This DVD has been written and is presented by Dr Peter Tate, the consultation skills guru. He gives a very clear introduction at the start.
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In the DVD, five scenarios that are commonly encountered in general practice are presented - for example a man with newly diagnosed hypertension. The aim of these carefully selected consultations is to demonstrate the key attributes of an effective consultation.
There are five tasks that should be completed for a successful consultation. One task is demonstrated in each of the five consultations. These are:
- Understanding why the patient has come.
- Understanding the problem.
- Explaining (or sharing an understanding).
- Management (sharing decision making and responsibility).
- Being effective.
The same actor plays the doctor in each of the five consultations and two other actors play the patients. The consultations have been carefully scripted by Dr Tate to illustrate the important tasks in each one.
The consultations vary in both their content and consultation styles, and at the end of each one, Dr Tate discusses the consultation in depth.
He demonstrates parts of the consultation that worked well for the patient and the doctor and parts that did not go well.
For example, in the first consultation the patient has a sore throat and requests antibiotics. The doctor examines her very early in the consultation, which then shifts the consultation to being doctor-led and disjointed.
Any relevant parts of the consultation are shown again after the discussion, which is very useful.
The consultations are scripted to show effective and non-effective strategies, and some made me cringe at times. For example, when the doctor looked at an infected foot and said it was 'not very pretty' and informed another patient with an abnormal smear that she needed 'a quick trip to hospital for some laser treatment'.
Negotiation and sharing
The last consultation was by far the best in terms of the doctor's performance. It demonstrated an effective patient consultation, exploring areas that mattered to the patient without being confrontational.
The doctor ensured that the patient had a good understanding of his condition and the treatment. Negotiating and sharing skills were clearly shown and the patient left this consultation in a positive frame of mind about their management.
This DVD is an excellent resource; both for established GPs and those in training. It would be best used with colleagues as many interesting discussion points arise from each of the consultations.
- An independent review by Dr Louise Newson, a GP in the West Midlands.