Ideas, Concerns and Expectations

Ideas, Concerns and Expectations (ICE)

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Table of Contents

A key component of history taking involves exploring a patient’s ideas, concerns and expectations (often referred to as ICE). Asking about a patient’s ideas, concerns and expectations allow you to gain insight into how a patient currently perceives their situation, what they are worried about and what they are expecting from the consultation. It can sometimes be challenging to use the ICE structure in a way that sounds natural in your consultation. As a result, we’ve put together some example phrases for covering each of the three points.

You might also be interested in our OSCE Flashcard Collection which contains over 2000 flashcards that cover clinical examination, procedures, communication skills and data interpretation.


Examples of how to explore a patient’s ideas:

  • “Tell me about what you think is causing the problem.”
  • “Do you have any theories about what might be going on?”
  • “It’s clear that you’ve given this a lot of thought and it would be helpful to hear what you think might be going on.”
  • “What do you think might be happening?”
  • “What’s your best guess as to what is causing this?”
  • “Do you have any ideas as to what is going on at the moment?”


Examples of how to explore a patient’s concerns:

  • “What’s your biggest worry at the moment regarding what this might be?”
  • “Are you worried about this being anything in particular?”
  • “In your darkest moments, what do you worry about?”
  • “What’s the worst thing you were thinking it might be?”
  • “What’s your number one concern regarding this problem at the moment?”


Examples of how to explore a patient’s expectations:

  • “What were you hoping I’d be able to do for you today?”
  • “What would ideally need to happen for you to feel today’s consultation was a success?”
  • “What do you think might be the best plan of action?”
  • “What were you hoping would happen today?”
  • “You’ve obviously thought about this quite a bit, did you have any thoughts on the best way we could tackle the issue?”


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