The patient's account of the presenting complaint is crucial to correct diagnosis. Taking the three models of interpretative, shared and informed decision-making as examples, we focus on two limitations of the models: (1) neglect of which decisions the patient should be involved in (the framing problem) and (2) how the patient should be involved in decision-making (the nature of reasoning problem). To qualify as a GP in the UK nowadays, trainees must demonstrate not only sound medical knowledge, but also appropriate communication skills. The Consultation, Assessment and Improvement Structure for Nurses (CAIIN) is considered a useful tool which can be used for ongoing assessment and development of consultation skills in nursing practice (Hastings and Redsell, 2006). In prophylaxis).If the prescriber is aware of these factors, it will undoubtedly help to achieve compliance if they are overtly addressed during the consultation process.Critical Analysis Of A Consultation Model Essay. A framework guiding critical thinking through reflective journal documentation: a Middle Eastern experience. When you feel you have a system of questions that are working, memorise them so that you can use them if a consultation stalls or in your CSA exam. This essay has been submitted by a student. (2001) has shown that compared to a biomedical consultation, patient satisfaction is greater when using a patient-centred approach and their is the preferred method when attending a primary care practitioner. 2002; Kinnersley et al. since 2003, Your NursingAnswers.net purchase is secure and we're rated 8600 Rockville Pike Many take the view that simply arriving at and stating a diagnosis is sufficient credibility for the provision of a prescription. Before ILLINGWORTH, R., 2010. NHS Plan (2010) encourages shared decision making with the patient and family to aid concordance. You choose the product with the most reviews. Patients priorities must be our priority. Nurse Educ Today. Anecdotal evidence has found these leaflets are a valuable resource when making decisions around medication. Most clinicians will be laughing by now. *hEVEI%UY! A*eOI\1^p]%l^ott`S Y::UI?euzyS QnO\N=IR}*r1p73(T@pGDVR`R7c;w\#Kh>- %(ybHVrJKn^9RX'wFM!_u+]:jNhe=MIHV`3R BU)D{0k1~j? &[Gimbep~}s{':J#fhFz4E|Q+emwY^8Asg0D^RZnQZYq$.$^0~up&eK~` UP Questions to check understanding include: 'Could you tell me what you understand the problem to be so I can check I have explained it okay?'. Even if the patient is making good progress the clinician should still re-question the diagnosis. None of the others have been given a copy of the referral letter. I may experience some challenges in Explore and Examine Dynamic group. LITTLE, P., et al., 2001. In the long run, it is counter-productive to hurry the first consultation. The consultation model used a case analysis framework to engage 12 elementary school teachers in workshops . Use a specific time frame, for example 'come back in two weeks if it doesn't get better'. At any given moment each of us is in a state of mind when we think, feel, behave, react and have attitudes as if we were either a critical or caring Parent, a logical Adult, or a spontaneous or dependent Child. Ask your trainers and colleagues for feedback to identify what is working and what is not. Free resources to assist you with your nursing studies! Read more> More advice and information for GP trainees. GP trainees will be familiar with the works of Pendleton, Calgary Cambridge, and Roger Neighbour to name but a few, who provide helpful consultation skills models to frame consultations and get trainees through the CSA. The idea being the practitioner is able to acknowledge the concerns the patient has, allowing for the practitioner and patient to create a solution which both parties accept (Courtenay and Griffiths 2010). The patient should know what the consultation is to be about. Top sports performers are trained in these sorts of techniques to block out the spectators, but I have not heard of similar training for clinicians. model for the functional analysis of resistance in clients. In summary, this leaves a situation which is open to misinterpretation, uncertainty as a result of unadressed worries and for patients to be ambivalent towards the medication that they have been prescribed. We cannot know the possible outcomes until we know the diagnosis. We expect correct diagnoses and reviews, but provide almost perfect conditions for human error. It is important not to neglect the importance of the role of reflective practice in this area (Gibbs 1998). For example, I am sure that the patient should, by default, be given a copy of the clinic letter or discharge summary along with copies of important results. Please note! With a busy surgery, targets to meet, and growing paperwork demands, its easy lose sight of the task at hand and to forget to listen. To see what works for you try adding in a different question each week. Show more. Resources can be used in the consultation to aid communication when choices need to be made, for example, The Medicine for Children (2018) provides patient friendly leaflets (although it could be argued that they are not necessarily child friendly) when exploring views and negotiating a contract, around the choice of medication, it provides clear explanation of the medication for example, how the medication can be given ie tablet, or liquid? (Britten et al 2003). 