PACES MADE EASY

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Please follow PACES made easy
Pearls for MRCP PACES Communication Skills
1. Golden Principles (Never Forget These)
Before any scenario, remind yourself:
• This station is about how you communicate, not how much medicine you know.
• Be safe, empathetic, structured, and patient-centred.
• Speak slowly, use simple language, and avoid jargon ( very important).
• A calm, kind doctor always scores well.
2. Universal Structure (Use This in EVERY Case)
You can apply this structure to all communication scenarios.

A. Introduction (30–40 seconds)
Greet politely
Confirm identity
Clarify purpose
Seek permission
Example:
Hello, my name is Dr ……... I am one of the medical doctors here. Could I please confirm your name and age?
I understand you have been asked to speak to me today about your condition- would that be okay ( mean consent)?

B. Open the Conversation – ICE ( also important in consultation)
Always explore ICE early.
• Ideas:
What do you think might be going on?
• Concerns:
Is there anything in particular you are worried about?
• Expectations:
What were you hoping we might discuss or achieve today?

C. Acknowledge Emotions (Very Important)
If the patient is upset, angry, or anxious:
• Pause
• Name the emotion
• Validate it
Examples:
• I can see this is very upsetting for you.
• That’s completely understandable.
• Anyone in your situation would feel the same.
Never ignore emotions and continue talking ( if you do scores will low).

3. Explaining Information Clearly
Rules for Explanation
• Use simple words
• Give information in small chunks ( do not bombard the patient with loads of info)
• Check understanding frequently
Example:
I will explain this step by step, and please stop me at any point if something is not clear.
Explain Using the What - Why – What Next Model
1. What is happening
2. Why it is happening
3. What happens next
4. Breaking Bad News (SPIKES - Simplified for PACES)
S – Setting
• Sit comfortably
• No rushing
• Ask permission
P - Perception
Before I go on, can I check what you understand so far?
I -Invitation
Would you like me to explain the results in detail?
K - Knowledge
• Give a warning shot
I’m afraid the results are more serious than we had hoped.
• Then explain slowly.
E - Empathy
I can see this is very hard to hear.
S - Strategy and Summary
• Reassure support
• Outline next steps

In every communication always do these
1. Provide follow up plan if required
2. Safety netting advice
3. CNS support and other support group
4. If patient wants to complain- Sign post to PALS
5. Do not ignore emotions
6. Information leaflet.

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