Communication Flashcards
(40 cards)
1
Q
Scientific Method vs Clinical Practice
A
- objective vs more subjective
- scientifically framed Qs vs messy, real life problems
- background research vs core knowledge
- conclusion reached if data requirements are made vs action must happen even if data is incomplete
2
Q
How do we make clinical decisions?
A
- Cognitive based decisions (knowledge/skills)
- Experience based
- Affect-initiated (feelings/emotions)
- Values based (ethics/culture)
- Subconscious mental processing
3
Q
What determines the type of approach we take?
A
- type of problem
- degree of certainty
- degree of risk
- decision making style
4
Q
4 Decision Making Styles
A
- Directive = rational and low tolerance for ambiguity
- Analytic = rational and high tolerance for ambiguity
- Conceptual = intuitive and high tolerance for ambiguity
- Behavioural = intuitive and low tolerance for ambiguity
5
Q
Decision Making Biases/Errors
A
- Using rules of thumb
- Overconfidence bias
- Immediate gratification bias
- Anchoring bias
- Selection perception bias
- Confirmation bias
- Self-serving bias
- Hindsight bias
6
Q
Evidence Based Medicine
A
- Ask, Acquire, Appraise, Apply, Audit
- combines clinical expertise, best available evidence, and client values/expectations
7
Q
What is pathophysiology to EBM?
A
The pathway to treatment!
8
Q
How does science inform our practice of vet science?
A
- Evaluating current symptomatic therapies is difficult due to shortage of good quality clinical trials
- No evidence that any of the current available therapy options halt disease progression
- Symptomatic therapies have limited, short-term efficacy and have side effects
9
Q
Pattern Recognition Based Approach
A
- used for common disorders w/ typical clinical recognitions
- shouldn’t be used w/o sufficient clinical experience
10
Q
Algorithm Based Approach
A
- directive approach; rigid/inflexible
- takes time to run necessary diagnostics
- as new evidence emerges, algorithms need to be updated
11
Q
Clinical Reasoning
A
critically thinking through various aspects of patient care to arrive at a reasonable decision regarding the prevention, diagnosis, or treatment of a clinical problem in a specific patient
12
Q
Clinical competency
A
incorporates clinical skills, clinical knowledge, and clinical reasoning
13
Q
Clinical Reasoning Framework Cycle (ccpieter)
A
- Consider the patient situation
- Collect cues/info
- Process info
- Identify problems/issues
- Establish goal/s
- Take action
- Evaluate outcomes
- Reflect on process and new learning
14
Q
The Presenting Complaint
A
- the starting point/mystery that is presented to us
- the reason the owner brought their pet in
- Do NOT underestimate!
15
Q
How do we unravel the mystery?
A
- Signalment
- History
- Physical Examination
- Diagnostic tests
- many paths could lead you to a diagnosis
16
Q
What makes a clinical encounter difficult?
A
- success is frustrated
- expectations are misaligned
- flexibility is insufficient
17
Q
DCE Frequency
A
- 3-4 per day
- 30% of consults
- females have more DCEs
- stressed/burned out vets have more DCEs
18
Q
The ADOBE Model for DCEs
A
- Acknowledge the problem
- Discover meaning (find common ground w/ client)
- Opportunities for compassion (legitimise client’s thoughts/feelings)
- Boundaries (time, language)
- Extend the system / Get help
19
Q
Prevention of DCEs
A
- Pause for 3 secs after client/colleague has finished talking to ensure s/he is finished
- Summarise what someone has told you to confirm your understanding
- Make your clinical reasoning explicit (talk to client as you go so they understand the process and why you do what you do)
- Discuss differential diagnosis/prognosis - different for each animal
- Manage expectations
- Develop self-awareness
20
Q
3 Qs to Improve Clinical Decision Making
A
- What can I do to inform or confirm this decision?
- If little evidence is available, what would help me make a better decision?
