| At the meeting | - Similar to silencing pagers and cell phones, mute/defer notifications on your computer and arrange so that you are not intruded upon during the appointment.
- During the introduction, describe your setting and members present. If on video, describe what you see and inquire about who may be present or listening to the discussion.
| - "Hello, I am Dr X. I am calling from my office to discuss the results of your biopsy. I see that you are in your living room and sitting down. Can you see/hear me clearly? Do you have time to discuss your test results now? Who is there with you? Is there anybody else present and able to hear our discussion?"
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| Perception, invitation, knowledge | - Disciplined use of communication skills, such as signposting or teach-back, can help to overcome the shortcomings of remote conversations.
- Anticipate delayed audio transmission by using short sentences and allowing longer-than-usual pauses after statements to give time for patients to ask questions.
- If videoconferencing, have the camera at eye level or slightly above. Have a simple backdrop behind you to minimize distractions.
| - "I am going to tell you the results of your biopsy/the treatment options for your cancer. I will be asking you questions often to ensure that you can hear me clearly and understand what I am saying. Please let me know if you have any questions at any time."
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| Empathy | - With telemedicine, displaying empathy can be difficult, but not impossible. Sometimes a prolonged silence can take the place of offering a tissue or an understanding touch that would be used in real life.
| - "I understand that this is difficult news to hear, especially over the phone/by video."
- "I can hear that you are upset. Please share your thoughts with me."
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| Summary | - Plan for follow-up by addressing the setting where the next meeting would be. Deliver handouts through mail or electronic transfer.
| - "Do you have any further questions? I will schedule a follow-up telephone/videoconference/in-person meeting in 2 weeks. I would like to share some handouts with you. Do you have any objections with us sending this to your e-mail address?"
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