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21 phrases to de-escalate difficult conversations in MRCS part B

Being a surgeon brings a lot of difficult conversations into our day and part B of the MRCS exam tests our ability to have these conversations. In your MRCS exams, you will have multiple stations to demonstrate your conversational skills in different scenarios that are put across to you. Often, the situation may be that of an angry or upset patient along with members present with them and it is extremely important to handle them in the right way to be able to achieve a good outcome and pass the station.

In scenarios that involve difficult conversations, we need to demonstrate our desire to listen to the concerns the patient seems to be having. We give them space to express all that they wish to, by acknowledging them with the right phrases and encouraging them to proceed. The conversation would usually end with a proposal to find a solution and help the patient feel better.

Some phrases that you can use to let the patient know that you are here to listen are:

• “Tell me more”

• “I understand”

• “Please continue. ”

• “I am here to listen. ”

• “Would you tell me more about that? ”

• “Tell me why that is important to you. ”

• “Is there anything else you would like me to know? ”

Making sure that you acknowledge what they say and understand everything is the next aim of the conversation. Some phrases to express this could be:

• “This is what I have heard you say so far.”

• “I appreciate you sharing this with me.”

• “I can see how much this has upset you.”

• “That is a difficult situation to be in”

• “That’s upsetting to hear.”

• “I am very sorry you are upset by what has happened.”

• “I am very sorry that this has been your experience.”

• “I’m sorry you are going through this.”

Once you have listened to and understood the reasons for the patients’ difficulties or anger, these are phrases that can be used to offer a solution and escalate it to a suitable authority if needed.

• “I am very sorry to interrupt but I want to make sure I understand everything before it is time to go.”

• “Let me think about what you have said and get back to you.”

• “I am grateful for your feedback, But it may take some time to resolve your situation.”

• “I have never thought of it that way. Let me talk to the team and see what they think.”

• “I may not be the best person to address your concerns. But let me find out who it is.”

As you begin to practice your conversation stations, it becomes increasingly common to use the phrases ‘I understand’ and ‘I am sorry’ but often, these are not enough to convey the right emotions and this list of phrases should give you an idea of a way to express your intentions better. This is not a hard list though and can be modified according to your comfort of speech as well as the situation. However, do remember that the most important thing in preparing yourself for this part of the examination is to practice, practice, and practice. We at StudyMEDIC, regularly hold mock sessions to help future members of the Royal College practice these skills so that you are your most confident selves on the exam day.