- How will I explain this decision to the owner or a colleague?
21
Q
The Unresolvable DCE - what to do
A
- build a strong support network
- develop your own system for self-evaluation and reflection
- don’t rely completely on external validation
- find an outlet: write, vent, do something different
- be there for others
22
Q
Cultural Competence
A
set of congruent behaviours, policies, knowledge, and attitude that comes together in a system, organisation, or group of professionals to enable effective work in the form of positive outcomes for practitioners, clients, and patients in cross-cultural situations
23
Q
What are the benefits of effective communication?
A
- breaks down barriers and improves relationships
- improvement in the health of the animal involved
- services used by clients more frequently
- increased level of ownership/self-empowerment of client
- improved professional and personal skills of the vet
- reduced likelihood of errors
24
Q
Desired results of communication
A
- vet - to communicate w/ client effectively in relation to the care of the animal involved
- client - own aims/outcomes and views around the care of the animal
25
Culturally Appropriate Communication
- finding a way to communicate effectively that also respects and accepts culture differences
- about discovering, recognising, understanding, and working effectively w/in the influences of each other's culture
26
Tools for Effective Communication
- Active listening
- Effective questioning cross-culturally
- Closed questions
- Open questions
- Funnel sequence
- Reflective Qs
- Probing Qs
- Focused Qs
- Leading Qs
27
Culturally and Linguistically Diverse clients (CALD)
- differences in vocabulary and meaning
- differences in sentence structure/intonation
- use of jargon/slang
- accents
28
SCORE Communication Principles
- Simplify and specify
- Clarify and confirm
- Organise and outline (main points of info)
- Rephrase and reframe
- Explain with examples
29
Non-verbal Communication
- silence doesn't mean they don't understand (or that they do)
- looking someone directly in the eye may be disrespectful
- lip point and eyebrow raise are common in indigenous communities
30
Sorry Business
includes taking part in funerals and mourning practices w/in a community - important to aboriginal ppl and may take them away from scheduled events w/o notice
31
Community Engagement
- process by which community benefit orgs. and individuals build ongoing relationships for the purpose of applying a collective vision for the benefit of the community
- planned process w/ a specific purpose of working w/ identified groups of ppl to address issues affecting their well-being
32
Benefits of Veterinary Community Engagement
- education
- getting to know your community and demographic
- feeling of giving back
- positive impact on your appearance in the community
33
Potential Risks of Community Engagement
- abusing the system
- poorly organised events
- bad turnout to events
- dangerous animals
- negative perception of the school/practice
34
Three D's of Disaster of Community Engagement
1. Descend on the community as an expert outsider
2. Disconnect or don't consider the community's specific concerns (using a "one size fits all" approach)
3. Decide - announce - defence (fail to consult, be dishonest)
35
Requirements of Successful Community Engagement
- identify community needs
- identify your goals
- cultural competence
- involve local representatives/team members
- consultation, consent, communication
- develop sustainable programs
- measurement of outcomes
36
Gaining the Attention of a Deaf Person
- touch - btw shoulder/elbow
- use of voice (for some)
- tables (tap on them)
- waving hands
- floors - carry vibrations
37
Communicating w/ a Deaf Person
- eye contact
- gesture and movement
- body language and facial expressions
- don't overarticulate your mouth movements
- writing
- face the person when you speak to them
- be aware of glare and shadows
38
Role of Deaf Interpreters
- facilitate info (meaning, intent)
- professional ethics
- content
- time lag
39
Pet Insurance Doesn't Cover:
- pre-existing or A-related conditions
- dental prophylaxis
- pregnancy/obstetrics
- elective procedures (like grooming)
- pet foods/diets
40
NSW Vet Practitioners Board Code of Professional Conduct
2. Primary consideration for welfare of animals
4. Maintain knowledge of current standards and carry out in accordance w/
5. Utilise the skills of colleagues by consultation or referral where appropriate
