Effective consulting

Question 1

COG connect: Preparing

Answer 1

• Preparing oneself
• Preparing the space
• Checking the medical record

Question 2

COGconnect opening:
Establishing
Establishing the
Initial

Answer 2

• Establishing relationships
• Establishing the agenda
• Initial observations

Question 3

COGconnect: Gathering

• PC
• ICEIE
• Relevant

Answer 3

• History and examination of presenting complaint
• Patients perspective of the problem (ICEIE)
• Relevant background information

Question 4

COG connect: formulating
Stop
Lists
Red flags

Answer 4

• Stop, think, consider personal bias
• Differential diagnosis and problem lists
• Red flags, signs and symptoms

Question 5

COG connects: explaining

check, chunk,check

Answer 5

• Check: current understandings and desire to know
• Chunk: simple language, visual aids and mini-checks
• Check that shared understanding has been achieved

Question 6

COG connect: activating

• Noticing
• Connecting to
• Helping

Answer 6

• Noticing self-care opportunities
• Connecting to useful resources
• Helping the patient to make important changes

Question 7

COG connect: planning

• Encourages
• Proposing
• ICEIE

Answer 7

• Encourages contribution
• Proposing options
• Attends to ICEIE

Question 8

COG connects: doing

Answer 8

• Formal and informal consent
• Due regard for safety
• Skilfully conducted procedure

Question 9

COG connect: closing

Answer 9

• Questions and summary
• Safety-netting
• Follow-up

Question 10

COG connect: integrating

Answer 10

• Updating the clinical record
• Noting and acting on learning need
• Dealing with feelings

Question 11

Opening: OICAN

Answer 11

O - Observation 
I - Introduction
C - Connection 
A - agenda setting 
N - negotiating

Question 12

Gathering information: Sign posting

• Definition
• Benefits

Answer 12

• A transitional statement which allows doctors to signal a change in direction, moving from one section of a consultation to another
• Patient knows where the Dr is going and why
• Self-clarification
• Adds structure, builds rapport and allows collaboration

Question 13

Gathering information: Summarising

• Definition
• Importance (3)

Answer 13

• The deliberate step of making an explicit verbal summary to the patient of information gathered
• Allows a pause in information intake
• Allows doctor to communicate ideas
• Patient can correct any inaccuracies

Question 14

Formulating STOP4What?:

Answer 14

• STOP: self-consciously pause in the consultation, allowing a moment to consider
• What?: what do you know
• So what?: What do I think is happening
• What else?: What else do I need to consider
• What next?: what should we do now?

Question 15

Activating: OARS

Answer 15

O - Open questions
A - Affirmations
R - Reflections
S - Summary

Question 16

Planning: ICEIE

Answer 16

I - Ideas 
C - Concerns 
E - Expectations
I - Impact 
E - Emotions