Consultation Models Hasna Begum Bradford GPST Programme.
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Transcript of Consultation Models Hasna Begum Bradford GPST Programme.
Consultation ModelsHasna Begum
Bradford GPST Programme
What is a model?
A certain way of doing something
We all have models for tasks that we have done more than once
eg Tying shoelaces
Why learn about consultation models?
Toolbox
Framework for learning to consult
Easier to pinpoint where difficulties occur
Offers alternatives
Think about the way you consult and try to map your own consultation
model
Consultation Models
Task vs Process
Doctor-Centred vs Patient-Centred
Task Orientated
Traditional medical interview
Pendleton
Helman folk model
PendletonTASK 1: Find out why the patient is here
TASK 2: Consider other problems
TASK 3: Choose (with patient) an appropriate action for each problem
TASK 4: Achieve a shared understanding of the problem
TASK 5: Involve the patient in management, encourage acceptance of responsibility
TASK 6: Use time and resources appropriately
TASK 7: Establish or maintain a relationship with the patient that helps to achieve other tasks
Helman Folk Model• Every patient comes to a doctor seeking the
answers to SIX questions. To be effective, the doctor needs to help the patient verbalise the questions so they can be addressed.
1. What has happened?
2. Why has it happened?
3. Why to me?
4. Why now?
5. What would happen if nothing was done about it?
6. What should I do about it / who should I ask?
Process Orientated
Balint - the dr, his patient and the illness
Byrne & Long's 6-stage model
Neighbour
Transactional analysis
Calgary-Cambridge
Balint"The Doctor, his Patient and the Illness"
Emotional relationship between dr and patient - collusion
Clinician may feel what patient feels - counter transference
Attentive listening helps patients feel better
Doctor as a therapeutic agent in the consultation - "doctor as the drug"
Consultations extending over years - mutual investment company
Listening as a skill that needs to be learned
Neighbour
5.
House
keep
ing
xt
1. C
onne
ctt
2. Sum
maris
e
3. Handover
4. Safety net
Calgary-Cambridge
Initiating the session
Gathering information
Building the relationship
Providing structure
Explanation and planning
Closing the session
Think about a recent consultation
Try going through the same scenario using one of the models mentioned today
References
Moulton, L. (2007). 'The Naked Consultation'. Abingdon: Radcliffe Publishing.
Usherwood, T. (1999). 'Understanding the Consultation'. Maidenhead: Open University Press.