Standardized Patient Checklist

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Checklist

Mr/s. Mendoza


Discussing a Cancer Diagnosis with a Patient Who Does Not Want to Know the Diagnosis

 


 
Your Name ______________________ Resident Name _____________________

 

  1. Mr/s. Mendoza was satisfied with this resident encounter.      YES        NO
  1. The resident appropriately greeted me and asked me how I have been feeling since my last visit.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident appropriately greeted AND asked me how I have been feeling/doing since my last visit

DONE INCORRECTLY: The resident appropriately greeted OR asked how I have been feeling since my last visit.

NOT DONE: The resident did not ask either.

  1. The resident asked me my preferences as to how much I wanted to know about my diagnosis.

DONE CORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked me what I would like to be told about my diagnosis.

NOT DONE: The resident did not ask my preferences.

  1. The resident asked me if I would like the resident to talk with my son or other family members about the diagnosis and treatment options.

DONE CORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked if I would like the resident to talk with my son or family members about diagnosis and treatment options.

NOT DONE: The resident did not ask about this.

  1. The resident respected my preferences in discussing the results of the colonoscopy (i.e., did not tell me that I had “cancer” but used other words).

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident discussed the results of the colonoscopy, but did not use the word “cancer.” Instead, the resident said that I had a “growth” or similar type word.

DONE INCORRECTLY: The resident revealed the diagnosis of cancer.

NOT DONE: The resident did not discuss the results of the colonoscopy.

  1. The resident explained the results in a way that I could understand.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident explained things in easy to understand language and terminology.

DONE INCORRECTLY: The resident explained things using medical words that I did not understand.

NOT DONE: The resident did not explain the results.

  1. The resident discussed next steps in a way that respected my wishes not to be told the diagnosis.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident discussed next steps—such as blood test, CT scan, and referral to the surgeon—without mentioning “cancer.”

DONE INCORRECTLY: The discussed tests but revealed that I might have cancer.

NOT DONE: The resident did not discuss next steps.

  1. As a patient, I would want to continue seeing this physician for my future care (circle one):
  1. Strongly agree
  2. Agree
  3. Neutral
  4. Disagree
  5. Strongly disagree
  1. Comments (if needed):