clinical communications Flashcards
what 7 things should you do once entering the station?
- greet both patient and examiner, state your name to examiner
- introduce yourself to patient and check their name and DoB
- explain your task without medical jargon (warn patient they may have to undress)
- obtain consent, state examiner will acts as chaperone
- pain or discomfort?
- position bed angle (45 degrees for cardiology and resp, abdo pt lying flat)
- hand hygiene - find the gel
what is PAT?
Permission: “can you lie down for me please?”
Assessment procedure
Thanks
what do you need to remember when concluding the station?
- thank patient
- ask if need assistance getting dresses
- sanitise hands
how do you introduce yourself in the OSPE station?
- introduce yourself
- state your role
- why you are there (GP has asked me to speak with you for 10 mins to take your history before your consultation, which I will then feedback to your doctor)
- check name and DoB
how do you open the conversation? give examples?
“so what brought you into the clinic today” - pt will talk about PC
“can you tell me more about it”
give pt oppurtunity to add anything else at end: “are there any other symptoms you would like to add before we continue”
- OPEN QUESTIONS
give example of signposting
“to help me get a better understanding of what’s going on, I am now going to ask you some more questions about each of the symptoms you’ve just told me about”
give examples of empathetic verbal and non-verbal cues
- body language, maintain eye contact
- open posture
- “i understand this must be really stressful for you”
- “we will do our best to take care of you”
what do you do next?
history of PC
- start with more open qiestions
- gradual shift to more closed questions as focus on specific aspects
what do you think of for pain?
S - site O - onset C - character R - radiation A - associated T - time E - exacerbating or relieving factors S - scale can also be used for coughs
what else should you integrate within your interview?
ICE
what should you move onto next?
PMH
“can I ask if you have any other medical conditions?”
probe further…
“have you ever been admitted to hospital?”
within the medical history what 2 things are important?
- drug history
- allergies
what other histories should you ask about?
- family history
- social history
what things should be asked about in social history?
- smoking (can i ask if you smoke?)
- alcohol
- substance misuse (would you mind telling me if you use, or have ever used recreational drugs)
- occupation (what do you do for a living)
- travel (have you been abroad anywhere recently)
- home life/family situation (who is at home with you)
- mobility and functional ability (esp for elderly, how does PC impact life)
- sexual history (only if relevant)
- diet (if relevant)
what general questions should be asked in a systems review (esp for cancer or TB)?
- weight loss
- night sweats
- any lumps
- fatigue
- appetite
- fevers
- itch
- recent trauma
