Cumberland Lodge Trainee Videos Dr Richard de Ferrars January 2011.
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Transcript of Cumberland Lodge Trainee Videos Dr Richard de Ferrars January 2011.
Cumberland Lodge
Trainee Videos
Dr Richard de Ferrars
January 2011
Videos - What’s It All About?Domain of Competence – Communication & Consultation Skills
Needs Further Development
Develops a working relationship with the patient, but one in which the problem rather than the person is the focus.
Produces management plans that are appropriate to the patient’s problem.
Provides explanations that are relevant and understandable to the patient, using appropriate language.
Achieves the tasks of the consultation but uses a rigid approach.
Competent
Explores the patient’s agenda, health beliefs and preferences.
Elicits psychological and social information to place the patient’s problem in context.
Works in partnership with the patient, negotiating a mutually acceptable plan that respects the patient’s agenda and preference for involvement.
Explores the patient’s understanding of what has taken place.
Flexibly and efficiently achieves consultation tasks, responding to the consultation preferences of the patient.
Excellent
Incorporates the patient’s perspective and context when negotiating the management plan.
Whenever possible, adopts plans that respect the patient’s autonomy.
Uses a variety of communication techniques and materials to adapt explanations to the needs of the patient.
Appropriately uses advanced consultation skills such as confrontation or catharsis to achieve better patient outcomes.
Practising Holistically - Impact of problem on work, family etc
Data-gathering & Interpretation - Targeted history & examination
Making Diagnosis/ Decisions - Disease patterns, generating functional solutions
Clinical Management - Treatment choices, follow-up arrangements
Primary Care Admin/ IM&T - Use of the computer during consultations
Where are the Opportunities?
How & where do our trainees learn?– Working with videos– Working in joint surgeries– Case discussions (rehearsal)– VTS : Communication skills– VTS : Working with simulators– Working with peers (CSA practice)
(Video work is just one part...)
Why Video? (Apart from having a larff)
Summative Approach:– COT framework– CSA model
Formative Approach:Spectrum of tools -
Watch me Pendleton
Novice Advanced
Disease Illness Model Calgary-Cambridge
Phase 3
Patient presents problem
Gathering information
Parallel search of two frameworks
Illness Framework
Patient’s agenda : Ideas Concerns Expectations
Feelings Thoughts Effects
Disease Framework
Doctor’s agenda :
History - symptoms Examination - signs
Investigations
Understanding the patient’s unique experience of the illness
Underlying pathology Differential diagnosis
Integration of the two frameworks
Explanation and planning :Shared understanding and decision making
Phase 1
Phase 2
Disease – Illness Model
When Watching the Videos...
Summative Approach:COT framework – calibration exercise
(CSA model)
Formative Approach:
Pendleton (Trianee1st, good bits, bad bits)
Disease Illness
Calgary Cambridge