Consultation Skills 3咨询技巧.pptVIP

Consultation Skills 3 6.10.11 Programme Neighbour consultation model Difficult aspects Practice part 2 consultation Video and role plays. Neighbour’s Consultation Model1987 1. Connecting 2. Summarising 3.Handing Over 4. Safety Netting 5. House Keeping Simple Model Data Gathering-Establish reasons for consultation-Pt centred then Dr centred Explanation and planning Rapport Ongoing in consultation Starts at greeting What else is involved Sometimes omitted as concentrate on other aspects 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 DIFFICULTIES –EXPLANATION2 SUMMARISE PRE CHUNK AND CHECK AVOID JARGON AND STANDARDISED KEEP SIMPLE VIDEO-http://youtu.be/A_iWmX28R7c 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) EXPLANATION GAME IDEAS CKD HYPO/HYPERTHYROIDISM ASTHMA COPD DIABETES ANGINA ATRIAL FIBRILLATION 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? 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 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? * * 1. Connecting 2. Summarising 3. Handing Over 4. Safety netting 5. House keeping Rapport Gambits Curtain Raisers Minimal cues What is said not said Eye movements 3 cardinal mental thought processes Speech censoring Internal Search Acceptance Set What information do we need? I, C, E. Feelings Effects of symptoms, treatment etc When should