# PWR-144 — High-stakes communication: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 15 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Basic stationery or digital tools — a qualified simulation of one high-stakes communication role.; A supervisor-approved fact sheet with must-say facts, prohibited assumptions and service escalation contacts.; A room or remote setup with privacy, interpreter/access options, pause signal and observer rubric. Space: Desk / seated Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Detailed research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context This lesson teaches the full conversation sequence for a role-specific simulation: verify role and facts, prepare privacy and access, warn plainly, give information in small pieces, check emotion and understanding, agree next action and escalate. A qualified supervisor controls realism and feedback; the page does not authorise real bad-news, clinical, legal or emergency conversations. Target outcome: In a qualified simulation, the learner communicates one serious fictional update accurately, checks understanding and emotion, and activates the correct escalation path. ### Authority and setup conditions - Prepare a qualified simulation of one high-stakes professional role using fictional facts, an actor or trained peer and an approved escalation script - Before the first high-stakes communication attempt, write the exact result you will score: Observed accuracy, comprehension, emotional safety, escalation, decision error and follow-through in role-specific simulation and practice. - The supervisor confirms the learner’s role, competence boundary, simulation level and who stops the scene. - Verify that no real patient, client, employee or family information appears in the case. ### Required or supplied materials - a qualified simulation of one high-stakes communication role. - A supervisor-approved fact sheet with must-say facts, prohibited assumptions and service escalation contacts. - A room or remote setup with privacy, interpreter/access options, pause signal and observer rubric. ## 1. Verify role and facts With the supervisor, underline the facts you are authorised to give, the decisions you cannot make and the person who answers beyond-scope questions. Why: High stakes amplify harm from confident guessing or role drift. Success check: The learner can separate must-say facts, unknowns and escalation contacts. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner can separate must-say facts, unknowns and escalation contacts.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Prepare privacy and access Check who is present, consent to their presence, preferred communication mode, qualified interpreter need, seating, exit and uninterrupted time. Why: Understanding and emotional safety depend on access and a controlled setting. Success check: The actor confirms identity, privacy, mode and who may remain. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The actor confirms identity, privacy, mode and who may remain.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Give a warning sentence Use one plain sentence that signals serious information is coming, then pause and watch for readiness. Why: A short warning reduces abruptness without hiding the message. Success check: The warning is direct, free of jargon and followed by a real pause. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The warning is direct, free of jargon and followed by a real pause.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. State facts in small pieces Give one or two verified facts at a time. Label uncertainty and stop after each piece for a question or reaction. Why: Information overload and speculation increase decision error. Success check: Every statement matches the fact sheet and unknowns are named as unknown. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Every statement matches the fact sheet and unknowns are named as unknown.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Acknowledge emotion without assumption Name the visible or stated response cautiously—“I can see this is a lot”—and ask what the person needs now. Do not diagnose the feeling. Why: Recognition supports communication while preserving the person’s account. Success check: The response refers to observed or stated information and offers a choice. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The response refers to observed or stated information and offers a choice.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Use teach-back Ask the actor to explain the key facts and next step in their own mode. Correct your explanation if a must-say fact is missing. Why: Teach-back detects communication error before the person acts. Success check: The actor accurately returns the key fact, uncertainty and next action. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The actor accurately returns the key fact, uncertainty and next action.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Close with action and escalation Name who will do what, by when, how questions will be answered and what requires urgent escalation. Provide the same information in an accessible written form. Why: A clear close turns information into accountable follow-through. Success check: The plan has named owners, timing, contact and urgent trigger. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The plan has named owners, timing, contact and urgent trigger.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Debrief the simulation With the supervisor and actor, compare the exact words with the rubric; identify one accuracy error and one emotional-safety feature before repeating. Why: Specific feedback improves the trained behaviour without pretending that simulation equals real-world competence. Success check: The record contains quoted evidence, not only “confident” or “empathetic.” Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The record contains quoted evidence, not only “confident” or “empathetic.”” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.