ABSTRACT
Introduction Explanation and planning is the Cinderella subject of communication skills teaching. Most teaching programmes concentrate on the fi rst half of the interview and tend to neglect or underplay this vital next stage in the consultation (Maguire et al. 1986b; Sanson-Fisher et al. 1991; Elwyn et al. 1999b). To some extent this emphasis is understandable, as so many problems in communication arise from the beginning or information-gathering phases of the interview. Also, as we show in this chapter, many of the skills of successful explanation and planning are inextricably linked with the skills of information gathering – effective explanation needs both to be based on information gathered about the disease aspects of a patient’s problems and to be framed in terms that take into account the patient’s illness framework of ideas, concerns and expectations.
