1. The Rough Guide to consultation skills

2. Consultation tasks Establish rapport
Get the patient to tell you what is wrong
Explore what the patient hasn’t told you
What does the patient think is wrong and what do they want?
Summarise (frequently!)
Examine the patient
Explain the problem
Share management options
Safety net

3. Five checkpoints (Roger Neighbour)
Connect
Summarise
Hand over
Safety net
Housekeeping

4. Consultation tasks Establish rapport
Get the patient to tell you what is wrong
Explore what the patient hasn’t told you
What does the patient think is wrong and what do they want?
Summarise (frequently!)
Examine the patient
Explain the problem
Share management options
Safety net

5. An exercise in establishing rapport

6. ‘Eliciting’ micro-skills
Nudging
Echoing
Feedback-eg ‘I noticed’
Checking (mini summary)
Explain why you are asking
Statement as a question
‘My friend John’
The ‘square search’

7. Group work to practice micro-skills
1. haematuria
2. several episodes of severe abdominal pain
3. a cough for 6 weeks

8. Recognising and responding to cues
verbal
emotional
Non-verbal

9. What a cue is and what it is not

10. Verbal cues to hidden agenda
What is said
What is not said
Speech censoring
Turbulence
Imprecise language
Emotive language
Opening gambits and curtain raisers

11. Non-verbal cues The ‘set-up’ Body language
Eye contact, internal search

12. Emotional cues
Micro emotions
Unexpected emotions
Mismatched emotions

13. What to do with cues? Ignore them Notice them and store for later
Comment
Act, change the consultation plan