As an intern, you meet Mrs S, a 55-year-old with ataxia and blurred vision. A mass is found on imaging and the family is upset about the next steps. Which communication approach is appropriate?

As an intern, you meet Mrs S, a 55-year-old with ataxia and blurred vision. A mass is found on imaging and the family is upset about the next steps. Which communication approach is appropriate?

• A. Explain the full diagnosis immediately to provide certainty.
• B. Apologise and acknowledge uncertainty, discuss that more information is needed, involve senior input, and organise a family meeting.
• C. Avoid discussing prognosis until more data is available and tell the family not to worry.
• D. Refer all questions to the treating team and do not engage with the family.

Answer: (B)

Handling uncertainty with honesty and a clear plan, while bringing the right people into the conversation, is the best approach here. Start by acknowledging what you know and what you don’t yet know, and apologize for the distress the situation is causing. Then bring in a senior clinician to ensure accuracy and coordinate the next steps, and organise a family meeting where the findings, possible options, and likely next steps can be explained in a calm, private setting. This approach shows empathy, maintains trust, and gives the family space to ask questions and feel involved in decisions, while you work on gathering more information. Giving a full diagnosis immediately isn’t appropriate when the information isn’t complete, and avoiding discussion of prognosis or telling the family not to worry shifts the burden or provides false reassurance. Simply referring questions to the treating team without engagement also fails to acknowledge the family’s concerns and misses an opportunity to support them.

Handling uncertainty with honesty and a clear plan, while bringing the right people into the conversation, is the best approach here. Start by acknowledging what you know and what you don’t yet know, and apologize for the distress the situation is causing. Then bring in a senior clinician to ensure accuracy and coordinate the next steps, and organise a family meeting where the findings, possible options, and likely next steps can be explained in a calm, private setting. This approach shows empathy, maintains trust, and gives the family space to ask questions and feel involved in decisions, while you work on gathering more information.

Giving a full diagnosis immediately isn’t appropriate when the information isn’t complete, and avoiding discussion of prognosis or telling the family not to worry shifts the burden or provides false reassurance. Simply referring questions to the treating team without engagement also fails to acknowledge the family’s concerns and misses an opportunity to support them.