Communication In Consultations Research Articles

How to learn skilled communication in primary care MUS consultations: a focus group study

Background Many general practitioners (GPs) experience communication problems in medically unexplained symptoms (MUS) consultations as they are insufficiently equipped with adequate communication skills or do not apply these in MUS consultations. Objective To define the most important learnable communication elements during MUS consultations according to MUS patients, GPs, MUS experts and teachers and to explore how these elements should be taught to GPs and GP trainees. Methods Five focus groups were conducted with homogeneous groups of MUS patients, GPs, MUS experts and teachers. MUS patients and GPs formulated a list of important communication elements. MUS experts identified from this list the most important communication elements. Teachers explored how these elements could be trained to GPs and GP trainees. Two researchers independently analysed the data applying the principles of constant comparative analysis. Results MUS patients and GPs identified a list of important communication elements. From this list, MUS experts selected five important communication elements: (1) thorough somatic and psychosocial exploration, (2) communication with empathy, (3) creating a shared understanding of the problem, (4) providing a tangible explanation and (5) taking control. Teachers described three teaching methods for these communication elements: (1) awareness and reflection of GPs about their feelings towards MUS patients, (2) assessment of GPs’ individual needs and (3) training and supervision in daily practice. Conclusion Teachers consider a focus on personal attitudes and needs, which should be guided by opportunities to practice and receive supervision, as the best method to teach GPs about communication in MUS consultations. KEY POINTS Many GPs experience difficulties in communication with patients with MUS. There is a need to equip GPs with communication skills to manage MUS consultations more adequately. Role-playing with simulation patients, reflection on video-consultations and joint consultations with the supervisor may increase the GPs’ awareness of their attitude towards MUS patients and may help GPs to identify their individual learning-points.

Preliminary assessment of a tool for measuring relationship-centred communication in veterinary consultations (adapted VR-COPE).

This article was migrated. The article was marked as recommended. Relationship-centred communication is considered a desirable goal in veterinary medicine, and a number of different tools have been developed to measure relationship-centred communication. This study was designed as an initial assessment of an adapted version of the Verona Patient-centred Communication Evaluation (VR-COPE) scale, originally developed for medical communication research, to evaluate its potential for measuring relationship-centredness in veterinary consultations. Fifty-five consultations in the United Kingdom and United States of America were videotaped and analysed. The median VR-COPE total score (out of a potential 100 points) was 76.00 for all consultations. The highest overall score was for "Structuring" (of the consultation), whereas the lowest scores were for "Client Worries," "Psychological Impact," and "Empathy." This initial assessment of the adapted VR-COPE suggests it may be helpful in measuring content, process, and structuring skills related to relationship-centredness in veterinary consultations. It may also help uncover aspects of relationship-centredness that are unique from those uncovered by other tools. Further research is needed to fully assess the role of VR-COPE in veterinary communication research and the contributions it can make to relationship-centredness in veterinary consultations.

Interventions for Improving medical students' interpersonal communication in medical consultations; Considering the evidence in the context of the COVID-19 pandemic

Interventions for Improving medical students' interpersonal communication in medical consultations; Considering the evidence in the context of the COVID-19 pandemic

Solution to support informal caregivers of patients with dementia

Abstract The dementia is a degenerative uncurable disease. Giving its high prevalence worldwide, it is considered a major global public health concern. Patients with dementia need long-term care and support at home. Current evidence demonstrates that their informal caregivers are prone to psychiatric and cardiovascular diseases and lack formal support that can help them in their exhausting daily routine. We intend to report the creation of an ICT solution to support informal caregivers of patients with dementia, addressing identified needs. The academic engineering project launched was divided in two phases: 1) requirements analysis and software design and 2) software development and deployment. The user-friendly and smooth functioning application developed, called OneCare, has a set of functionalities that allows the free access to information about the disease, useful resources, medication, outpatient consultation management and communication with peers. We consider that this application may improve effectiveness in care provided by informal caregivers of patients with dementia, while having a positive impact in their health outcomes and quality of life. We advocate that future policies in this area should consider the use of this kind of technology as a way to reduce disease burden, institutionalization needs and increase the chances of living well at home.

