The Rough Guide to consultation skills

Consultation tasks Establish rapport Get the patient to tell you what is wrong Explore what the patient hasn’t told you What does the patient think is wrong and what

do they want? Summarise (frequently!) Examine the patient Explain the problem Share management options Safety net

Five checkpoints (Roger Neighbour)

Connect Summarise Hand over Safety net Housekeeping

Consultation tasks Establish rapport Get the patient to tell you what is wrong Explore what the patient hasn’t told you What does the patient think is wrong and what

do they want? Summarise (frequently!) Examine the patient Explain the problem Share management options Safety net

An exercise in establishing rapport

‘Eliciting’ micro-skills

Nudging Echoing Feedback-eg ‘I noticed’ Checking (mini summary) Explain why you are asking Statement as a question ‘My friend John’ The ‘square search’

Group work to practice micro-skills

1. haematuria

2. several episodes of severe abdominal pain

3. a cough for 6 weeks

Recognising and responding to cues

verbal

emotional Non-verbal

What a cue is and what it is not

Verbal cues to hidden agenda

What is said What is not said Speech censoring Turbulence Imprecise language Emotive language Opening gambits and curtain raisers

Non-verbal cues

The ‘set-up’ Body language Eye contact, internal search

Emotional cues

Micro emotions Unexpected emotions Mismatched emotions

What to do with cues?

Ignore them Notice them and store for later Comment Act, change the consultation plan