MPSU Special Bulletin - New to Practice: Hints and Tips to Improve Consultation Skills
Multi-Professional Support Unit (MPSU) Bulletin – New to Practice - January 2022
Special Issue #1
Introduction
Good consultation skills are essential for all clinicians in primary care. Whether your consultation is face to face or remote, this bulletin aims to provide some useful hints and tips to improve the care you deliver.
Preparation
Proper preparation is key before you contact the patient.
Check that the IT (including computer and phone if needed) are working smoothly.
Ensure the consultation method is appropriate for issue presented.
Gather relevant information prior to consultation to help interaction.
Effective beginnings
Introduction and confidentiality
Whatever the setting it is important to always confirm who you are speaking to using 3 identifiers.
Tip: If contacting patient remotely always ask about setting (as they are not always at home) and whether anyone else is in the room.
Active listening
When starting the consultation, use an appropriate open question to allow the patient their ‘golden minute.’ Listen carefully to what they say.
Demonstrate you are listening by using appropriate verbal cues such as ‘mmm’ and ‘ok’ or non-verbal cues, for example, a smile or nod.
Information gathering
During the consultation you will need to explore the patient’s ‘story’. It is important that you work out what their ideas, concerns and expectations are.
Tip: When gathering information, it is important to work out the level of urgency. ‘Why now?’ can be a useful question for this.
Explanation and planning
Shared decision making
Any decisions or plans should incorporate the patient’s perspective and agreement.
Check for understanding
Before finishing remember to summarise the consultation.
Tip: The chunk and check technique of breaking down information discussed into manageable sections can help the patient’s understanding.
It is also important to allow time towards the end to enable the patient to ask any questions or provide further clarification if needed.
Safety netting
Patients need to know the what, why, when and how to proceed should things worsen. This should be checked and clearly documented in the medical notes.
Further learning
For further training a really good resource for all is the Greater Manchester Training Hub Teaching and Learning Consultation Skills (TALC) modules.
Tip: Look to reflect on your skills by either getting a peer to observe a consultation and provide feedback, or by recording one (remember to get consent).
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