The International Council of Ophthalmology Ophthalmic Clinical Evaluation Exercise

Purpose:Fifteen years after the publication of the Ophthalmic Clinical Evaluation Exercise (OCEX), it was deemed necessary to review and revise it, and to validate it for an international audience of ophthalmologists. This study to revise the OCEX and validate it for international use.Methods:The OCEX rubric was changed to a modified Dreyfus scale; a behavioral descriptor was created for each category. An international panel of ophthalmic educators reviewed the international applicability and appropriateness of the tool.Results:A tool for assessing and giving feedback on four aspects of clinical competence during the ophthalmic consultation (interview skills, examination, interpersonal and communication skills, and case presentation) was revised. The original scoring tool was improved to a new behavioral one, and relevant comments and suggestions from international reviewers were incorporated. The new tool has face and content validity for an international audience.Conclusion:The OCEX is the only tool for workplace assessment and feedback specifically for ophthalmology residents and the ophthalmic consultation. This improved and simplified version will facilitate its use and implementation to diverse programs around the world.

Measuring the quality of patient-physician communication.

Patient-physician communication is an often overlooked yet a very important aspect of providing medical care. Positive patient-physician quality of communication within discourse has an influence on various aspects of a consultation such as a patient's treatment adherence to prescribed medical regimen and their medical care outcome. As few reference standards exist for exploring semantics within the patient-physician setting and its effects on personalized healthcare, this paper presents a study exploring three methods to capture, model and evaluate patient-physician communication among three distinct data-sources. We introduce, compare and contrast these methods for capturing and modeling patient-physician communication quality using relatedness between discourse content within a given consultation. Results are shown for all three data-sources and communication quality scores among physicians recorded. We found our models demonstrate the ability to capture positive communication quality between both participants within a consultation. We also evaluate these findings against self-reported questionnaires highlighting various aspects of the consultation and rank communication quality among seventeen physicians who consulted amid one-hundred and thirty-two patients.

Promotion of Safe Work Practices in the Agricultural Sector through Coaching as a Training Strategy in Australia

There is currently, and historically, a high rate of workplace incidents and fatalities in the Australian Agricultural sector. This paper considers the use of coaching as a mechanism for provision of best practice safety training and development of a safety culture in Agricultural work places, particularly based on the current industry profiles and preferred methods of workplace learning. Current studies, including Safe Work Australia and AgHealth Australia data, and literature, such as Krauesslar and Passmore (2015) and Somes (2018), are reviewed to explain how coaching can enable workers to feel motivated and involved in workplace safety, and in effect, reducing the incidence of workplace injuries and fatalities. As such, the paper considers ‘what is the most successful training method to develop a stronger health and safety culture in the Agricultural Sector?’ The discussion finds that the most commonly and most effective learning approaches utilized in agricultural settings are based on ‘farmers learning from farmers’. This is effectively a coaching approach, and in turn, workplace coaching should be considered as a generic foundation skill taught to all workers in Agriculture to encourage effective consultation practices and communication between workers. The development of coaching skills can occur through their inclusion in formal training programs, such Certificate III or IV level programs in Vocational Education and Training and through short specific targeted programs.

Ascending aorta pseudoaneurysm simulating mediastinal lymphoma in computed tomography, a possible diagnostic error: a case report

BackgroundAn ascending aortic pseudoaneurysm is a severe and rare complication following cardiothoracic surgery. This case report demonstrates its possible misinterpretation and the consequent importance of multidisciplinary evaluation.Case presentationWe present a case of an 18-year-old Caucasian man with Marfan syndrome who developed an ascending aortic pseudoaneurysm about 1 year after undergoing cardiac surgery with the Bentall procedure. Computed tomographic examination of the thoracic aorta and positron emission tomography–computed tomography initially suggested a lymphomatous pathology. However, these imaging results were in contrast to the transesophageal echocardiogram and the laboratory data that showed negative results for hematological pathology. A second computed tomographic scan redirected the diagnosis toward a pseudoaneurysm.ConclusionThis case demonstrates the utility of close communication and interdisciplinary consultation between cardiovascular radiologists and the cardiac surgery team, which are mandatory in order to maximize their diagnostic skills in identifying postoperative complications.

