Tuesday 20 February 2018

Labs - about talking?

This might be hard to understand, but we do have labs...not in labs...and not a pipette in sight!

These labs are based on consultation skills. They are endorsed with our placements, either in the GP or the hospital, which in turn strengthen the lectures and tutorials on a particular aspect of the consultation.

The consultation is broken up into different elements. These elements obviously craft together to make the perfect consultation with the purpose of finding out what is wrong with the patient (by taking a history and an examination) and then interpreting your findings to come to a conclusion and then a plan of action (such as medication).

If we are given a part of the consultation, like examining the complaint which is being presented to us by the patient, we will have a lecture on this. In the lecture, we will be taught about the purpose of taking a history of a presented complaint, and the type of questions we will have to ask. We can even hear of examples of when this goes wrong, or poor practice in doctor consultations that leads to poor outcome for the patient.

After the lecture, we meet in our small tutorial groups of around eight peers and discuss what we have learnt from the lecture. These are our "labs".

These labs involve a lot of role play. Such as acting out particular consultation scenarios, structured by a plan that has been prepared for the session. For example, we could be pretending to be Mr Smith who has a family history of cardiovascular disease and I have just presented very high blood pressure and need to answer my peer's questions (as the doctor) to help them breakdown my presented complaint to build up a possible diagnosis and plan of action.

These lectures and tutorials can be delivered either in the university or the hospital I'm doing my placements in.
The labs also involve developing communication. My university's Medicine course was updated last year (I'm the first cohort) to provide more teaching on the communication aspect of being a doctor. Imagine having a doctor who didn't know how to talk to you or deliver the information correctly or understandably. Therefore, this year they are focusing on providing more teaching on this! So in the labs, we learn how to use vocal cues in our consultations to give better understanding (eg. the importance of paraphrasing to show understand and using it as an opportunity to make sure you've collected all of the relevant points).

For example, we ask patients "What is your past medical history?" and they often think only of diseases and illnesses. They'll tell you about their pneumonia or chest pain ... but they always forget surgery! So make sure you ask whether or not the patient has had any recent surgery, as this can explain symptoms. Abdomen pain can sometimes be explained by previous surgery in this region creating weakness in the bowel.

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