SCA explaining phrases, in plain English

How to use this phrase bank

These are examples of natural wording, not scripts. Examiners mark what you do for this patient, and a memorised line delivered without listening often sounds worse than plain words of your own. Read them, pick two or three that sound like you, and practise saying them in your own way. The “avoid” versions are common habits we hear in practice consultations; each comes with the reason it tends to fall flat.

Starting from what they know

Find the starting point before you explain.

• Try: “What do you already know about diabetes?”
  Avoid: “(Starting a full explanation straight away.)”. You may explain what they already know, or miss what they have misunderstood.
• Try: “How much detail would you like?”
  Avoid: “Right, let me explain everything.”. Some people want the headline, some want the detail. Asking lets them choose.
• Try: “What have you read about it?”
  Avoid: “Don’t believe what you read online.”. Dismissing their research closes a door; asking about it shows you where to start.
• Try: “Is there a particular part you want me to start with?”
  Avoid: “(Following your own order regardless.)”. Starting with their main worry helps them listen to the rest.

Plain words

Say it the way you would to a friend who is not medical.

• Try: “Your thyroid gland is a bit underactive, so it’s not making quite enough hormone.”
  Avoid: “You have subclinical hypothyroidism.”. The label alone means nothing to most patients.
• Try: “The heart isn’t pumping as strongly as it should.”
  Avoid: “Your ejection fraction is reduced.”. Technical terms need translating, or leaving out.
• Try: “Your kidneys are filtering a bit less well than they should.”
  Avoid: “Your eGFR is 48.”. A number without meaning creates worry, not understanding.
• Try: “It’s a type of arthritis where the cushioning in the joint wears thin.”
  Avoid: “It’s just wear and tear.”. “Just wear and tear” can sound dismissive, and some hear it as hopeless.
• Try: “It’s a growth that we need to find out more about.”
  Avoid: “It’s a lesion of uncertain significance.”. Vague jargon is still jargon, and it can sound like hiding something.

Chunking and checking

Small pieces, with pauses.

• Try: “There are three things I’d like to cover: what it is, what we can do, and what to watch for.”
  Avoid: “(One long uninterrupted explanation.)”. A signposted structure helps people follow and remember.
• Try: “Does that make sense so far?”
  Avoid: “Any questions? No? Good.”. A quick closed check said in passing rarely invites a real answer.
• Try: “What questions has that raised for you?”
  Avoid: “Do you understand?”. “Do you understand?” can feel like a test; asking for their questions assumes they have some.
• Try: “Just so I know I’ve explained it well, how would you describe it to your family?”
  Avoid: “Can you repeat that back to me?”. Framing the check as your responsibility makes it feel less like an exam.
• Try: “I’ll pause there, because that’s a lot.”
  Avoid: “(Moving straight on after difficult news.)”. People stop listening after a shock; a pause lets them catch up.

Explaining risk

Use whole numbers and a consistent frame. The figures below are only examples; use the numbers that apply to your patient.

• Try: “If 100 people like you took this for ten years, about 4 would avoid a heart attack or stroke.”
  Avoid: “It reduces your risk by 30%.”. Relative risk on its own sounds bigger than it is and is hard to picture.
• Try: “Out of 100 people, about 2 get this side effect.”
  Avoid: “Side effects are rare.”. “Rare” means different things to different people.
• Try: “So for most people it makes no difference either way, but for a few it does. That’s the choice.”
  Avoid: “It’s definitely worth it.”. Presenting a close call as obvious takes the decision away from them.
• Try: “Would a picture help? I can show you a chart of 100 faces.”
  Avoid: “(Reading out several percentages.)”. Visual aids help many people understand risk.

Uncertainty and what happens next

Honest about what you do not know, clear about what happens next.

• Try: “I don’t know yet what’s causing it. What I do know is what we need to do next.”
  Avoid: “It’s probably nothing.”. False reassurance falls apart if the test is abnormal.
• Try: “The most likely explanation is a viral infection, but I want to rule out a couple of other things.”
  Avoid: “It could be lots of things.”. An open list without a working view is unsettling.
• Try: “The scan will tell us more. It usually takes about two weeks to get the result.”
  Avoid: “We’ll see what the scan shows.”. People cope better with uncertainty when they know the next step and timescale.
• Try: “If it turns out to be something else, we’ll change the plan.”
  Avoid: “This should sort it out.”. Leaving room to change the plan is honest and builds trust.

Linking it to their life

An explanation lands when it connects to what they told you.

• Try: “You mentioned you’re worried about your mum’s stroke. This is different, and here’s why.”
  Avoid: “(Giving a standard explanation that ignores their concern.)”. Using their words shows you listened and addresses the real worry.
• Try: “For your job, that means…”
  Avoid: “(Explaining only the medical side.)”. People want to know what it means for work, family and plans.
• Try: “I’ll send you a link so you can look at it again later.”
  Avoid: “Google it.”. Pointing to a reliable source is helpful; telling them to search is not.

Practise saying them

Read a case brief, set a 12-minute timer and run it with a partner, the AI patient or out loud on your own. The Hot Seat holds the full case bank with a scorecard for each case. The Consultation Conversation Lab drills the Relating to others skills (cues, ideas and concerns, shared plans), and Worked Example Consultations show what a passing consultation sounds like from start to finish. Then put a few of these cases into your next mock exam.

Frequently asked questions

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