Introduction to Clinical Skills Module

1. Introduction to Clinical Skills Module

2. Communication and Clinical Skills Dr Jane Kidd Associate Professor Clinical Communication j.m.kidd@warwick.ac.uk

3. Introduce the Clinical Skills module Raise awareness of some of the communication and clinical challenges you will meet Consider how clinical skills are central to effective practice Aims

4. List components of the clinical skills module List components of effective communication Identify skills to commence a consultation effectively Identify why awareness of feelings is important Identify some barriers to effective clinical communication List some solutions to problems Outcomes

5. Communication Component Dr Jane Kidd Clinical skills component Drs Vinod Patel and Linda Maxwell Inter-professional learning pathway Dr Ann Jackson Clinical Skills

6. Phase 1 Introduction Clinical Skills 1 and 2 Inter professional Learning Programme Developing Interview Skills in the Consultation (DISC) Clinical Skills: Communication

7. Communication Collaboration Team working Inter Professional Learning – Why?

8. 1000+ students 13 professional groups Interwoven online pathway Student discussions in virtual learning sets Patient based journey Weekly episodes and e-activities Inter Professional Learning – How?

9. How many consultations do you think you will conduct over your professional lives?

10. Diagnosis from History alone: 85% Diagnosis after Examination only: 5-10% Diagnosis after Investigation: 5-10% So Good Communication Skills are central to Clinical Medicine!

11. Effective communication: 3 sets of skills • Process • Content • Perceptual • Silverman , Kurtz & Draper, 2005

12. Silverman, J, Kurtz, S., and Draper, J. Skills for Communicating with Patients, 2005 Radcliffe Medical Press, Oxford Recommended Reading:Communication Skills

13. “I hear and I forget… I see and I remember… I do and I understand…” Chinese Proverb

14. Observe a consultation Discuss the questions with your neighbour Share your ideas with the group Structure for next part of session

15. What do you think worked well? Why do you think the student is behaving in this way? What impact does the behaviour have on the patient? What could be done differently? What ethical issues do you think this consultation raises? Questions

16. Prepare Establish initial rapport Identify reasons for the consultation Silverman, Kurtz and Draper 2005 Commencing the consultation

17. Preparation • Environment • - location, room, seating, desk • Self • Activities • Emotions • Silverman , Kurtz & Draper, 2005

18. Greet patient Check/Obtain patient’s name Introduce self, role, nature of interview Obtain consent Empower patient to ask questions Demonstrate respect and interest Attend to patient’s physical comfort Explain confidentiality Mention note taking Silverman, Kurtz and Draper, 2005 Establish initial rapport

19. Consider non-verbal aspects • Calm approach • Tone of voice • Use of touch – is a handshake appropriate? • Personal space

20. Open questions - allow patient to complete response Listen attentively/use active listening Use “wait” time/silence Confirm list and screen for further problems Negotiate agenda Silverman, Kurtz and Draper, 2005 Identify reasons for the consultation

21. Your own – can impact on your effective behaviours Your patients – differentiate thoughts from feelings - important for empathy Awareness of feelings

22. Clinical Skills Interpret the results of commonly used investigations. Communication Skill Explain investigation Explain result GMC: Clinical and Communication Skills Relationship with patient, History, Examination, Problem Solving and Management

23. Clinical Skills Work out drug dosage and record the outcome accurately. Write safe prescriptions for different types of drugs. Communication Skills Explain drug effects and side effects Write it up effectively GMC: Clinical and Communication Skills Relationship with patient, History, Examination, Problem Solving and Management

24. Clinical Skills Give intramuscular and subcutaneous injections. Carry out arterial blood sampling. Perform suturing. Communication Skills Explain procedure Respond to patient’s emotions GMC: Clinical and Communication Skills Relationship with patient, History, Examination, Problem Solving and Management

25. Clinical Skills Perform bladder catheterisation Communication Skills Explain need Explain procedure Be sensitive to patient’s needs GMC: Clinical and Communication Skills Relationship with patient, History, Examination, Problem Solving and Management

26. Solutions • Get to know yourself • prejudices, assumptions, values • Identify your strengths and weaknesses • Practice, practice, practice • Get feedback on what you do • Reflect on – oops! learn from what you do • Take every opportunity to learn • Be self directed and find more!