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Day 1 - Basic

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20 views5 pages

Day 1 - Basic

Uploaded by

althroughpi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Data gathering

IPS – interpersonal skills


Management
Don’t study the content map – this is for PLAB 1
3EEE – the showmanship
E – English (Linguistics)  ask in simple English px could understand
E – Emotions – sensible – sensitive (rapport and empathy) – unfortunately, I’m
sorry to tell you
E – Energy – the performance
Hello do not say Hi.
Don’t say you must be John, am I speaking to Sara?
Della – one of the doctorS
GP is not department  in this GP or in this clinic
Involve the patient in the management.
No need to say you are a caring mother/father  stockphrases
Dellaneira Setjiadi GMC number 7973362
Hello Hello
I am Dr Last Name, one of the doctorS in this department or in this surgery/clinic,
are you patient’s full name?
May I know your name please? Can you please confirm your age for me please?
What can I call you? What would you like me to call you? Nice to meet you XX.
How can I help you today?
Mrs Ms Rebekka JONES – no need to use Mrs or Ms
Telephone
Anonymous! If video, still check ID.
1. Ask for the patient – James Parker
2. Then you – introduce yourself
3. Purpose of the call – we have an appointment
4. Consent – good time
5. Sign post and check the identity – DOB, 1 st line address. Do it ONE BY ONE
6. Avoid – social  speaking to colleagues then no identity check
Hello Hello
Are you James Parker? Am I speaking to James Parker?
I am Dr Setjiadi one of the doctors, I am calling from the GP practice.
The reason I am calling today because I understand we have an appointment. Is
it now a good time to talk? – except in an emergency simply ask Can I talk to you
right now?
I’m calling you because we had a discussion earlier/you visited us with your
son/you had some tests done, etc.
Before I continue, I just want to make sure I am talking to the right person. Can I
check the identity first. Can you confirm you date of birth please? Can you
confirm the first line of your address please?
Learn to acknowledge
Acknowledge to reassure
- My husband asked me to see you  why did he ask you to see us?
- My husband thinks I have dementia  why did he think you have
dementia?
- I have an embarrassing problem  nothing to be embarrassed; you don’t
need to be embarrassed because doctor come across variety of problems.
- I have some personal problem  can you tell me more what bothers you?
You don’t need to worry.
- Body language  you seem to be a little anxious, is there anything
bothering you? Is there anything you would like to tell us?
- Confidentiality – how – offering confidentiality; whatever you told me will
be kept between the team that looks after you except in certain
circumstances.
- Angry patient  I can see that you are upset/you are not very happy.
The starting
Talking to relatives – golden rule: must know the patient’s name! Cannot
refer as a patient; must know the name. No need to ask age of relative –
common sense! May I know your name please? I understand you are related to
(patient’s name), how are you related to (patient’s name)? Can you confirm
(patient's name)’s age?
Paraphrasing (if our plan): I understand you come for follow up; I
understand you are here for your test result; I understand you are here
for xxx is there anything you would like to talk to?
Non-paraphrasing – how can I help you?  if patient made an appointment, if
angry patient (if patient’s plan, for example, patient does not want colonoscopy)
P2MAFTOSA
P1 - Presenting complaint (SOCRATES – for pain, ODIPARA, non-ODIPARA ---
weight gain weight loss, insomnia, confusion, constipation)
XYZ –
rixk factor (X)
systemic review (Y)  selective (if affecting the whole system)
cancer symptom (Z)  selective
DDs
P2 – past medical history (Q1 to Q8 – anyone in the family having the same
thing?)
Do you have ongoing medical conditions?
family history: ask about similar symptoms or disease running in the
family (heart condition)? Depending on the PC to ask about SS or
established disease. MUST be specific: joint-related condition. Then ask:
I’m sorry to ask about this, anyone in the family has breast cancer?  if
relevant
Don’t use term history or investigations or management or vital
MAFTOSA

DESA
-DIET
-EXERCISE
-SMOKING
-ALCOHOL
Occupation DVLA ICE Effects of symptoms
ICE – don’t do it in the beginning! It is the last thing, but before physical
examination
Ask the idea matching what the patient thinks; don’t answer immediately
because we have to do physical exam first. Must do this.
Idea – what do you think is going on?
Concern – is there anything that worry you?
Expectation – is there anything particularly that you are hoping for
us to do today?
Effects of symptoms
For long term SS – is there anything you have done about this?
How is this affecting your: sleep, work, relationship, sexual life?
Examination – I would like to do some examinations on you that includes
your blood pressure, temperature, your pulse, and breathing rate as
well as oxygen level.
Head to toe examination will NOT work  specify, tummy examination, back
passage examination, I would like to check your hearing, listening to your lung
sound, body mass index
EXPLAIN the findings to the patient  I would like to check your blood pressure
standing and lying. Mention specifically what exam you want (in layman term).
Doing blood test – after physical exam and diagnosis especially in GP, ecg, urine
dipstick, pregnancy test – can be done by ourselves. CXR, thyroid profile,
electrolyte  in the management
Diagnosis in PLAB 2 – provisional diagnosis, no findings yet usually it is a clinical
diagnosis.
Example: hyponatremia scenario – test results already there.
Management: Diagnosis, explain something to the patient (definition) for
example, why we cannot issue a sick note, or procedure, formulating a
management plan.
Diagnosis
Thank you for giving me this information. Tell – Ask – Explain – Check
- Tell: just tell the name of the diagnosis
- Ask: have you heard about it?
- Explain 3 sentences (give the definition); Let me explain to you: what is
the problem? What is happening there? What are the risk factors.
- Check: do you understand? Is it clear? Are you able to follow me?
- Don’t explain the symptoms when you tell the diagnosis but tell the risk
factors
Explain what Parkinson is but no need to justify why it is Parkinson.
From what you’ve told me and from what we’ve done, it seems like you have a
condition named obstructive sleep apnea.
Avoid: how does that sounds to you? Are you getting my point? – casual
Formulate management plan – let me explain what WE are going to do for
you
1. What type of condition? It will settle on its own or emergency (call 999)
2. Where is the patient is going next – ADMISSION
3. What need to be done to confirm – investigations (how this condition is
diagnosed); don’t waste resources
4. Main medication
5. Other medication
6. Advice to patient (good and bad) – safety netting (when we leave px on
their own)
7. Follow up – when are you going to see me? PMR – monthly follow up; how
long the treatment will be.
8. Leaflet – always (just say: you’ll provide some information for you to read
in order to get to know this conditions/complications/treatment in a better
way).
a. Cannot say just go to the specialist and they will treat you
b. Must explain what the specialist will do for you and treatment for
you
c. Refer to memory clinic, seizure clinic, GUM clinic, etc. When you go
there, you will get tested for …. You will get medication for …. You
will also get support from multidisciplinary team consisting of …..
d. We advise you not to ….
When answering questions, start with “Well, …” it is highly unlikely; it does not
look like … - don’t jump and say no.
I don’t know  change to I’m not really sure. Unfortunately, it is now very clear.
I’m afraid it is difficult to say
Yes  that should be okay.
No  it is highly unlikely, it doesn’t look like, we are not really sure.
We would like to offer you some medications. We would like run some tests. Let
me explain to you what are we going to do now.

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