quiz 1

Question 1

autonomy

Answer 1

principle that ensures that patients are afforded the chance to make informed, uncoerced decisions

Question 2

beneficence

Answer 2

principle that obligates doctors to do everything they can that would benefit or help the patient

Question 3

non-maleficence

Answer 3

principle of “primum non nocere” (first, do no harm) which obligates doctors to do as little harm as possible

Question 4

justice

Answer 4

principle of fairness. In health care justice normally refers to distributive justice, which is fairness in distribution of resources

Question 5

paternalistic model

Answer 5

the guardian

Question 6

informative model

Answer 6

competent technical expert

Question 7

interpretive model

Answer 7

counselor or advisor

Question 8

deliberative model

Answer 8

friend or teacher

Question 9

patients want their doctor to:

Answer 9

care about them as people, be competent, be effective, be efficient, be an advocate in “the system”

Question 10

elements of caring

Answer 10

empathy, arrange to meet healthcare needs, respect and non-judgment

Question 11

elements of effective communication

Answer 11

active and engaged listening-non controlling or interrupting
give info in appropriate doses
choose words carefully and check for meaning
be direct and straightforward but not abrupt
consistent in verbal and nonverbal behaviors
soft but confident tone, slow pace, comfortable appearance

Question 12

talking constitutes up to ___ of a Dr/Pt interaction but only 7% of the conveyance of humanistic qualities

Answer 12

75%

Question 13

____ of humanistic quality is conveyed by “tone of voice”

Answer 13

22%

Question 14

____ is conveyed by visual perception of your body language

Answer 14

55%

Question 15

what drives empathy

Answer 15

recognition and understanding of another’s viewpoint

Question 16

examples of bad body language

Answer 16

sighing, crossed arms/legs, head tilt, eye contact, leaning away, tensing of muscles, facial expression, breathing changes, squirming and shifting

Question 17

examples of good body language

Answer 17

eye contact consistent, forward lean, avoid fidgeting, avoid distracted looks, hands… where are they & what are they doing, facial expressions of concern understanding, nodding of head

Question 18

LOCQSMATT

Answer 18

location
onset
chronology
quality
severity
modifying factors
associated symptoms
treatments (previous)
treatment (goals)

Question 19

three key elements of patient compliance

Answer 19

expectancy that results can be achieved
belief that actions will lead to desire outcome
having attractive or valuable goals

Question 20

what is the most frequent source of patient dissatisfaction

Answer 20

failure to receive an adequate explanation of the problem

Question 21

the best ROFs

Answer 21

explain the problem
connect the dots between patients narrative and problems and problems and solutions
empathize with pt & reassure them you have mastery over the situation
eliminate fears, reduce uncertainties, set the stage to achieve goals of care
demonstrate optimism
collaborate with them, codify shared nature of improvement

Question 22

ROF: step 1

Answer 22

greet the patient
give the problem a name and then explain in lay terms
explain how you got to conclusion using the Hx and exam highlights
Lay terms
explain the cause
ask if there are questions

Question 23

ROF step 2:

Answer 23

outline goals of care. example of 3 laudable goals:
pain management
return to full function
eliminate the cause of the problems and provide options to prevent it in the future
ask for questions…

Question 24

ROF step 3:

Answer 24

outline specifics of treatment plan

• treatment modalities you will use
• what each modality will do for the patient
• what it will feel like (will it hurt)

Question 25

ROF step 4:

Answer 25

explain what you expect in terms of their trajectory of improvement
best guess as to how long it will take to be “done’

Question 26

enhancing patient compliance with the treatment plan

Answer 26

tie symptoms and limitations to cause of problem
stress patient’s role in recovery
identify barriers to compliance
involve patient in addressing barriers

Question 27

PARQ

Answer 27

procedures
alternatives
risks
questions

Question 28

procedure

Answer 28

what you’re going to do and how it will feel ie if it will hurt

Question 29

alternative

Answer 29

include the “do nothing” option unless it would be patently unsafe

Question 30

Risks

Answer 30

if it is minor and rare, forget about it
if it is minor and not rare discuss it
if it is major and common- discuss it
if it is major and uncommon or rare- discuss it
if it is major and very rare- depends on what it is

Question 31

questions

Answer 31

hopefully you’ve been engaging that all along so this is the grand summary “do you have any areas of uncertainty remaining?”

Question 32

t/f ROF is about explaining what is wrong and how you are going to address it- it is more comprehensive than PARQ

Answer 32

T

Question 33

t/f PARQ focuses on ensuring a patient understands the treatment options and what can go wrong

Answer 33

T

Question 34

t/f PARQ can be nested within a ROF- or not

Answer 34

T

Question 35

t/f PARQ is the minimum requirement before tx

Answer 35

T

Question 36

t/f PARQ must include opportunity for questions

Answer 36

T