Domain 3 and 4 Flashcards
How do you communicate effectively with patients/ family members? (Domain 3- Communication, Partnership and teamwork)
Communicating effectively
-always ICE, exploring patient’s ideas, concerns, and expectations. Be honest when responding to their questions
-also exploring concerns with their relatives and providing them with up-to-date information in regards to management
-if there is a language barrier, seek someone on the ward that can speak the same language. If not-> intranet translator. Taking hx from family members is not appropriate as it risks breaking confidentiality. Persisting despite language barrier-> worst option
-be readily available to patients and colleagues seeking information. Questions where patient’s family is on the phone-> what do you do?
What are the key principles to establishing continuity and coordination of care (Domain 3- communication, partnership and teamwork)?
Domain 3- Communication, partnership and teamwork
ADCEB
Continuity and coordination of care.
It is important to provide detailed handover to the next team member in charge. If this is not possible or you are off-duty, delegating task to someone appropriate with enough knowledge of the patient.
What are the important aspects of a great team? ((Domain 3- Communication, Partnership and teamwork))
Working collaboratively with colleagues
-work collaboratively with colleagues, be mindful of their skills and contributions
-treat everyone with respect
-be aware of how a team member’s behaviour can affect the whole team (if nurse or registrar is being rude-> speak to them in private)
-if there is not enough medical cover, this can affect patients’ care-> contact rota coordinator if you cannot make it. Work until contract end date. Take up any formal posts you accept
What are the important aspects when it comes to teaching, training, supporting medical students and junior doctors?
Teaching, training, supporting medical students and junior doctors
-be willing to take part in teaching opportunities and mentor role
-important to make sure medical students are ALWAYS SUPERVISED
-feedback (MSF form) must always be honest about one’s competence, skill level. Dishonest-> least appropriate.
-must always be supportive to colleagues that have struggling with performance or health. However, patients’ safety always come first
How do you ensure effective continuity of care?
What do you do if you are off duty but you still have important tasks to do?
Effective continuity of care
-important to deliver proper handover with detailed information to relevant team member to ensure continuity of care
-if you are off duty, delegating this task to the next FY1. Text message is not an appropriate option as person might not receive/acknowledge text. Leaving task to the next day is the least appropriate option
How do you establish and maintain partnerships with patients?
-patients in general
-patients with religious beliefs like Jehovah’s witness
-patients that have unhealthy lifestyle choices like smoking etc
-after death of patient
Establishing and maintain partnerships with patients
-treat every patient with respect, dignity and privacy
-be respectful towards patients with religious beliefs like Jehovah’s witness. If colleague is being disrespectful and making it known to the patient, important to pull them aside in private as this is unprofessional
-encourage patients to make healthy life choices to prevent progression of condition (e.g smoking cessation clinic, dietician etc.)
-provide patient with enough information about the condition so that they can make their own informed decisions:
-information about condition, their progression, risks and benefits
-delegation of team members
-if information is to be shared in research project
-information remains confidential even after death of patient
What are the 4 main principles when it comes to establishing partnership with patients? (Domain 3- Communication, partnership and teamwork domain)
Domain 3- Communication, partnership and teamwork domain
C, D, F
C, D- listening and addressing to family member’s concerns
F- telling family about how smoking cessation may help patient’s condition, helps to empower them with more information
Establishing partnership with patient
-you must be polite and considerate to patients
-you must treat each patient with dignity and respect: for example chaperone for PV (vaginal examination)
-information about patient is confidential even after death
-you must work in partnership with patient:
a) whether it is providing them information about team members involved in their care
b) providing them about information of progress of condition, management
c) empowering them with information about lifestyle changes that can improve their health-smoking cessation like COPD
What is the main principle in this question when it comes to teaching, training and supporting colleagues? (Domain 3- Communication, partnership and teamwork domain)
Domain 3- Communication, partnership and teamwork domain
C, F, H
If colleagues are stressed or overwhelmed with work, it’s important to be a supportive colleague:
-ask them to see the GP
-ask them if you can do anything to help them
If you feel that this may compromise patient’s safety, it is important to flag this to the educational supervisor (domain 2-safety and quality)
You have volunteered to be a facilitator on a clinical exam for medical students. A fourth-year medical student, Sarah, approaches you while you are walking out of work. Sarah knows that you are one of the facilitators for the clinical exam and asks you what type of scenarios will be covered in the clinical exam. You have worked with Sarah closely over the last few months.
