Year 1 Flashcards
What are the aspects of Cambridge Calgary Model of Consultation?
Initiate consultation Gather information Provide structure Develop a relationship with the patient Explanation and planning Closing the session
What are the Roger Neighbour tasks of doctor in consultation?
To connect with patient
To summarise and check the reasons for attendance
To hand over and bring the consultation to a close
To ensure safety netting exists so no serious possibilities have been missed.
To deal with the housekeeping of recovery and reflection.
What is the definition of risk?
Chance of consequences or loss
What is the definition of uncertainty?
State of being not completely confident or sure of something
What is stress defined as?
Imbalance between demands and resources or pressures exceeds ones perceived ability to cope.
What are the different coping strategies?
Problem focused vs emotion focused.
What are the main aspects of safety netting?
Ensure patient is aware of worsening symptoms
Aware of where to seek help. Arrange follow up appointment
Understand the time course. Made clear that if there is any concerns, should not delay seeking advice.
What is the name of the concept which allows doctor to come to most probable diagnosis?
Hypothetico-deductive reasoning
What are the main personal qualities of a doctor?
Effective communicator with patient and family Maintain high level of clinical skills Understand importance of teamwork Empathetic – caring towards patient Organised Work within limitations Seek advise when appropriate Keep medical knowledge up to date Be able to relate to the public Commitment to providing high quality care Ability to deal with uncertainty
What are the online IT systems used for?
Book and store appointments
Support prescribing
Assist in consultations (patient records)
Electronic management of hospital letters and blood
Patient leaflets/resources
Public health information
Use in audits
What occurs every 5 years to ensure medical knowledge?
Revalidation to maintain medical knowledge
What occurs yearly to ensure medical knowledge?
Annual appraisal
What are the members of the practice team?
IT staff Receptionist Administrator Practice manager Secretarial staff Practice nurse/ staff nurse Advanced nurse practitioners Health visitor GPs
What are the 4 essential components of clinical competence?
Knowledge
Communication skills
Physical examination
Problem solving
What are the 3 broad types of skills needed for successful medical interviewing?
Content (what doctor communicates) Perceptual (what they are thinking & feeling) Process skills (how they do it)
What factors influence consultation?
Physical factors: site & environment, time constraints, adequacy of medical records & patient status
Personal factors: age, sex, backgrounds & origins, knowledge & skills, beliefs & illness
What are the main types of doctor-patient relationships?
Authoritarian/ paternalistic
Cooperation/ Guidance
Mutual participation
What are the main interviewing techniques?
Open-ended questions
Listening & silence
Facilitation - use of manner or gesture
What are the question types?
Open-ended, closed, direct, leading and reflected.
What is non-verbal communication observed from?
Instinctive
Learned from life experience or from training
Clinical observation
What 4 points do you need to consider with body language?
Culture, context, gesture clusters and congruence.
What are the main types of body language?
Posture, gaze behaviours and specific gestures
What is the definition of medical ethics?
The body of moral principles or values governing or distinctive of a particular culture or group.
What are the 4 ethical principles?
- Respect for autonomy (promote right to self determination – confidentiality, informed consent and promote capacity)
- Non- malfeasance (do not harm)
- Beneficence (to do good)
- Justice (fairness and inequality)
What is the definition of culture?
The learned and shared values of a particular group that guides thinking, actions, behaviours and emotional reactions to daily living.
What is cultural sensitivity?
The ability to be open to learning about and accepting of different cultural groups.
What is multiculturalism?
The recognition and acknowledgment that society is pluralistic. In addition to the dominant culture, there exists many other cultures based around ethnicity, sexual orientation, geography, religion, gender and class.
What are the main cultural barriers?
Language barriers, stereotyping, fear and distrust, lack of knowledge, bias and ethnocentrism, differences in perceptions and expectations.
What is the definition of cultural competence?
An understanding of the diverse attitudes, behaviours, beliefs, practices and communication patterns attributable to a number of factors such as race, ethnicity, gender, age, sexual orientation, religion, mental or physical ability or generational or acculturation status.
What is the definition of hazard?
Anything with the potential to cause harm
What is the definition of risk?
The likelihood of harm occurring
What does a risk factor do?
Increases the risk of harm
What decreases the risk of harm?
Protective factor
What influences the likelihood that something will cause harm?
Susceptibility
What are the main hazards?
Chemical, physical, mechanical, biological and psychological
What are the main routes of exposure?
Blood, ingestion, inhalation, skin and sexual contact.
What are the factors that influence the degree of risk?
How much the person is exposed,
How the person is exposed and conditions of exposure.
How is a risk perceived?
Familiarity with risk
Size of the possible harm
Feeling in control
What is health?
“A state of complete physical, mental and social well-being and not merely the absence of disease and infirmity”
What is statistical normality?
Normal distribution describes the shape of a population in that of a bell curve.
What is cultural normality?
Depends on the expectations and standards of society and thus on political and economic as well as social factors.
What are the 5 positive ideas 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 the lay beliefs of health?
Absence of disease, functional ability and physical fitness.
What are the factors that influence health beliefs?
- Age – older people more focussed on functional ability whilst younger more on physical fitness and strength.
- Socio-economic class – those in difficult socio-economic class place more emphasis on functional ability whilst women of higher social class have a more multidimensional view of health.
- Gender – women find the concept of health more interesting and include the social aspect of health.
- Cultural differences – different cultures have different health beliefs
What are the main reasons for health inequalities?
- Access to health care
- Environmental exposures (physical and social environment)
- Health behaviours
- Life course factors
What does access to healthcare depend on?
Accessibility, affordability and acceptability.
A persons behaviours is comprised of 2 systems?
Reflective
Autonomic
What are the 5 core concepts of social cognitive theory (SCT)?
- Observation learning/modelling
- Self efficacy
- Self regulation
- Goal setting
- Outcome expectations
According to behavioural change theory, what factors are an individuals behaviour influenced by?
- Personal factors (knowledge and information must be relevance to current goals, easily understood and readily available at the moment of decision. Personal factors also include self-efficacy, the importance of the outcomes – outcome expectations. Personal relevance
- Environmental factors (social support, time, money
- Behavioural factors (habitual or autonomic the behaviour is)
The ability to change is governed by what?
Self-efficacy
Self-efficacy underpins what?
Goal setting
effort investment
persistence in the face of adversity
recovery from setbacks.
Medical consultation involves 3 separate activities including?
Talking together
Doctor examining patient
Performing procedures
Personal factors influence on behaviour must be:
Relevant to current goals
Easily understood
Readily available in moment of decision
