, have you felt that you were treated unfairly or received substandard care because of your race, gender, sexual orientation, or disability?
Economic context	Since your last visit, have you been unable to take or start medications because you were unable to afford the cost? Have you had issues finding and affording allergen-free products (eg, food, formula)? Do you ever have difficulty making ends meet at the end of the month? In the last year, has there been any time where you were without medical insurance?
Social context	Sometimes, words in English that we use in the medical field are difficult to understand even for native English speakers. Would you mind if I use a translator to ensure we prevent anything from being lost in translation? You seem hesitant about our plan for your treatment, what concerns do you have about what we have discussed so far? I know that sometimes it can be confusing and/or overwhelming to come to the doctor’s office. We’ve gone over a lot of information, is there anything that I can help explain or communicate more clearly before we finish our visit today? Can you tell me, in your own words, what you think was the most important information you learned from this visit today? I recognize that it can be difficult or expensive for some patients to come to my clinic. I’ve noticed that you arrived late the past few visits. Are there any barriers that make it difficult for you to get here (like cost of transportation or arranging for childcare)? (Follow-Up Question) Is there anything that I can do to help make it easier for you to connect with our medical team? How confident are you in filling out medical forms by yourself?65,66
Environmental impact	It’s important for me to know about your home environment and how it might impact your health. Have you noticed any regular and/or recurring issues with mice, visible mold, cockroaches, or other infestations in the place where you live, work, or spend the majority of your time? Do you feel safe where you live? Is the area where you work, live, or spend a lot of time close to buildings and structures where you (or your child) might be exposed to pollutants (eg, an interstate/highway, power plant, industrial plant, or other similar places)? In the last few months, have you had significant worries or concerns about having a safe and stable place where you own, rent, or stay? (Follow-Up Question) Do you know what housing resources are available to you if you feel unsafe?