Look at the list of examples of establishing and developing rapport with a child. Compare it with your own list

☺ Say hello to the child and call him/her by name.

☺ Eye-level with the child. Make sure you talk to the child at their eye-level. Scoot your chair next to them, sit down and have a conversation.

☺ Pay the child a compliment, e.g. admire article of clothing/toy, etc.

☺ Praise the child for something, e.g. the picture she’s drawing.

☺ Pace conversation accordingly. If you actually speak quickly, try taking it down a notch for the child.

☺ Use a friendly/gentle tone of voice.

☺ Ask the child about hobbies, favourite subject at school, etc.

☺ Repeat words used by the child.

☺ Smile at the child.

Remember! In Anglo-Saxon countries the following body language can be used to open the interview: open seating position (no crossed arms/legs), slight inclination of the head, sitting slightly forward, eye contact and a smile.

6. Read and translate the beginning of a consultation with a new patient. The doctor is talking to a six-year-old girl and her mother:

Doctor: Hello, Mrs. Long. Hello, Sara.

Mrs. Long: Hello, Doctor.

Doctor: Please take a seat.

Mrs. Long: Thanks. Sara, sit here next to me, sweetheart[1].

Doctor: Right, so can you tell me what seems to be the problem?

Mrs. Long: Um, Sara has been complaining of stomach cramps[2] and she’s off her food[3].

Doctor: I see. And when did the cramps begin?

Mrs. Long: Yesterday. She felt poorly in the morning, didn’t you, Sara?

Doctor: Any idea what might have caused the cramps?

Mrs. Long: I think it might be some kind of bug. A few of the children in her class have the same thing.

Doctor: Right, well, I’ll have a look at her. Sara, could you lie on the bed and I’ll look at your tummy?

1. Does the doctor try to establish rapport with the child?

2. Does he develop it?

3. Who does the doctor direct the conversation at?

4. Does the doctor include Sara in the conversation?

5. Does Sara feel comfortable? Give your comment.

6. What examples of good practice can you find in the conversation?

7. The way in which a doctor receives a patient can make or break the consultation that follow. A doctor needs to treat their patients with respect, of course, but establishing rapport within the first few minutes is also about how doctors greet the patients and introduce themselves, clarifying their role, making sure patients are comfortable. Look at these phrases and give each set of objectives a heading [4]:

Objective 1 ∙ Hello, [Sara], take a seat please… ∙ Good morning, [Billy], come in … ∙ Hello, can I just check it’s [Nick]? We’ve not met before…	Objective 2 ∙ My name is Dr. Smith. ∙ I’m Dr. Brown. ∙ Dr. Linley has referred you to me for further investigation. My name is Dr. Quinn.
Objective 3 ∙ I’m a student doctor working with Mr. [House]. ∙ I’m one of the registrars on the word this evening. ∙ My colleague, Dr. [Taylor], has asked me to come and see you about …	Objective 4 ∙ Do you want to sit here next to your mummy? ∙ If I could just ask you to sit here next to me. That’s great. Are you comfortable? ∙ Yes, it’s a bit cool here. Let me just close the window before we begin.

8. Read and translate another dialogue. Another doctor is talking to a seven-year-old boy and his mother:

Doctor: Hello, Billy. Hello, Mrs. Jones. My name’s Dr. Gordon. I’m one of three partners who makes up this family practice. Now, Billy, do you want to sit here next to your mummy, and I’ll sit here. Just let me raise your chair up a bit so you can see me. That’s better. That’s a great football shirt, Billy. So, you’re a Manchester United supporter?

Billy: Yes.

Doctor: And do you support Manchester United as well, Mrs. Jones?

Mrs. Jones: Oh, yes. The whole family does.

Billy: My dad is their biggest fan.

Doctor: Does he take you to any matches?

Billy: I’ve been to three matches this year.

Doctor: You’re very lucky.And who’s going to win the league?

Billy: Man U, of course!

1. Does the doctor cover all four objectives? Give examples.

2. Does he include Mrs. Jones in the small talk?

3. Can the doctor gain Billy’s trust and co-operation? Give your comments.

4. What topics put Billy at ease? Make up a list of things that make Billy comfortable. (Consult Ex. 4).

9. Compare both dialogues. Tick the stages both doctors include:

Doctor 1		Doctor 2
Greets the child	V	Greets the child	V
Calls the child by her name		Calls the child by his name
Introduces himself		Introduces himself
Clarifies his role		Clarifies his role
Makes sure the child is comfortable		Makes sure the child is comfortable
Pays the child a compliment		Pays the child a compliment
Asks questions about the child’s personal inertest		Asks questions about the child’s personal inertest

10. Work in pairs. Make up a micro dialogue. It should cover first three objectives: greeting the child and his/her mother/ father, introducing yourself and clarifying your role.

11. There are two approaches to gathering information: a patient-centered (patient-led) approach and a doctor-centered (doctor-led) one. They are quite different from each other in the respect of doctor-patient relation. Study the table and answer the questions below.

Doctor-centered approach · Doctor takes the dominant role · Tightly controlled situation · Patient has limited participation

Patient-centered approach · Triangular form of consultation · Doctor shows more empathy · Patient is the main source of information

1. Which approach does the first doctor use during his consultation?

2. Which approach does the second doctor prefer to use in his practice?

3. Describe the beginning of the consultation of the second doctor.

Model: The doctors model consultations in two different ways. The first doctor tries to interview Sara’s mother in a tightly controlled way. He neither applies the small talk nor includes Sara in the conversation. Of course, within first few minutes he learns the problem Sara is having with her stomach and is ready to examine her. But all these things don’t make Sara feel comfortable and she’s probably scared.