title: 'Any questions?'--Clinicians' usage of invitations to ask questions (IAQs) in outpatient plastic surgery consultations.
abstract: OBJECTIVE
  To explore use of 'Invitations to Ask Questions' (IAQs) by plastic surgeons in outpatient consultations, and consider how type of IAQ impacts on patients' responses to, and recollection of, IAQs.
  
  
  METHODS
  Descriptive study: 63 patients were audio recorded in consultation with 5 plastic surgeons, and completed a brief questionnaire immediately after the consultation. Consultation transcripts were analyzed using inductive qualitative methods of Discourse Analysis and compared with questionnaire findings.
  
  
  RESULTS
  A taxonomy of IAQs was developed, including three types of IAQ (Overt, Covert, and Borderline). Overt IAQs were rarely identified, and almost all IAQs occurred in the closing stages of the consultation. However, when an overt IAQ was used, patients always recollected being asked if they had any questions after the consultation.
  
  
  CONCLUSIONS
  Patients are rarely explicitly offered the opportunity to ask questions. When this does occur, it is often in the closing stages of the consultation. Clinicians should openly encourage patients to ask questions frequently throughout the consultation, and be mindful that subtle differences in construction of these utterances may impact upon interpretation.
  
  
  CONCLUSIONS
  Clear communication, of message and intention, is essential in clinical encounters to minimize misunderstanding, misinterpretation, or missed opportunities for patients to raise concerns.
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, UK. Electronic address: katherine.bristowe@kcl.ac.uk.
authors.forename: Katherine
authors.initials: K
authors.lastname: Bristowe
authors.affiliation: Department of Language and Linguistics, University of Essex, UK.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Patrick
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D010358:Patient Participation / Q000379:methods*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D013518:Surgery, Plastic; D011795:Surveys and Questionnaires; D013637:Tape Recording; D006113:United Kingdom
keywords: Clinician–patient interaction; Outpatient interactions; Patient integration; Question use