Communication in high risk ante-natal consultations: a direct observational study of interactions between patients and obstetricians

BackgroundEffective communication is crucial to any doctor-patient consultation, not least in pregnancy where the outcome affects more than one person. While higher levels of patient participation and shared decision making are recognised as desirable, there is little agreement on how best to achieve this. Most previous research in this area is based on reported data such as interviews or surveys and there is a need for more fine-grained analysis of authentic interaction. This study aimed to identify the discourse characteristics and patterns that exemplify effective communication practices in a high-risk ante-natal clinic.MethodsWe video-recorded 20 consultations in a high-risk ante-natal clinic in a large New Zealand city with patients attending for the first time. Post-consultation interviews were conducted with the 20 patients and 13 obstetricians involved. Discourse analysis of the transcripts and videos of the consultations was conducted, in conjunction with thematic analysis of interview transcripts.ResultsMost patients reported high quality communication and high levels of satisfaction; the detailed consultation analysis revealed a range of features likely to have contributed. On the clinician side, these included clear explanations, acknowledgement of the patient’s experience, consideration of patient wishes, and realistic and honest answers to patient questions. On the patient side, these included a high level of engagement with technical aspects of events and procedures, and appropriate questioning of obstetricians.ConclusionsThis study has demonstrated the utility of combining direct observation of consultations with data from patient experience interviews to identify specific features of effective communication in routine obstetric ante-natal care. The findings are relevant to improvements needed in obstetric communication identified in the literature, especially in relation to handling psychosocial issues and conveying empathy, and may be useful to inform communication training for obstetricians. The presence of the unborn child may provide an added incentive for parents to develop their own health literacy and to be an active participant in the consultation on behalf of their child. The findings of this study can lay the groundwork for further, more detailed analysis of communication in ante-natal consultations.

Evaluating relationships between lung cancer stigma, anxiety, and depressive symptoms and the absence of empathic opportunities presented during routine clinical consultations

ObjectiveEmpathic communication in clinical consultations is mutually constructed, with patients first presenting empathic opportunities (statements communicating emotions, challenges, or progress) to which clinicians can respond. We hypothesized that lung cancer patients who did not present empathic opportunities during routine consultations would report higher stigma, anxiety, and depressive symptoms than patients who presented at least one. MethodsAudio-recorded consultations between lung cancer patients (N = 56) and clinicians were analyzed to identify empathic opportunities. Participants completed questionnaires measuring sociodemographic and psychosocial characteristics. ResultsTwenty-one consultations (38 %) did not contain empathic opportunities. Unexpectedly, there was a significant interaction between presenting empathic opportunities and patients’ race on disclosure-related stigma (i.e., discomfort discussing one’s cancer; F = 4.49, p = .041) and anxiety (F = 8.03, p = .007). Among racial minority patients (self-identifying as Black/African-American, Asian/Pacific Islander, or other race), those who did not present empathic opportunities reported higher stigma than those who presented at least one (t=-5.47, p = .038), but this difference was not observed among white patients (t = 0.38, p = .789). Additional statistically significant findings emerged for anxiety. ConclusionDisclosure-related stigma and anxiety may explain why some patients present empathic opportunities whereas others do not. Practice implicationsClinicians should intentionally elicit empathic opportunities and encourage open communication with patients (particularly from diverse racial backgrounds).

Conjugando diálogo y tecnología. Los medios digitales y el diálogo organizaciones-públicos desde la perspectiva de las multinacionales en España y Latinoamérica

Introducción: El artículo analiza cómo perciben las empresas multinacionales de España y Latinoamérica el impacto de las tecnologías digitales en el diálogo con sus públicos y si consideran que los consultores de comunicación pueden ayudar a reducir la brecha entre normatividad académica y práctica profesional en este campo. Metodología: Tratándose de una perspectiva de investigación poco explorada, donde aún resulta necesario construir categorías analíticas específicas, se realizaron 22 entrevistas en profundidad a altos ejecutivos de empresas multinacionales en 9 países del ámbito iberoamericano. Resultados: Las compañías perciben de manera predominantemente positiva el impacto de las tecnologías digitales sobre el diálogo organizaciones-públicos, a pesar de que las investigaciones académicas más recientes sugieren un “incumplimiento de la promesa dialógica” de los nuevos medios. El estudio también revela la coexistencia de dos definiciones de diálogo y tres roles asignados a las firmas consultoras en relación a esta temática. Discusión y conclusiones: La investigación detecta una “disonancia pragmática” en las organizaciones: por un lado, se presenta el diálogo como búsqueda de entendimiento mutuo, pero en la práctica se considera como dialógico cualquier intercambio comunicativo. Además, la investigación ofrece categorías analíticas para futuros estudios sobre el tema.

"What's Going on With My Ears?": Some Reflections on Managing Uncertainty in the Audiology Consultation.

