COMMUNICATION SKILLS CHECKLIST

The SEGUE Framework for teaching and assessing communication skills (Makoul 2001)*

Greg Makoul in 2001 developed the SEGUE framework, a research-based checklist of

medical communication tasks that has gained wide acceptance throughout North America.
The framework consists of the following areas:

1. Set the stage

2. Elicit information
3. Give information
4. Understand the patient's perspective
5. End the encounter
6. If suggesting a new or modified treatment/prevention plan
S.No NA Yes No
1 Set the Stage 1. Greet the patient appropriately
2. Establish reason for visit
3. Outline agenda for visit (e.g.,
“anything else?”, issues, sequence)
4. Make a personal connection during
visit (e.g., go beyond medical issues
at hand)
5. Maintain patient’s privacy (e.g.,
close door)
2 Elicit information 6. Elicit patients view of health
problem and/or progress
7. Explore physical/physiological
factors
8. Explore psychosocial/emotional
factors
9. Discuss antecedent treatment
10. Discuss how health problem affects
patient's life (e.g., quality-of-life
11. Avoid directive/leading question
12. Give patient opportunity/time to
talk (e.g., don't interrupt)
13. Listen. Give patient undivided
attention
14. Check/clarify information
3 Give information 15. Use of Device / storage of
medicine / adherence to medicine
16. Encourage patient to ask
questions/check understanding
17. Adapt to patient 's level of
understanding (e.g., avoid/explain
jargon)
4 Understand the 18. Acknowledge patients
patient's accomplishments / progress /
perspective challenges

5 End the encounter
19. Acknowledge waiting time
20. Express caring, concern, empathy
21. Maintain a respectful tone
22. . Ask if there is anything else patient
would like to discuss
23. Review next steps with patient

*Reference : https://each.international/teachresources/segue-framework/

Use of a Medical Device – Metered Dose Inhaler(MDI)*

S.No Steps to use MDI Yes No
1.
Take off the cap. Shake the inhaler. Prime the inhaler, if needed, as
shown in your instructions.
2. If you use a spacer, put the inhaler in the rubber ring on the end of
the spacer.
3. Stand up or sit up straight
4. Breathe out completely to empty your lungs.
5. Place the mouthpiece in your mouth and close your lips around it to
form a tight seal.
6. As you start to breathe in, press down firmly on the top of the
medicine canister to release one “puff” of medicine. Continue to
breathe in slowly for 3 to 5 seconds. Take as big a breath as possible.
7. Hold your breath and count to 10.
8. Take the mouthpiece out of your mouth. Release your breath.
9. If your action plan says to take more than 1 puff of medicine, wait 1
minute between puffs. Repeat steps 3 through 8 for each puff you
need to take.
10. Put the cap back on the inhaler.
11. If your medicine is an inhaled corticosteroid, rinse your mouth with
water and spit it out. Rinsing will help to prevent an infection in the
mouth.
*Reference : file:///C:/Users/drpka/Downloads/How-to-Use-a-Metered-Dose-Inhaler_21-HL-
8165.pdf

Use of a Prefilled Insulin Pen*

S.No Steps to use Insulin Pen Yes No

Insulin Injection to be 30 minutes before meals or as directed by the
1.
physician depending on type of insulin you are using.
Check whether enough insulin is available in the cartridge for the
2.
injection.
For ‘cloudy’ long-acting mixed insulin, turn your pen up and down at
least 10 times to make sure the cloudy insulin is mixed. / Check to
3.
make sure that your insulin is not clumpy and that your fast-acting
insulin is clear and colourless.
4. Remove the pen cap, insert the needle.
Do not allow the needle to touch anything except the skin where
5.
you will be injecting.
 Explain the sites where insulin to be injected – abdomen, thigh,
6.
buttocks.
Do not give into skin that is thickened, or has pits or lumps, irritated,
7.
tender, bruised, red, scaly, hard, scarred, or has stretch marks.
8. The site should be clean and dry before injecting insulin
Adjust the dose to be injected as prescribed. Double check the dose
9.
before injecting.
If length of needle is 8mm, you should lift the skin between the
10. thumb and forefinger. This is not needed if you are using shorter
needles.
11. Inject the needle at 90⁰ to the skin into fatty tissue lying below
12. Inject the insulin slowly, count to 10 and then withdraw the needle.
Remove the needle and dispose it safely into needle/sharp disposal
13.
box. Dispose it as per the local guidelines for Bio Medical Waste.
14. Move the site where you give the shot with each shot.
*Reference: https://www.dgft.nhs.uk/wp-content/uploads/2014/11/How-to-use-your-insulin-pen-
V5.pdf

Explaining the importance of medication adherence

Eg. Diabetes Mellitus

S.No Steps Yes No

1. Explain about the disease and importance of taking medicine.
Explain how the disease will be under control and improves the
2.
quality of life.
Explain the complications of the disease, if the disease is not under
3.
control.
The medication to be taken regularly without missing the dose and
4.
as suggested by physician at the same time.

Storage of Medicines

Eg. Tablet. Metformin

S.No Steps Yes No

Store in an area without exposure to direct sunlight and moisture
1.
free place
2. Store the medicines in their original pack / bottle
3. Keep them out of reach of children
Do not consume the medicine when the pack is not intact / any
4. colour change / texture and in case of syrups if there is any colour
change / clumps / smell noted

Explain about the Adverse Drug Reactions of a drug prescribed for a disease

Eg. Metformin

S.No Steps Yes No

Explain the importance of medicine prescribed for the disease and
1.
why it should be used
 Explain about the common adverse drug reactions that are
2. associated with the drug. Eg. Metformin causing GI symptoms
Bloating, diarrhoea etc.
Assure the patient in case the reaction is mild to continue
3.
medication
Consult the physician immediately in case of severe / serious
4.
reaction