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COMMUNICATION FOR FINALS

COMMUNICATION FOR FINALS. TOM CUFFLIN AND ANNE-MARIE SIMONS. Types of Stations . History Explanation Breaking Bad News. Possible Stations. History Depression (+/- Alcohol) Menorrhagia Teen weight loss Post-Menopausal Bleeding Anxiety Schizophrenia Mania Haematemesis Haemoptysis

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COMMUNICATION FOR FINALS

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  1. COMMUNICATION FOR FINALS TOM CUFFLIN AND ANNE-MARIE SIMONS

  2. Types of Stations • History • Explanation • Breaking Bad News

  3. Possible Stations • History • Depression (+/- Alcohol) • Menorrhagia • Teen weight loss • Post-Menopausal Bleeding • Anxiety • Schizophrenia • Mania • Haematemesis • Haemoptysis • Asthma • Non-Accidental Injury • Nocturnal Enuresis

  4. Remember the basics… • Consent and Confidentiality • Avoid Jargon • Summarise • Open to Closed Question cones • Clinical Reasoning • Direct consultation as appropriate - Signposting

  5. Sample History Station • You are the GP, a patient comes to see you expressing low mood since her daughter moved to University, she has two other sons who live away and works part-time at the local supermarket. She is recently divorced and says her “life is not worth living without my children at home” • Please proceed with the consultation as if you were the GP.

  6. Explanation Stations • Explanation • Counselling and management of asthma with antibiotics • Treatment of Temporal Arteriitis (Side effects of Steroids) • MMR Vaccination • Pregnant Smoker – Persuasion • Hypertension – Management • Dementia

  7. How to approach Explanation stations • Assessing the baseline • What do they want to know + what do they need to know? • Chunking and checking • Written aids • Avoid premature reassurance

  8. Sample Explanation Station • You are the GP. A 24 year old female is requesting the combined oral contraceptive pill (COCP) as she does not want to become pregnant. Please explain the risks/benefits of the COCP and any other information you feel may be relevant.

  9. Breaking Bad News Stations • Breaking bad news • Dyskaryosis on smear • Breast lump • May be not be explicit – may say ‘Explain’

  10. S.P.I.K.E.S. • A system for breaking bad news S – Setting – (environment) – Open body language, maintaining eye contact, use of touch (!), P- Perception – assess the baseline I – Invitation – How much the patient wants to know K – Knowledge – Chunk and Check E – Explore – Acknowledge emotional responses S – Strategy and Summary – Negotiating a way forward

  11. Sample Breaking Bad News Station • You are the respiratory consultant a patient has come to see you regarding the results of a lung biopsy. The results show T2 N1 M1 tumour in the right lung. This is inoperable. • The patient is aware he has a “suspicious mass” which needed further evaluation but has not been told it is malignant. • Please explain the results accordingly

  12. Anne Marie’s tips… • Smile and be nice • Approach every station with S.P.I.K.E.S – Could it be BBN? • Don’t just rush to one diagnosis – exclude others • Past stations may subtly change •  features quite heavily – remember to risk assess • New Station - New Marks

  13. GOOD LUCK

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