Purpose Feedback sessions after audiology consultations predominantly involve information counseling or patient education, where the patient is informed about their hearing status and possible management options. Effective communication is vital to ensure that information about the hearing impairment, recommendations, and/or management options is appropriately provided and understood by patients and that patient needs and expectations from the session are met. This research note reports on an exploratory study that sought to describe communication in follow-up audiological consultations within a context where ototoxicity monitoring is routine practice. Method Six interactions between patients and audiologists were video-recorded at an in-patient treatment facility for drug-resistant tuberculosis in Johannesburg and analyzed using a sociolinguistic approach. Semistructured interviews were also conducted with participants and analyzed using content analysis. Results These interactions differed considerably to other audiology consultations we have analyzed in terms of aspects such as the length of the interaction and the type of information given to patients. We observed a substantial amount of mitigative, vague, and exaggerated language in these interactions. Conclusions In this research note, we offer some reflections on this data set using a lens of uncertainty management theory and explore factors within the broader context that may contribute to the interactional features observed in the current study. Overall findings suggest the need for clinicians to be trained to embrace and address uncertainty rather than avoid it within challenging clinical encounters.

Ready for the unexpected: theoretical framework and empirical findings on communication consulting

PurposeAlthough the market for communication consultancies has been booming worldwide for many years now, there are still only a handful of theoretical concepts and empirical findings pertaining to communication consulting. This is the fundamental starting point for this paper, which sets out to answer the following research questions: What is the function of communication consulting? What are the differences between consultants' expectations of consulting and those of clients? How do consultants and clients deal with the contradiction between proximity and distance? What are the potential threats to the autonomy of consulting?Design/methodology/approachThe paper combines a theoretical framework of communication consulting with a survey of German communication consultants and clients.FindingsFirst, a theoretical framework is developed in which communication consulting is defined as follows: First, it opens up decision-related contingency and thus produces additional options for managing communicative relationships with internal and external target groups, before helping to close decision-related contingency. The results of the survey show that the expectations of clients and consultants for communication consulting are largely similar. In the closing dimension especially, most clients share the active role of self-conception of most consultants. On the other hand, in some opening activities, clients wish for more critical, independent and courageous consulting.Research limitations/implicationsThe scope of the empirical material is limited to communication consultants and clients in Germany and may therefore not be valid in other cultural contexts.Originality/valueThe paper closes a gap in both theory building and empirical research in communication consulting. The theory presented conceives of communication consulting as a hybrid of management consulting and process consulting and, in addition to the opening dimension, also takes the closing dimension of consulting into consideration for the first time. The study reveals a certain schizophrenia in clients: on the one hand, clients demand more critical consultants and thus call for more distance; on the other hand, clients prefer to be close to their consultants, particularly if they wish to work with them for the long-term.

The clinical application value of mixed-reality-assisted surgical navigation for laparoscopic nephrectomy.

PurposeLaparoscopic nephrectomy (LN) has become the preferred method for renal cell carcinoma (RCC). Adequate preoperative assessment or intraoperative navigation is key to the successful implementation of LN. The aim of this study was to evaluate the clinical application value of mixed‐reality–assisted surgical navigation (MRASN) in LN.Patients and MethodsA total of 100 patients with stage T1N0M0 renal tumors who underwent laparoscopic partial nephrectomy (LPN) or laparoscopic radical nephrectomy (LRN) were prospectively enrolled and divided into a mixed‐reality‐assisted laparoscopic nephrectomy (MRALN) group (n = 50) and a non–mixed‐reality‐assisted laparoscopic nephrectomy (non‐MRALN) group (n = 50). All patients underwent renal contrast‐enhanced CT scans. The CT DICOM data of all patients in the MRALN group were imported into the mixed‐reality (MR) postprocessing workstation and underwent holographic three‐dimensional visualization (V3D) modeling and MR displayed, respectively. We adopted the Likert scale to evaluate the clinical application value of MRASN. The consistency of evaluators was assessed using the Cohen kappa coefficient (k).ResultsNo significant differences in patient demographic indicators between the MRALN group and the non‐MRALN group (P > .05). The subjective score of MRASN clinical application value in operative plan formulation, intraoperative navigation, remote consultation, teaching guidance, and doctor‐patient communication were higher in the MRASN group than in the non‐MRASN group (all P < .001). There were significantly more patients for whom LPN was successfully implemented in the MRALN group than in the non‐MRALN group (82% vs 46%, P < .001). The MRALN group had a shorter operative time (OT) and warm ischemia time (WIT) and less estimated blood loss (EBL) than the non‐MRALN group (all P < .001).ConclusionMRASN is helpful for operative plan formulation, intraoperative navigation, remote consultation, teaching guidance, and doctor‐patient communication. MRALN may effectively improve the successful implementation rate of LPN and reduce the OT, WIT, and EBL.

