Damian Kenny's Rudimentary Web Page!

These are a few tools which GP Educators may wish to use to help GP Registrars learn good consulting skills. I have made a few suggestions for how they can be used, but individual Educators and Registrars may find other ways of using them to enhance their consultation skills. I would appreciate feedback and suggestions for how to develop these tools, and for other ways of using them. My email address is at the bottom of this page.

Consultation Navigation Tool 2012 This is a tool for helping to teach consultation structure. It shows a navigation path for the consultation, emphasising the importance of gathering all relevant data first, before 'crossing the bridge' to discussing management planning. By following this consultation structure, the doctor avoids looping back and forth between gathering data and discussing management. The consultation is more focussed, the patient is more involved, and it is quicker.

Some GP Registrars have found it helpful to laminate this Navigation Tool and place it on their consulting desk as an aide-memoir during consultations.

It can also be used to facilitate analysis of consultations on video, and aid discussion of alternative pathways through a particular consultation.

(You can see the orgininal tool here)

For a version in Chinese, click here

Consultation Analysis Tool This is a tool which we can use to analyse parts of the consultation. In the first column, write down some actual words that we hear the doctor say, for example. “How are you sleeping?”

In the second column, write an analysis, for example, ‘history, explanation, open question, closed question, statement, verbal echo, summarising, discussing options, etc’.

In the third column, write I if the comment relates to Information Gathering.

In the fourth column, write M if it relates to Management and Planning.

We can then note the structure of the consultation, whether it moves smoothly from 'Gathering Information' to 'Management Planning' or whether there is looping back and forth. We can discuss with the Registrar what happened, and consider alternative phrases for any areas that he wishes to develop.

List of Phrases during Consultations If the Registrar has difficulty with a particular part of the consultation, she may wish to consider using one of these phrases. She should find a phrase that she feels comfortable using, perhaps by trying out a few of the phrases on the list with her Educational Supervisor, then with patients.

Some Consultation Microskills This is a list of microskills that GP Educators may wish to help Registrars learn, to enhance their consultation skills. Perhaps start by identifying which skills the Registrar already uses, then discussing which one he would like to learn. It is useful to practise the skill during a tutorial, then try to use it when appropriate during a real consultation.

Some Ideas about Active Listening This is a list of some ideas which enhance active listening during consultations. There is also a list of some common reasons which reduce active listening. GP Edcuators may wish to discuss these with their Registrar, perhaps trying some of the ideas during a tutorial, then with patients.

COT Mapping Grid This is a grid for mapping COT assessments. You can use it to record the assessment level for each competency area, then for a future COT choose to discuss competency areas which are not yet assessed as 'Competent'. You can then select areas to aim for 'Excellence'. It can also help to ensure you discuss a wide variety of types of patient and consultation.

CBD Mapping Grid This is a grid for mapping CBD assessments, in a similar way.

CBD Preparation Template This is a template for preparing questions for a CBD assessment, and for recording some brief notes of the Registrar's answers. It helps to focus the questions on one particular competence at a time, and is useful when making a judgement of the level of competence demonstrated. It can also be used to note areas for teaching after the CBD is completed.

Planning Template for Educational Event This is a template that helps us plan a learning event. It is designed for those who have not have training about teaching methods, and is a blank template which helps us to identify our Aims and Objectives for the session, and then consider the best methods of delivering what we want the learners to learn.

Damian Kenny is a Community Education Advisor for Gloucestershire, part of the team of GP Educators of the Severn School of Primary Care.

Please contact me via email Damian Kenny