Rate appropriateness .(1=Veryappropriate;4=Inappropriate).
A)Provide Sarah with some publicly available information about medical school examinations
B)Explain to Sarah that it would be unfair to other candidates if only she knew the clinical scenarios before the exam
C) Reassure that Sarah doesn’t need to know the scenarios to do well before the exam
Link answers to “maintaining trust domain”
Domain 4 Maintaining trust domain
-Key principle in this question is acting with honesty and integrity. This applies to all areas of work:
-profession
-role, experience as doctor
-honest about data like collecting data for audits, research, national governance guidelines
A)Provide Sarah with some publicly available information about medical school examinations: 1
B)Explain to Sarah that it would be unfair to other candidates if only she knew the clinical scenarios before the exam:1 (very appropriate as it emphasizes importance of honesty and integrity)
C) Reassure that Sarah doesn’t need to know the scenarios to do well before the exam: 2 somewhat appropriate because even though you are reassuring Sarah, you are not emphasizing the importance about being honest in the exam
What is the main principle in this question when it comes to maintaining trust between patient/doctor relationship? (Domain 4-maintaining trust)
Domain 4-maintaining trust
DACEB
When it comes to medical errors, it is important to help re-establish the trust between the patient/doctor relationship
a) apologise and acknowledge frustrations
b) rectify and come up with solutions; e.g stating that there is a system in place for investigation
c) explain short-term and long-term effects
It is also important to maintain clear channels of communication by keeping them up-to-date with information
Balance between training requirements and patient care
ABDCE
When you have to 2 things to attend, it’s important to known how to balance these:
1. establish urgency of discussion and ask them if you can discuss it after your teaching (you’re meeting both requirements)
2. ask senior to discuss with patients/family instead
3. to miss both completely/partially is inappropriate
4. completely disregarding patients/family and attending the teaching session is inappropriate
Domain 4-maintaining trust
ECDAB
It is important to not unfairly discriminate against patients/colleagues due to your own personal views. If you feel that a colleague is discriminating against a patient, it’s important to raise a concern (25c.)
1. establish importance of respecting patient regardless of beliefs
2. explaining that it is not professional to be judgemental of patient’s beliefs
3. Not doing anything is always the least appropriate
How do you show respect towards patients?
Showing respect towards patients
-it is not professional to pursue a sexual/emotional relationship with patient. Most appropriate-> politely decline and emphasize that this is not within professional boundaries. If there is a breakdown in trust, can ask another colleague to take over care of patient. Least appropriate-> flirt back and pursue relationship
-it is important to respect their political, moral, religious beliefs.
-if there is a medical mistake, always:
-apologise for the mistake
-rectify and find solution
-explain what has happened, short term and long term benefits
Explain the Importance of treating patients and colleagues fairly and not discriminating against them.
-if their lifestyle choices (e.g smoking) contribute to the progress of the condition
-if they are disabled (e.g whether it is a physical disability, or hearing problems)
-if there are many patients to be seen and you need to manage your time according to clinical priority. However, resources do not allow you to do so
-if they have a condition that can potentially affect your health (e.g STI, HIV, communicable disease)
Treating patients and colleagues fairly and not discriminating against them.
-if their lifestyle choices (e.g smoking) contribute to the progress of the condition-> this does not deny them of treatment
-if they are disabled (e.g whether it is a physical disability, or hearing problems)-> make reasonable adjustments within practice
-if there are many patients to be seen and you need to manage your time according to clinical priority. However, resources do not allow you to do so-> raise this to person-in-charge whether it is ward manager for available beds. Nurse-in-charge-> for procedures/bloods. or consultant-in-charge
-if they have a condition that can potentially affect your health (e.g STI, HIV, communicable disease)-> take steps to minimise spread of infection
If a patient asks for a GMC number despite the fact that you did not make a mistake, what do you do?
You have to provide your GMC number if a patient asks for this. Always have indemnity and insurance cover
