Comms Lab: Phone referral

Comms Lab: Episode 37

Mastering The Phone Referral: Comparing Structured Approaches

As clinicians, we engage in negotiation every day – with our patients and with our colleagues.

Phone referrals, Consults, Admission Handoffs – whatever you want to call them – are one of the biggest communication challenges in medicine. That’s why researchers have developed structured approaches to these conversations.

In this video I’ll be examining 3 different approaches: ISBAR, PIQUED, and The 5Cs. I’ll give examples of each, look at their origin and evidence base, and give you my opinion on the pros and cons based on real-life experience.

Got feedback for me? Great! I’m always trying to make my videos better and more relevant. Let me know what you think in the comments section, or anonymously via jotform


  • Identify
  • Situation
  • Background
  • Assessment
  • Request / Recommendation


  • Preparation and Review
  • Identification of Involved Parties
  • Questions
  • Urgency
  • Educational Modifications
  • Debrief and Discuss

The 5Cs

  • Contact
  • Communicate
  • Core Question
  • Collaborate
  • Close the Loop

0:00 – Phone Referrals – Why Structure them?
0:38 – ISBAR
1:22 – PIQUED
1:54 – The 5Cs
2:37 – So which is the winner?


Further reading

More from the Comms Lab


Comms Lab

A path to highly effective communication skills

Hayden is an emergency physician at University Hospital Geelong and a senior lecturer at Deakin University, Geelong. He is somewhat obsessed with the science and art of effective communication, and in particular: difficult conversations. He believes that we can all get better at having difficult conversations, and that the process of learning to do so can be seriously fun.

Hayden is also an avid but terrible surfer, ad hoc gardener, and dad to two awesome kids. | LinkedIn |


  1. best video so far IMO. very relevant topic, great presentation of the info and some valuable first-person tips and tidbits.

    a suggestion you could consider is filming the shots from a further distance/smaller zoom. IMO filming too close up takes the focus away from the subject at hand a little bit and can be a little distracting. another advantage of having a wider scene is being able to put up text props and pics on frame while you were talking (in the style of my favorite youtubers like strongmedicine, vsauce and veritasium)

    cheers from brazil

    • Thanks lucasplaining. This great feedback. I’ll check out those other channels and see what I can take from them.

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