The "Kalamazoo Consensus Statement: Essential Elements of Physician-Patient Communication," developed by experts from medical schools and residencies, and representatives from medical education organizations in North America, and used as guidance by the Accreditation Council on Graduate Medical Education (ACGME) and other educational leadership organizations, says that physicians should focus on the following elements and tasks.

• Establishes rapport
  • Encourages a partnership between physician and patient
  • Respects patient's active participation in decision making
• Opens discussion
  • Allows patient to complete his/her opening statement
  • Elicits patient's full set of concerns
  • Establishes/maintains a personal connection
• Gathers information
  • Uses open-ended and closed-ended questions appropriately
  • Structures, clarifies, and summarizes information
  • Actively listens using nonverbal (e.g., eye contact, body position) and verbal (words of encouragement) techniques
• Understands patient's perspective on illness
  • Explores contextual factors (e.g., family, culture, gender, age, socioeconomic status, spirituality)
  • Explores beliefs, concerns, and expectations about health and illness
  • Acknowledges and responds to patient's ideas, feelings, and values
• Shares information
  • Uses language patient can understand
  • Checks for understanding
  • Encourages questions
• Reaches agreement on problems and plans
  • Encourages patient to participate in decisions to the extent he/she desires
  • Checks patient's willingness and ability to follow the plan
  • Identifies and enlists resources and supports
• Provides closure
  • Asks whether patient has other issues or concerns
  • Summarizes and affirms agreement with the plan of action
  • Discusses follow-up (e.g., next visit, plan for unexpected outcomes)

The various questions on the survey relate to different elements and tasks from this consensus list.