1. The computer in the consultation

2. What is it useful for? Access to old patient information Ability to record info systematically and retrievably Access to information to share with patient Access to information for doctor

3. Knowledge flows (old)

4. Knowledge flows (new)

5. Disadvantages? Takes doctors attention Distracts patient Doc may be preoccupied with keyboard skills Comes between doctor and patient Patient may find it mystifying Confidentiality problems

6. Aim of session Identify and learn skills to help maintain rapport with the patient while using the computer in the consultation Specific competencies in areas of rapport, information giving, explanation and planning (adapted from Calgary- Cambridge framework)

7. Maintaining rapport Adapt behaviour to relative position of doctor, patient and computer Open posture while using computer Indicate (verbally and non verbally) when paying attention to screen Structure consultation so patient unlikely to talk while doc uses computer Respond to patient cues while attending to computer

8. Involving the patient Explain why the computer is being used Negotiate with patient when computer used as an information source Let patient read info from the screen when appropriate

9. Explanation and planning Check patient can see screen clearly Remain quiet, give patient time to read text Check patient has understood text Give patient opportunity to ask questions On crowded screen, point out relevant info