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How to do a Reflective C ase P resentation

How to do a Reflective C ase P resentation. Reflective practice in medicine: method. Devised by Dr Michael Balint , author of the landmark book 'The doctor, his patient & the illness'.

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How to do a Reflective C ase P resentation

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  1. How to do a Reflective Case Presentation

  2. Reflective practice in medicine: method • Devised by Dr Michael Balint, author of the landmark book 'The doctor, his patient & the illness'. • Adapted for our PGPPP teleconferences by Dr. Bambi Ward, experienced Medical Educator/teleconference facilitator/GP. • Unique addition: Cultural Educator - group member.

  3. How do NTGPE’s reflective case presentations work? • An opportunity to present and discuss patients who are of particular concern • Focus of the discussions are on what is happening regarding the doctor patient relationship. • Held every 2 weeks. Each session is 1.5 hrs. • 2 case discussions/session. • Delivered by group members, without notes.

  4. Ground rules • Everything said in the group will be treated as confidential, whether it is about patients, colleagues or group members. • Everyone should be listened to & everyone’s contribution respected.

  5. Format of reflective case presentations • Four phases for each case discussion: • Presentation • Inquiry • Push Back • End

  6. The presentation • Presenting doctor tells group about patient. • No notes • Presenter allowed to speak uninterrupted until finished. • Typical problems include: • Patients with chronic, medically unexplained symptoms, “puzzling” or “difficult” patients. • Patients who make the doctor uncomfortable • Patients with complex problems • Patients with cultural issues • Patients with ethical issues • A patient that you like whom you are worried about

  7. Inquiry phase • Facilitator asks if anyone has any factual questions. • AVOID asking presenter • how they feel, • why they did certain things or • what they plan to do now.

  8. 'Push back' phase • Facilitator asks presenter to “push back from virtual circle of chairs” • Group members, and then the facilitator and CE, explore & reflect on their own thoughts about the story they've heard & their feelings. • Group members encouraged to wonder out loud re: • how the patient is feeling • what they really want from the doctor • how they'd feel if they were in the doctor's shoes. • eg,' I wonder how...."

  9. End of presentation • Facilitator invites presenter to rejoin group. • Presenter free to comment or not. • We are less concerned with finding solutions (though these will be discussed), than with exploring & understanding what is going on for the doctor & the patient. • Facilitator thanks presenter for providing the case and asks them to give a follow-up report if / when ready to do so.

  10. Reflective practitioner • A reflective practitioner is self aware, insightful and mindful. • Able to step back & observe what's going on in their lives as if they were watching someone in a movie.

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