Addressing Perinatal Mental Health Risk within a Fetal Care Center.

Diagnosis of a fetal anomaly in pregnancy increases the risk for perinatal mental health difficulties, including anxiety, depression, and traumatic stress among expectant parents. Common emotional challenges include uncertainty about the diagnosis/prognosis, anticipated neonatal course, fears of fetal or neonatal demise, loss of a typical, uncomplicated pregnancy and postpartum course, and disruption of family roles due to medical care-related activities and restrictions. Psychologists in multidisciplinary fetal care centers are uniquely positioned to assess mental health risks and address the needs of expectant parents. Psychologists bring additional expertise in screening and assessment, clinical interventions to promote coping and symptom reduction while preparing for birth and a complicated neonatal course, consultation and effective communication, and programmatic development. This review paper provides an overview of the challenges and behavioral health risks for expectant parents carrying a fetus with a birth defect and the unique role psychologists play to support patients and families within fetal care settings.

A Case Study Of The Environmental Impact Assessment Legislations In Sarawak, Malaysia

Environmental Impact Assessment (EIA) is a planning tool used to identify, predict, evaluate and mitigate the environmental effects of development projects. In Sarawak, EIA is governed by the both the State and the Federal EIA Orders. This leads to ambivalence in determining the legislation under which a prescribed activity demanding an EIA falls. This case study aims to investigate the implications associated with the coexistence of both EIA Orders in the state of Sarawak from the viewpoints of practicing environmental consultants. The case study reviews the EIA legislations governing EIA practices in the State and includes a qualitative survey involving practicing EIA consultants to gather feedback on the implications associated with the EIA practices and recommendations to resolve the problems identified. The study shows that even though a prescribed activity is defined by the EIA legislations, different stages of the prescribed activity eventually become prescribed activities on their own, which demand fulfillment of different EIA legislation. Unclear demarcation of EIA jurisdiction and different requirements on the scope of an EIA particularly for earthworks also contribute to doubts among environmental consultants interviewed. Consultation, involvement and effective communication with environmental protection as priority are crucial to minimize any uncertainty resulted from co-implementation of both the EIA legislations. Future study can look into comparing perceptions on the effectiveness of the State and the Federal EIA legislations. The case study delves into a crucial issue related to EIA practices in Sarawak, Malaysia which has persisted without being formally addressed in any previous studies.&#x0D;

Is sharing the TARGET respiratory tract infection leaflet feasible in routine general practice to improve patient education and appropriate antibiotic use? A mixed methods study in England with patients and healthcare professionals.

Patient education on treatment choices for common respiratory tract infections (RTIs) is important to encourage appropriate antibiotic use. Evidence shows that use of leaflets about RTIs can help reduce antibiotic prescribing. TARGET leaflets facilitate patient-clinician communication in consultations. To explore patient, healthcare professional (HCP) and general practice (GP) staff views on the current Treating Your Infection (TYI)-RTI leaflet and proposed new 'antibiotic effect' column aimed at sharing information on the limited effect antibiotics have on the duration of RTIs. Service evaluation underpinned by Com-B behavioural framework, using patient and HCP questionnaires, and GP staff interviews/focus groups. Patients completed 83 questionnaires in GP waiting rooms. A lack of patient understanding about usual illness duration influenced their use of antibiotics for some RTIs. Patients provided positive feedback about the leaflet, reporting it increased their capability to self-care, re-consult when necessary and increase understanding of illness duration. Patients indicated they would value information on the difference antibiotics can make to illness duration. In total, 43 HCP questionnaires were completed and 16 GP staff participated in interviews/focus groups. Emerging themes included: barriers and facilitators to leaflet use; modifications; and future dissemination of the leaflet. GP staff stated that the 'antibiotic effect' column should not be included in the leaflet. Patient education around usual illness duration, side effects of antibiotics and back-up prescriptions gives patients a greater control of their infection management. As GP staff opposed the extra information about benefits of antibiotics on illness duration, this will not be added.

Improving Communication in Outpatient Consultations in People With Cirrhosis: The Development of a Question Prompt List (QPL).