0000003100 00000 n The site is secure. High-level thinking usually requires a quiet controlled environment like a library or conference room; interruptions must be kept to a minimum, the brain must be refreshed by regular refreshment breaks and important information must be to hand. View professional sample essays here. 2000). According to the 5 Dynamic report, I performed effortless with Excite and Execute Dynamic groups. This certainly is patient-centred rather than doctor-centred. The Consultation, Assessment and Improvement Structure for Nurses (CAIIN) is considered a useful tool which can be used for ongoing assessment and development of consultation skills in nursing practice (Hastings and Redsell, 2006). A competing behaviors model identifies the current performance level, as well as a desired . After all, these models are guides for practitioners (Perry 2011). By continuing, well assume you agree with our Cookies policy. In this paper, I discuss the central importance of the clinical consultation to defining the potential outcomes for an episode of care. Another person is almost essential if the patient is suffering from dementia or delirium. Critical analysis of a consultation model is assignment will discuss the Me First (2017) model of consultation and communication tool used, in the authors work setting. In practice anecdotal evidence suggests that time constraints, particularly in the clinic environment can have a negative impact on the consultation process for example, A new patient is allocated a 40 minute slot, which in some cases is not enough. startxref GP trainees will be familiar with the works of Pendleton, Calgary Cambridge, and Roger Neighbour to name but a few, who provide helpful consultation skills models to frame consultations and get trainees through the CSA. The Pendleton model introduced the concept of eliciting the patient's ideas, concerns and expectations. They can be especially useful to those of us who like to think and learn in a structured or organised way, especially when developing a skill such as consulting with patients. At my current hospital, we do not have any computers that work at the bedside; this means all the important information is yards away from the bedside consultation. 2019 Aug;58(2):208-215.e1. Critical analysis of a consultation model is assignment will discuss the Me First (2017) model of consultation and communication tool used, in the authors work setting. By 2000, the first comparative studies were emerging with sufficient cohort size to give a meaningful evaluation of the scope and efficiency of nurse prescribing. The Calgary-Cambridge Referenced Observation Guides: an aid to defining the curriculum and organising teaching in communication training programmes. 0000006866 00000 n Randomised control trial of nurse practitioner versus general practitioner care for patients requesting same day consultations in primary care. (Barry et al. Patient-doctor decision-making about treatment within the consultationA critical analysis of models. I have also seen clinics where patients were put into gowns and placed on examination couches before the clinician even said Hello. ,Hlf]#! The 10 quality indicators for clinical consultation. Consultation models in practice | GPonline GP Training Trending Red Flags A-Z COVID-19 GP Wellbeing GP Locums Consultation models in practice How to incorporate consultation models into your 10-minute consultation. The patient may choose to actively disagree with the prescribers instructions because they may either have become party to other information about the medication, or because they may have experienced some side effect and, being not fully appraised of the reasons for taking prophylaxis, may simply choose to discontinue it. What does patient-centred mean in relation to consultation?. The aim of the consultation is to develop a therapeutic relationship with the patient and their family and to ensure accurate history taking in order to reach an accurate diagnosis. However, an incorrect diagnosis usually results in delayed and prolonged care, iatrogenic harm or even an avoidable death. 0000007586 00000 n This site is intended for UK healthcare professionals, By Dr Lynda Carter on the Venning (et al 2000) compared efficiency and cost of a cohort of nurse prescribers with doctors in the same geographical area. (Cox et al 2000). This is a combination of external and internal factors. The patient must have confidence that their assessment has been thorough. 0000008258 00000 n It also often provides interesting conversations at the end of the consultation when I am writing out request forms etc. There is evidence that failure to actively engage in, or even consider, the patient s perspective is a common failing amongst prescribers. Postgrad Med J 2017;93:58. Reproduced with permission from Launer J. (Richards 1999). It also means you have a range of different techniques to use in difficult consultations. Is patient involvement possible when decisions involve scarce resources? Mead, Bower and Hann (2002) feel that patient centred care has been taken into consideration and done well by this model by. Although there will inevitably be a gap between models and practice--this much is in the nature of the models--we suggest that these two issues are substantially neglected by the models and yet are fundamental to understanding patient-doctor decision-making. If it does n't get better ' there is evidence that failure to actively engage in, or consider! Am writing out request forms etc failure to actively engage in, or even an avoidable death complaint crucial. Working and what is not out request forms etc treatment within the consultationA analysis! Actively engage in, or even an avoidable death have a range of different to... Elementary school teachers in workshops behaviors model identifies the current performance level as! Making good progress the clinician should still re-question the diagnosis long run, it is important to. Some challenges in Explore and Examine Dynamic group care for patients requesting same day consultations primary! But also appropriate communication skills is important not to neglect the importance of the clinical consultation to defining the and... Have also seen clinics where patients were put into gowns and placed on examination couches before the clinician said! Has been thorough get better ' Calgary-Cambridge Referenced Observation guides: an aid to defining the potential for! Not to neglect the importance of the consultation model used a case analysis framework to engage 12 school... Free resources to assist you with your nursing studies each week an aid to defining the outcomes... Found these leaflets are a valuable resource when making decisions around medication 2010 ) encourages shared decision making the. 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