One to One



Assessment  Reading


 Some of the common problem patterns which occur in consultations are as follows:

·        the learner does not discover all the issues or problems the patient wishes to discuss

·        the learner does not listen, often not asking open ended questions initially or interrupting with closed questions

·        the learner does not elicit the patient’s ideas, concerns, expectations and feelings; or establish a collaborative relationship, and instead takes a doctor-centred position throughout the interview

·        the learner develops little rapport or is not responsive to  the patient

·        the learner misses important cues from the patient

·        the learner obtains an inaccurate or incomplete clinical history because of  failure to  get the balance right between open and closed questions, summarising, checking, or sharing his thinking process

·        the learner forgets to find out what the patient already knows before giving an explanation

·        the learner gives too much information at once and uses jargon

·        the learner does not negotiate with the patient and check that the patient is agreeable to the plan

·        the learner makes inadequate follow up arrangements or none at all

A useful set of questions to ask yourself as the facilitator as you are watching any consultation are: 

·        can you recognise any patterns here?

·        have you seen this problem before?

·        how might the learner who performed the consultation be feeling?

·        how might the “patient” be feeling?

·        what does the learner/group already know?

·        how could you “generalise away”?

·        when would the best time be to do it?

·        what area or what research and theory would be relevant to teach on?

·        do you have the knowledge?  do any of the learner(s) have the knowledge?

·        is the overall balance of experiential work with didactic material from the literature right for the group?

·        have you got an aide-memoire / handout for the learner/group?




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