Liver health professionals have difficulty discussing liver cirrhosis and its prognosis with patients and families. Question Prompt Lists (QPLs), which are evidence-based lists of "recommended questions," may improve communication but need to be designed specifically for the target population. This study aimed to develop and pilot a QPL for patients with cirrhosis. A mixed-methods design in 3 phases. In phase 1 (item generation), potential questions for inclusion in the QPL were identified from 3 sources-a scoping literature review; an online survey; and interviews with patients, family members, and health professionals. In phase 2 (QPL construction), a multidisciplinary expert panel finalized the selection of questions and the format of the QPL. In phase 3 (pilot study), the QPL was assessed for acceptability and feasibility in a hepatology outpatient clinic population. From 258 topics initially identified, 30 questions were included in the first draft of the QPL. After review by a multidisciplinary expert panel including patients, the QPL was reduced to 22 questions. In the pilot study, 133/215 eligible patients consented to participate, although only 67/133 used the QPL in their clinic appointment. Among those who used the QPL, all questions were asked at least once. The most commonly asked question related to life expectancy. Most participants expressed support for the content of the QPL. A QPL, suitable for use in patients with liver cirrhosis attending hepatology outpatient clinics, has been developed and piloted. The QPL seems to be feasible to use and acceptable to patients and clinicians. Further work is needed to evaluate its effectiveness and to determine optimum delivery in clinical practice.

PUBLIC RELATIONS STRATEGY ON RESPONDING ENVIRONMENTAL ISSUES TO SUSTAIN CORPORATE IMAGE: A Descriptive Study of Danone-AQUA's #BijakBerplastik

This study began with a contamination problem that was often brought up when speaking about environmental issues on a larger scale. The most debatable aspect of environmental issues nowadays is about marine plastic pollution that already contaminated the world's ocean. This issue then motivated societies in the world to start reducing plastic usage, but unfortunately, there are only a few companies that tried to support this movement. In Indonesia, Danone-AQUA is one of the companies that support the movement. In mid-2018, Danone-AQUA stated their commitment to engage in this said movement by making #BijakBerplastik commitment. This research was conducted using Cutlip and Center’s strategic public relations phase in understanding the social marketing effect that was done by Danone-AQUA in maintaining the positive image of the company as the pioneer of bottled drinking water in Indonesia. Using case study research method as its base with a post-positivistic paradigm and qualitative approach in descriptive nature, data was gathered by doing in-depth interviews and literature review studies. There are five key informants, two public relations communication consultants, representatives from Danone-AQUA, one public target, and one communications expert. This study found that the public relations strategy used by Danone-AQUA with the form of social marketing applied in #BijakBerplastik successfully maintains the corporate image in a positive way. To cite this article (7th APA style): Megan, D. & Noer, M. K. (2020). Public Relations Strategy on Responding Environmental Issues to Sustain Corporate Image: A Descriptive Study of Danone-AQUA's #BijakBerplastik. Journal Communication Spectrum, 10 (1), 58-67. http://dx.doi.org/10.36782/jcs.v9i2.1984

A Case Study Of The Environmental Impact Assessment Legislations In Sarawak, Malaysia

Environmental Impact Assessment (EIA) is a planning tool used to identify, predict, evaluate and mitigate the environmental effects of development projects. In Sarawak, EIA is governed by the both the State and the Federal EIA Orders. This leads to ambivalence in determining the legislation under which a prescribed activity demanding an EIA falls. This case study aims to investigate the implications associated with the coexistence of both EIA Orders in the state of Sarawak from the viewpoints of practicing environmental consultants. The case study reviews the EIA legislations governing EIA practices in the State and includes a qualitative survey involving practicing EIA consultants to gather feedback on the implications associated with the EIA practices and recommendations to resolve the problems identified. The study shows that even though a prescribed activity is defined by the EIA legislations, different stages of the prescribed activity eventually become prescribed activities on their own, which demand fulfillment of different EIA legislation. Unclear demarcation of EIA jurisdiction and different requirements on the scope of an EIA particularly for earthworks also contribute to doubts among environmental consultants interviewed. Consultation, involvement and effective communication with environmental protection as priority are crucial to minimize any uncertainty resulted from co-implementation of both the EIA legislations. Future study can look into comparing perceptions on the effectiveness of the State and the Federal EIA legislations. The case study delves into a crucial issue related to EIA practices in Sarawak, Malaysia which has persisted without being formally addressed in any previous studies.&#x0D;