LESSON 2.4: The Art of Explaining to Patients
The Art of Explaining to Patients
Clear, patient-centred explanation is one of the highest-scoring skills in the SCA. It is tested in almost every case. A strong explanation demonstrates clinical knowledge (Domain 2), shows you understood the patient’s concerns (Domain 3), and proves you gathered the right information (Domain 1).
Principle 1: Know Your Audience
Assess health literacy: A nurse will understand differently from a retired builder. Adjust your language.
Check existing knowledge: “What do you already know about [condition]?”
Read the emotional state: A terrified patient needs reassurance before information.
Respect their experience: “You’ve been managing this for a long time — tell me what you already know.”
Principle 2: Use Simple Language and Analogies
✅ GOOD EXAMPLE: “Think of insulin like a key that opens the doors of your cells to let sugar in for energy. In diabetes, that key stops working properly.”
✅ GOOD EXAMPLE: “Your airways are like small tubes. In asthma, the lining gets inflamed and swollen, making them narrower. The inhaler reduces that swelling.”
❌ BAD EXAMPLE: “Your HbA1c is elevated at 58, indicative of a glycaemic range consistent with Type 2 diabetes mellitus.” — Technically accurate, completely unhelpful.
Principle 3: The WHAT-WHY-HOW-NEXT Framework
WHAT: What is the condition or issue, in plain terms?
WHY: Why does it matter? What are the implications if untreated?
HOW: How are we going to manage it? Medication, lifestyle, referral?
NEXT STEPS: What happens from here? Follow-up, tests, monitoring?
WHAT-WHY-HOW-NEXT IN ACTION WHAT: Your blood tests show that your blood sugar levels are higher than they should be. This means you have Type 2 diabetes. WHY: It’s important we manage this because over time, high blood sugar can affect your heart, kidneys, eyes, and nerves. But the good news is that most people live well with diabetes. HOW: We’ll start with diet and activity changes, and I’d recommend starting metformin, which helps your body use sugar more effectively. NEXT: I’d like to see you in about 4 weeks to check how you’re getting on, and we’ll arrange blood tests. I’ll also refer you to our diabetes education programme.
Principle 4: Chunk-and-Check
Give one concept
Pause: “Does that make sense so far?”
Respond to questions or concerns
Move to the next concept
Principle 5: Use Evidence to Build Confidence
“The current guidelines recommend this as the first-line treatment because it has the best evidence.”
“Research shows that this combination is the most effective approach.”
“This screening is recommended every 2 years for your age group, based on the latest evidence.”
Principle 6: Empower, Don’t Lecture
Offer choices: “There are a couple of approaches — let me explain them and you can tell me what you think.”
Validate their role: “You know your body best.”
Offer resources: “I’ll send you a link to a reliable website.”
Principle 7: Emotional Intelligence During Explanations
“I can see this is a lot to take in. Would you like to take a moment?”
“I notice you look a bit worried. What’s going through your mind right now?”
TEMPLATE: Greet → Empathise → Assess understanding → WHAT-WHY-HOW-NEXT → Chunk-and-check → Empower → Support → Close
⭐ KEY POINT: Practise explaining the 10 most common GP conditions (diabetes, hypertension, asthma, COPD, depression, anxiety, eczema, UTI, back pain, raised cholesterol) using WHAT-WHY-HOW-NEXT in under 90 seconds each. Previous Next