Consultation skills/Medical Interview Flashcards
What are the five steps of the calgary-cambridge model?
- Preparation n initiation of the session
- Gathering info
- Physical exam
- Explanation n planning
- Closing the session
What are the two processes that last throughout the session?
- establishing the relationship
- providing structure to the interview
What do you explore when taking the history of presenting complaint? hint: 8
- Site where problem is located
- Onset (when/how did the pain start)
- Character (describe the pain)
- Radiation (has the pain spread to other parts)
- Associated symptoms
- Time course (has the pain improved or worsened since)
- Exacerbating/ relieving factors ( what makes the pain worse or what lessens the pain-medication)
- Severity (scale of 1-10)
SOCRATES
How do you explore the patient’s perspectives on the illness? hint: 5
- Concerns
- Ideas
- Feelings
- Functions
- Expectations (what they expect out of the consultation)
CIFFE
What background information should you explore?
hint: 6
- Past medical history (previous disease/ongoing disease)
- Past surgical history
- Medication history (currently on any medications or previous medications)
- History of allergy
- Family history (any disease runs in the family)
- Social history and lifestyle (in any relationship, have kids, social clubs or physical activity, sexual history, substance use, any social support, health insurance)
Please Pass More HAm For Susie
How do you provide structure to the session? hint: 5
- Timing: how long the session is
- Contents: what gets discussed
- Logical Sequencing
- Summarizing: It is important to summarize from time to time and check whether you and the patient understand each other.
- Signposting: A means of indicating to your patient that you want to move from the point being discussed to another point.
The Cat Left SUMMits POST
Patients are more likely to be open to you when you signpost. T or F.
T
Summary is inevitable at the explanation/ information sharing stage and during session closure. T or F.
T- stages 4 n 5
How do you go about building relationships? hint: 3
- Establish and foster rapport
- Active listening
- Show empathy: Non-verbal behavior (eye contact, facial expression, posture); Verbal empathy
EAS
How do you show Verbal Empathy? hint: 4
- Name that feeling: Name the feeling you think your patient is passing through.
- Understanding: Show understanding of how your patient feels! (don’t say i understand how you feel but its understandable)
- Respect: Let the patient know that you respect their attempts at coping!
- Support: Express willingness to help/ support them.
NURS
Barriers to a good clinical consultation?
hint: 3
- environmental-related (room temp, 3rd parties, noises, sitting arrangement)
- patient-related (extremes of age, severity of condition, mental status, substance use, aggressive behaviours, language barrier, internet use)
- clinician-related (experience, poor knowledge, mental status, substance use, language barrier, arrogant behaviour, being judgemental, lack of empathy)
Non-verbal communications? hint: 5
- face patient SQUARELY
- adopt an OPEN posture and attitude
- LEAN toward with interest
- EYE contact
- RELAXED behaviour and posture
SOLER
What is vital for a successful interaction/interview?
Developing rapport
What is the three function model?
- Cohen-Cole and Bird developed this model of the consultation in 1989.
- The 3 functions are:
- Gathering data to understand the patient’s problems
- Developing rapport and responding to patient’s emotion
- Patient education and motivation
Gather, develop, educate!
note: revised in 2000 to “Building the relationship” in front of “Assessing the patient’s problems”, and “Managing the patient’s problems”.
