General Practice

Question 1

Name 6 personal qualities of a GP

Answer 1

Ability to care about patients
Commitment to providing high quality care
Awareness of own limits
Commitment to keeping up to date
Appreciation of team work 
Good interpersonal and communication skills
Clinical competence
Organisational ability 
Ability to manage oneself
Ability to work with others
Maintaining good practice 
Relating to the public
Ability to deal with uncertainty

Question 2

Give 4 examples of what GPs are responsible for

Answer 2

Running business affairs
Providing adequate premises
Providing safe patient services
Employing and training staff

Question 3

Give 6 examples of the uses of a practice IT system

Answer 3

Store and book appointments
Assist in consultations 
Support prescribing
Electronic management of hospital letters and results
Use in audits
E-consultations
Chronic disease management and recall 
Patient leaflets / resources
Public health information 
Identify patients for screening programmes

Question 4

What are the 4 essential components of clinical competence

Answer 4

1. Knowledge
2. Communication skills
3. Physical examination
4. Problem solving

Question 5

What are the 3 skills needed for medical interviewing

Answer 5

Content skills - what doctors communicate, the info they gather and give and treatments

Perceptual skills - what they think and feel, internal decision making, clinical reasoning, awareness of own biases, attitudes and distractions

Process skills - how they do it, way they communicate with patients, how they discover history and provide info, verbal and non-verbal skills, how they structure communication

Question 6

Name 4 physical factors which affect the consultation

Answer 6

Site and environment (field vs practice)
Adequacy of medical records (avoid wasting time)
Time constraints 
Patient status (patient known vs unknown, new or old problem)

Question 7

Name 6 personal factors which influence the consultation

Answer 7

Age
Sex
Backgrounds and origins
Knowledge and skills
Beliefs of health 
The illness

Question 8

Name 3 different types of doctor-patient relationships

Answer 8

Authoritarian or Paternalistic - no autonomy

Guidance / co-operation - some autonomy

Mutual participation - great autonomy

Question 9

Name 3 interviewing techniques

Answer 9

Open-ended questions
Listening and silence
Facilitation (change of expression, posture etc)

Question 10

Give 5 examples of some types of questions

Answer 10

Open-ended - signals patient to speak whatever they want (tell me about the pain)

Direct - asks about specific thing (where is the pain)

Closed - yes or no (is the pain severe)

Leading - presumes answer (the pain is severe?)

Reflected - allows doctor to avoid direct question from patient (you want to know the cause of the pain?)

Question 11

Give 7 examples of body language which are important to consider in a consultation

Answer 11

Culture - body language differs between cultures

Context - posture patient adopts may be due to pain or difficulty hearing

Gesture Clusters - repeated gestures reinforce message

Congruence - between non-verbal messages and words

Gaze Behaviour - eye contact important

Posture

• Head bowed, slumped = depressed
• Restless = anxious
• Hands behind head - confident, superior

Specific Gestures

• Hand to face: doubt, lying
• Cheek and chin: interest and evaluation
• Head support: bored
• Pointing finger: critical thoughts
• Clenched hands - frustration

Question 12

What are 3 activities that the medical consultation typically involves

Answer 12

Talking together - always
Doctor examining the patient - often
Performing procedures - sometimes