Advanced consultation skills and shared decision making

Question 1

What are the 2 systems of the Dual process therapy?

Answer 1

System 1: Rapid, automatic, unconscious and familiar decision making
System 2: Slower process, that requires effort and conscious thinking.

Question 2

List the types cognitive biases

Answer 2

> Anchoring bias
Ascertainment
Availability
Bandwagon effect
Gambler fallacy
Omission
vertical line failure
Blind spot bias

Question 3

What is Anchoring bias

Answer 3

> Anchoring bias: Undue emphasis on early features in a consultation

Question 4

what is Ascertainment bias

Answer 4

> Ascertainment: Thinking shaped by previous experiences

Question 5

what is availability bias

Answer 5

> Availability: Recent experience over evidence

Question 6

describe a bandwagon bias

Answer 6

> Bandwagon effect: Doing what everyone else does or what the data says

Question 7

Describe the Gambler’s fallacy

Answer 7

> Gambler fallacy: Thinking a run of diagnosis means sequences cannot occur

Question 8

What is an omission bias

Answer 8

> Omission: Inaction, as event due to natural diseases progression, as preferred to those due to action of professional

Question 9

What is vertical line failure

Answer 9

> vertical line failure: Routine repetitive tasks lead to thinking in silos

Question 10

what is blind spot bias

Answer 10

> Blind spot bias: ‘other people susceptible bias but I’m not’

Question 11

What strategies can be used to avoid cognitive bias

Answer 11

> Double checking calculation
Safety netting: Red-flags/ if symptoms persist
Check medicine interaction
Embrace interprofessional working
Report error
establish a culture where challenging is acceptable

Question 12

What are the barriers to shared decision making (SDM)

Answer 12

> ‘We do it already’: HP might think they already doing SDM
Thinking they don’t have the correct tool
Thinking patient don’t want it
Don’t know how to measure it
They have too many demands and priority

Question 13

what are the different types of questions asked during a consultation

Answer 13

Open

probing

leading

Question 14

what constitutes active listening

Answer 14

Paraphrasing

summarising

reflection

Clarification

Question 15

what are the 3 key components of clinical decision making

Answer 15

Best available evidence

expertise, experience, skills and judgement

patients values, needs and preferences