Communication in the Consultation

Communication lies at the heart of general practice. It is not merely the transmission of information but the foundation of clinical reasoning, relationship-building, and shared decision-making. In a healthcare environment that is increasingly diverse, complex, and digitally enabled, the ability to communicate effectively and empathetically is more critical than ever.

Effective communication in general practice extends far beyond delivering information. It encompasses listening actively, managing uncertainty, responding to emotion, and tailoring conversations to the patient’s values, culture, level of health literacy, and social context.

The general practice consultation is unique. It is brief, multifaceted, and often unfolds within long-term therapeutic relationships. Unlike in many other clinical settings, GPs are frequently tasked not only with identifying illness but also with confidently excluding disease and managing undifferentiated symptoms. The ability to hold clinical uncertainty, support self-care, and guide patients over time is central to the GP’s role and it all depends on skilled communication.

• CC1.    Practice active listening and validate patient concerns to ensure they feel heard and understood, particularly in complex or emotionally charged situations.
• CC2.    Build interpersonal rapport and continuity of care to foster a trusting and positive doctor-patient relationship. 
• CC3.    Tailor communication to a patient’s values, health literacy, cultural background, and social context, ensuring a collaborative and inclusive approach. 
• CC4: Adapt communication and consultation skills, to individual patient needs while maintaining professionalism, ethical standards, and cultural sensitivity.
• CC5: Develop skills in shared decision-making by presenting evidence-based options in an understandable way, supporting informed patient choices.
• CC6: Identify and address the "hidden agenda" within consultations by applying the biopsychosocial model and recognizing the emotional factors influencing patient behaviour.
• CC7: Apply de-escalation techniques and conflict resolution strategies in challenging consultations to maintain a calm and constructive atmosphere.
• CC8: Manage personal emotions to maintain a professional and effective doctor-patient relationship during the consultation.
• CC9: Recognize the role of a patient’s wider support network (e.g., family and friends) and balance patient autonomy with appropriate involvement of others in care decisions.
• CC10: Demonstrate the ability to conduct effective, patient-centred telemedicine consultations by adapting communication techniques to the virtual environment, ensuring confidentiality, professionalism, and equitable access while recognising the limitations and ethical considerations of remote care.
• CC11: Communicate effectively in multidisciplinary teams and during transitions of care (e.g., hospital discharge, referrals), ensuring continuity and clarity.
• CC12: Demonstrate an understanding of recognised consultation models in primary care and reflect on how they can be used to structure effective, patient-centred consultations.
• CC13: Commit to self-reflection through tools such as video consultation reviews and reflective logs to identify and address personal biases, communication gaps, and areas for improvement.
• CC14: Address discrimination and challenge harmful behaviours, fostering a respectful, inclusive, and culturally competent healthcare environment.
• CC15: Demonstrate an understanding of the legal requirements for report writing and providing expert witness testimony in court, ensuring accuracy, objectivity, and adherence to professional and ethical standards.
• CC16: Demonstrate the ability to effectively use interpreters and language translation applications to facilitate accurate, respectful, and person-centred communication with patients who do not share a common language, ensuring that clinical information is clearly understood and culturally appropriate care is provided.
• CC17: Develop skills in effective communication of risk probability, diagnostic uncertainty, prognosis and watchful waiting – in such a way that is accessible, understandable and tailored to the patient’s health literacy
• CC18: Demonstrate effective time management in the consultation by judicious use of effective communication skills including appropriate structure, agenda setting, use of questioning styles, reflective listening , signposting and summary.

Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

Self-Directed

Blended Learning Resources (Education Platform)

Useful Websites:

HSE Healthcare Communication

EACH International

HSE Social Inclusion - Emaspeaking

Workplace Based Learning

Communication skills in general practice are best developed through authentic, workplace-based learning, where the complexity and nuance of real patient encounters provide rich opportunities for growth. Unlike simulated settings, the clinical environment exposes learners to a diverse range of consultations - from routine reviews to emotionally charged or ethically complex interactions - each requiring adaptive communication strategies. Learning occurs through observation of experienced clinicians, direct patient care, feedback from supervisors and colleagues, and structured reflection on one’s own performance. Tools such as video consultations, consultation analysis and patient feedback support deliberate practice and highlight areas for improvement. Over time, repeated exposure, critical self-awareness, and tailored feedback help learners move beyond scripted techniques toward genuinely person-centred, responsive, and professional communication that meets the needs of patients and the wider healthcare team.

Day Release

Day release teaching offers a structured and supportive environment for GP trainees to develop and refine their communication skills. These sessions provide a valuable opportunity to step back from clinical work and engage in focused discussions on the theory and practice of communication. Trainees explore a range of consultation models; such as the Calgary-Cambridge guide, Pendleton’s model, and the Stott and Davis model - comparing their structures, strengths, and relevance to real-world practice. These frameworks help trainees understand how to structure consultations, manage agendas, and incorporate patient-centred care effectively. A key component of day release teaching is the use of video-recorded consultations, which enable trainees to critically analyse their own consultations and reflect on their communication style, use of language, non-verbal cues, and responsiveness to patient concerns. Facilitated group review encourages constructive peer feedback and promotes deeper self-awareness. Reviewing both face-to-face and telemedicine consultations allows trainees to adapt their approach across different formats, building confidence and competence in remote communication. Through a combination of theory, observation, feedback, and reflection, day release sessions support the development of skilled, adaptable, and person-centred communicators.

Registrar Tutorials

Registrar tutorials provide a vital space for personalised, in-depth development of communication skills within the context of workplace-based learning. Delivered one-on-one with a trainer, these sessions allow registrars to explore challenging cases, reflect on recent consultations, and refine their approach to complex communication scenarios. Tutorials often involve case-based discussions, role-play, and the use of video consultations as a reflective tool, enabling registrars to analyse their consultation style, language, empathy, and responsiveness in a safe and supportive environment. Trainers can use this protected time to introduce or revisit key consultation models, discuss handling of emotionally sensitive topics, or explore communication across cultural or linguistic differences. Because registrar tutorials are closely tied to day-to-day clinical experience, they help bridge theory and practice, allowing for real-time application and feedback. Over time, these sessions support the development of confident, reflective communicators who are able to adapt their style to meet the diverse needs of patients and the demands of modern general practice.

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

EPA 12: Manage the mental health needs of adults including older people

Recording and reflecting on a video consultation, for example of a patient presenting with low mood, can further support self-awareness and professional growth, reinforcing the importance of clear, respectful, and inclusive communication across all consultation formats. This could be recorded using a CBD tool in the EPAs.

Core Knowledge Test (CKT)

(Note that communication in the consultation is best assessed via the CCT examination and via EPA Observed consultations (PIP-C & PIP-P)) 

• Selecting the most effective response when a patient becomes angry during a discussion about test results.
• Identifying the best approach to explore a patient’s hidden agenda when they raise it at the end of the consultation.
• Choosing the most appropriate communication method for breaking bad news over the telephone. 

Clinical Competency Test (CCT)

Communication in the consultation is assessed throughout the CCT examination, below are further examples of how communication skills could be assessed.

• A patient seen with the use of a telephone translation service.
• A telephone consultation.

Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.