SITUATIONS AND ROLEPLAY

Question 1

Breaking bad news

Answer 1

S - et the scene (introduce, identity, check if wants someone)
P - erception (Determine what the patient know, listen to patient understanding)
I - nvitation (Ask patient if s/he wishes to know, accept, offer q’s)
K - nowledge (avoid jargon, educational level, socio-cultural background, current emotional state, small chunks, allow processing time)
E - motion (Explore emotions and sympathise, active listening nodding offer tissues)
S - ummary (Ask whether they want to clarify something else, repeat)

Question 2

Dental anxiety

Answer 2

C - communicate clearly (Explain procedures in simple terms)

A - knowledge emotions (Validate the patient’s anxiety - offer ways to reduce this music)

L - isten carefully (Encourage them to express their concerns)

M - inimize uncertainty (step-by-step guidance, use ‘Tell-Show-Do, signal to stop)

Question 3

Child + parent

Answer 3

• listen
• ask why
• accept opinion
• lay all options out

BENIFICENCE AUTONOMY GILLICK COMPETENCY

Question 4

Breach of confidentiality

Answer 4

• report
• how YOU found out
• Breach of confidentiality- lack of trust, bad for the reputation of dentists (GDC)
• Professionalism - upholding gdc standards, the way patients look at the dental profession
• Patients first - beneficence - mental distress
• insurance companies
• extreme emergency cases
• court
• child or adult without capacity

Question 5

ETHICS

Answer 5

• MADE AS AN MDT
• order on the basis as who will benefit and survive from the transplant
• ensuring prejudice and assumptions aren’t included (age, living conditions, ethnicity, lifestyle choices) - no judgment - instead address with the patient and consult them on their commitment to quit drinking and rehab
• no personal bias to play into my clinical descisions
• matching of liver
• age (risk factor - more likely to survive surgery)
• comorbodities (more comorbidities = least likely to survive)
• recurrence of disease (possibility of relapsing so less likely to survive)
• most likely to survive
• impact on society
  likiness of success

Question 6

How Is A Child Deemed Gillick Competent?

Answer 6

whether a child U16 can consent to their own medical treatment

• How old are they? How mature are they?
• What’s their mental capacity?
• Does the child understand what the treatment entails?
  -Has the child understood the advice and information they’ve been given?
• Is the child aware of alternative options, if available?

Children can not refuse treatment in their best interests

Question 7

Fraser guidlines

Answer 7

advice under 16

• is child mature enough to understand?
• are they in a safe consenting relationship?
• can you persuade to tell parents?
• will they do it anyway?
• will this cause mental or physical harm if advice isn’t given?

Question 8

How to tell a patient they’re tooth is being extracted

Answer 8

take into account who the patient is

ask name check the mr number and identity
introduce yourself and the procedure
comfortable safe environment
ask what they know about their procedure and how much they know?
give time to absorb the news

mentioning localised anaesthesia - let them know about how it’s delivered
explain extractions
loosen tip - may be bleeding
pull it out - may feel pressure or tugging lmk

do you understand can you repeat this back to me
answer questions
side effects + tips

Question 9

Patient wants sedation - senior unavailable

Answer 9

• Wait till senior is available
• Have a conversation, history taking, dental history, trauma
• Oral hygiene & health
• Sedation advised not to carry out without a senior present
• It’s okay to ask for help (outside scope of practice - cdc and beneficence)

Question 10

patient dentist relations

Answer 10

• boundaries between patients - consequences - safety and confidentiality - bias - cloud judgment - improper diagnosis
• Patient needs to referred - responsibility to protect
• entitlement to favouritism
  NHS = equal health for all

Question 11

advanced directive

Answer 11

• check validity of advanced directive
• speak to family - privately - explain advanced directive (patient had capacity and made an informed decision) - any q’s about the condition
• explain the reasons of an advanced directive (previous health concerns can increase issues)
• give mental support and empathy

Question 13

legal

Answer 13

• document
• justify
• beneficence
• seniors in the mdt
• hospital legal team