Year 1 Flashcards
How often are GPs revalidated?
Every 5 years by colleague
What staff might make up a GP surgery?
Manager IT/Admin staff Secretarial Staff Reception Staff Nurses - Staff/Auxiliary Nurse Practitioner/Physician Associates Phlebotomist Doctors
What are the aims of the Calgary-Cambridge type consultation?
Initiating the session Gathering Information Providing Structure Building Relationship Explanation and Planning Closing the Session
What are the three types of doctor-patient relationship?
Authoritarian/Paternalistic
Guidance/Cooperative
Mutual Participation
Three broad communication skills needed for medical interviewing?
Content Skills - what doctors communicate
Perceptual Skills - clinical reasoning, internal decision making
Process Skills - technique, verbal/non-verbal skills
What are the three main interviewing techniques?
Talking
Examination
Procedures
What are the four points of body language?
Culture
Context
Gesture Clusters
Congruence
What are some different types of question?
Open-ended Direct question Closed Leading Reflected
What are the definitions of risk, uncertainty, and hazards?
Risk - chance of bad consequences
Hazard - something with potential to cause harm
Uncertainty - uncertainty
What are some types of hazard?
Physical - heat, radiation Chemical Mechanical - trips, slips Biological - infections Psychosocial - stress
What are the three principles that govern the perception of risk?
Feeling in control - voluntary vs involuntary
Size of the possible harm
Familiarity with the risk
What individual variables might affect risk perception?
Previous experience Attitudes towards risk Values Beliefs Socio economic factors Personality Demographic factors
Different systems of decision making protocols?
Algorithms
Pattern Recognition
Scenario/Option planning
Pathways
What three actions to take in ‘safety netting’?
Advise expected course of duration
Advise symptoms indicating deterioration
Advise who to contact if deterioration occurs
What are some barriers to trans-cultural communication?
Lack of knowledge Fear and distrust Bias and ethnocentrism Stereotyping Language barriers Differences in perception and expectations
What are the four principles of ethics?
Beneficence
Non-maleficence
Justice
Autonomy
What is the WHO definition of health?
A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
What are the Seedhouse 5 major characteristics of health?
Health as an ideal state Health as physical and mental fitness Health as a commodity Health as personal strength or ability Health as the basis for personal potential
What are some possible lay beliefs of ‘health’? What might affect these beliefs?
Absence of disease
Physical fitness
Functional ability, and relativity to age
Age
Gender
Social Class
Cultural differences
What is ‘self-efficacy’?
One’s belief in one’s ability to succeed in specific situations or accomplish a task.
What aspects might you address in promoting a healthier lifestyle to a patient?
Diet Exercise Alcohol Smoking Recreational Drugs Sexual Health
What makes a GP an appropriate person to address health and social concerns?
Aware of current and past medical history
Aware of social circumstances
GP has knowledge of many illnesses and diseases
Trusted health professional
GP has role in prevention in health
GP usually local
What factors may affect a person’s motivations to change their lifestyle?
Advantages and disadvantages in terms of health Positive response from peers Social pressure (positive or negative) Behaviour consistent with self-image? Self-efficacy
What actions could the government take to affect health?
Health education Tax on unhealthy foods Legislation regarding labelling Enforcement of legislation Ban on advertising Improve facilities Subsidise healthy foods Transport policies Funding of NHS
What is ‘cultural competence’?
The ongoing capacity of healthcare systems, organisations, and professionals to provide (for diverse patient populations) high quality care that is safe, patient and family centered, evidence-based and equitable.
What difficulties may arise in consulting patients from different cultures?
Lack of knowledge about NHS/UK healthcare system Lack of knowledge about common health issues/different health beliefs Fear and distrust Racism Bias/ethnocentrism Stereotyping Language barriers Presence of third party e.g. family, interpretor Differences in perceptions/expectations Examination taboos Gender differences Religious beliefs Difficulties using 'language line' Patient may not have NHS entitlement
Name ways people can be exposed to hazards?
Blood Sexual Contact Inhalation Ingestion Skin
How can risk be minimised (Neighbour)?
Safety netting
Summarise and verbally check reasons for attendance
Hand over to patient to ensure all issues have been covered
Deal with housekeeping of recovery and reflection
What is meant by the GP as a ‘gatekeeper’?
GP controls access to secondary care and beyond
Advantages of the GP as a gatekeeper?
Can identify patients who need secondary care
Personal advocacy
Patient might not know which specialty to go to
Increases likelihood of referral to appropriate department
Increases likelihood of appropriate referral/use of resources
Limits exposure to certain investigations e.g. X-rays
GP acts as coordinator of care
Puts GP in position to provide patient education
What percentage of illnesses occurring in the community are referred to secondary care?
1%
1-5%
