1 / 17

Consultation Skills 3

Consultation Skills 3. 6.10.11. Programme. Neighbour consultation model Difficult aspects Practice part 2 consultation Video and role plays. Neighbour’s Consultation Model 1987. 4. Safety netting. 3. Handing Over. 5. House keeping. 2. Summarising. 1. Connecting. 1. Connecting.

hilda-downs
Download Presentation

Consultation Skills 3

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Consultation Skills 3 6.10.11

  2. Programme • Neighbour consultation model • Difficult aspects • Practice part 2 consultation • Video and role plays.

  3. Neighbour’s Consultation Model1987 4. Safety netting 3. Handing Over 5. House keeping 2. Summarising 1. Connecting

  4. 1. Connecting • Rapport • Gambits & Curtain Raisers • Minimal cues • What is said & not said • Eye movements • 3 cardinal mental thought processes • Speech censoring • Internal Search • Acceptance Set

  5. 2. Summarising • What information do we need? • I, C, E. • Feelings • Effects of symptoms, treatment etc • When should you elicit that information? • What signals can the patient give to suggest that • more information could be elicited? • How should we elicit the information?

  6. 3.Handing Over • Negotiating • Give the patient options • Influencing • in my opinion… • Use questions instead of statements • Reframing • Shepherding • Pre-empting • My friend John… • Gift Wrapping • Chunk & Check • How to give instructions – rule of 3.

  7. 4. Safety Netting • “General Practice is the Art of Managing Uncertainty” • If I am right, what do I expect to happen? • Worst case scenario • Instructions to patient • F/U - What if patient doesn’t come back? • How will I know if I am wrong? • What will I do then? • What to say to the patient

  8. 5. House Keeping • Long term • In between Patients-clear the mind of the psychological remains of one’s consultation • During Consultations • Am I in good enough shape for the nextpatient?"

  9. Data Gathering-Establish reasons for consultation-Pt centred then Dr centred Explanation and planning Simple Model Rapport Building

  10. Rapport • Ongoing in consultation • Starts at greeting • What else is involved • Sometimes omitted as concentrate on other aspects

  11. DIFFICULTIES –EXPLANATION • EXPLANATIONS-KEEP SIMPLE 30SEC LANGUAGE • WHAT DO YOU KNOW? • WHAT DO YOU WANT TO KNOW? • WHAT DO YOU NEED TO KNOW? • EXPLANATION GAME

  12. DIFFICULTIES –EXPLANATION2 • SUMMARISE PRE • CHUNK AND CHECK • AVOID JARGON AND STANDARDISED • KEEP SIMPLE • VIDEO-http://youtu.be/A_iWmX28R7c

  13. EXPLANATION GAME • IN PAIRS PRACTICE EXPLANATIONS • 30-60secs.pre management plans • Swap over. How to assess • Ease of understanding • Avoidance of medical jargon • Use of analogies • Timing • Alternative resources-diagrams/PILS( quality control)

  14. EXPLANATION GAME IDEAS • CKD • HYPO/HYPERTHYROIDISM • ASTHMA • COPD • DIABETES • ANGINA • ATRIAL FIBRILLATION

  15. SHARING OPTIONS • WHAT IS DIFFICULT? • IS THERE ALWAYS AN OPTION? • USE ICE • KITES IN THE AIR-NEIGHBOUR • Relative risks and benefits • LEAVE PAUSES • KEEP SIMPLE NO JARGON • LOOK AT NON VERBAL CUES • CHECK UNDERSTANDING –How?

  16. CONCORDANCE-THE END • WHAT IS IT ? • HOW ACHIEVED • PATIENT AND DOCTOR AGENDA MET • PT SUMMARISE TO CHECK UNDERSTANDING • SAFETY NET • http://youtu.be/MQFuLLX-KCY 314 - 3:35

  17. VIDEO • How effective was the GP? • Informed controller-how to deal with? • A shared understanding? • How to communicate risk? • What was good? • What could be improved?

More Related