EH 1 WEEK 11

Question 1

Discuss the importance and relevance of communication skills in daily practice (3 main factors)

Answer 1

1) Communication skills impact diagnositic formulation (prevents missing information e.g. psychological issues are detected)
2) Communcation skills are linked with patient satisfaction (increased compliance with treatment and follow up)
3) communciation skills are linked to clinical outcomes (e.g. patients experience less pscyhological distress)

Question 2

What are the elaboration/clarification probes

Answer 2

• minimal encouragers (head nods, uhuh)
• paraphrasing (so you had pain in your right hand fro a week)
• summarise (so you had pain in your right hand for a week and you are worried because you cannot do the assignment)

Question 3

What are the “rules” feedback

Answer 3

• Briefly clarify matters of fact
  The learner in question goes first
• good points first (provide positive reinforcement)
• Recommendations not criticisms
• specific suggestions towards behaviour that the learner can do something about
• limit the amount of information

Question 4

What are some interview techniques

Answer 4

• establish rapport
• attending behaviour (eye contact, body language, attentive listening)
• Closed questions (focussing effect e.g. do you smoke)
• Open questions (encourage patient to talk “could you tell me about that”
• Reflect feelings and meaning
• Transitional statements
• Respect and warmth

Question 5

What are the key elements of the patient centred interview

Answer 5

• It is about the integration of the disease framework and illness framework
• Unwellness leads to the search of the two frameworks
• Disease frame work is the doctors agenda (history, physical exam and investigations)
• illness framework (patients agenda) ideas concerns and expectations

Question 6

What are the elements of teh patient centred clinical method

Answer 6

1) Exploring the disease and illnee - history, labs, ICE, effects on function
2) Understanding the whole person , the patient, their proximal and distal context
3) finding common gorund (problems, goals and roles - mutual decisions)
4) Incorporating prevention and health promotion
5) enhancing doctor patient relationship
6) being realistic