Transcript Clinical Skills

Introduction to
Clinical Skills
Module
Communication and Clinical Skills
Dr Jane Kidd
Associate Professor
Clinical Communication
[email protected]
Aims
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
Outcomes
• 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
Clinical Skills
• Communication Component
Dr Jane Kidd
• Clinical skills component
Drs Vinod Patel and Linda Maxwell
• Inter-professional learning pathway
Dr Ann Jackson
Clinical Skills: Communication
Phase 1
Introduction
Clinical Skills 1 and 2
Inter professional Learning Programme
Developing Interview Skills in the Consultation
(DISC)
Inter Professional Learning
– Why?
Communication
Collaboration
Team working
Inter Professional Learning
– How?
1000+ students
13 professional groups
Interwoven online pathway
Student discussions in virtual learning sets
Patient based journey
Weekly episodes and e-activities
How many consultations do you think you
will conduct over your professional lives?
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!
Effective communication:
3 sets of skills
Process
Content
Perceptual
Silverman , Kurtz & Draper, 2005
Recommended Reading:
Communication Skills
Silverman, J, Kurtz, S., and Draper, J.
Skills for Communicating with Patients, 2005
Radcliffe Medical Press, Oxford
“I hear and I forget…
I see and I remember…
I do and I
understand…”
Chinese Proverb
Structure for next
part of session
Observe a consultation
Discuss the questions with your neighbour
Share your ideas with the group
Questions
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?
Commencing the
consultation
Prepare
Establish initial rapport
Identify reasons for the consultation
Silverman, Kurtz and Draper 2005
Preparation
• Environment
- location, room, seating, desk
• Self
Activities
Emotions
Silverman , Kurtz & Draper, 2005
Establish initial rapport
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
Consider non-verbal aspects
• Calm approach
• Tone of voice
• Use of touch
– is a handshake appropriate?
• Personal space
Identify reasons for the
consultation
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
Awareness of feelings
Your own – can impact on your effective
behaviours
Your patients – differentiate thoughts from
feelings
- important for empathy
GMC: Clinical and Communication
Skills
Relationship with patient, History, Examination, Problem Solving and Management
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
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
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
Clinical Skills
• Perform bladder catheterisation
Communication Skills
• Explain need
• Explain procedure
• Be sensitive to patient’s needs
Solutions
• Get to know yourself
- prejudices, assumptions, values
- Identify your strengths and weaknesses
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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!