Registrar pre teaching session worksheet
>click here for printable version<For Basic Term Registrars
Introduction
Counselling is a basic skill that underpins almost every consultation in general practice. When we are listening to a patient tell us about their illness experience, when we are talking to a patient about quitting smoking, or helping them deal with their anxiety; in all of these situations we are using counselling skills. They are ubiquitous!
At a basic level these skills might include active listening, empathising, validating the patient’s experience or assessing their readiness to make change. More challenging aspects of counselling might include breaking bad news or working with patients with chronic pain or extremely stressful life experiences.
There are different levels at which GPs can be involved in counselling; some may want to undertake further training in order to provide focused psychological strategies for their patients, such as cognitive behavioural therapy.
Activity
To prepare for the next teaching session, you will review a consultation that you have videotaped. Therefore as soon as possible, you should videotape a session of consultations. You should then look at a consult where the patient needed help with lifestyle change (eg smoking cessation, weight loss).
As you go through the two activities, make some notes for further reference:
- View the videotape and use the Counselling Skills Observation Schedule to analyze your basic counselling skills. Record your observations on the sheet.
- The patient needed help with a lifestyle change. Use the accompanying Motivational Interviewing Checklist to look at motivational interviewing techniques and identify what skills you used with this patient. What might you do differently the next time?
Bring the observation materials and the recording of the consultation with you to the next tutorial with your supervisor.
For Advanced Term Registrars
Introduction
There are two activities for Advanced term Registrars. One serves to raise awareness of materials already provided in the Basic terms. The other is a reflective exercise based on an actual clinical encounter.
Counselling is a Basic skill that underpins almost every consultation in general practice. When we are listening to a patient tell us about their illness experience, when we are talking to a patient about quitting smoking, or helping them deal with their anxiety; in all of these situations we are using counselling skills. They are ubiquitous!
At a basic level these skills might include active listening, empathizing, validating the patient’s experience or assessing their readiness to make change. More challenging aspects of counselling might include breaking bad news or working with patients with chronic pain or extremely stressful life experiences.
There are different levels at which GPs can be involved in counselling; some may want to undertake further training in order to provide focused psychological strategies for their patients, such as cognitive behavioural therapy.
Activities
Activity 1
Find the Primary Care Mental Health Training Workshop Outline and Resources Document which was provided during the Primary Care Mental Health Training course in the Basic terms.
- Review this resource.
- Keep it in the consult room where it is easy to access.
- Bookmark some useful websites.
Have you used the Structured Problem Solving Resource? How has it been useful?
Have you instructed any of your patients in relaxation techniques? How has this been useful?
Activity 2
To prepare for the next teaching session, you will need to review a consultation that has been videotaped. Therefore, as soon as possible, videotape a session of consultations. Then look at a consult where the patient presents with a mental health issue (or what you suspect might have been a mental health issue).
Answer the following questions and write down your answers:
- How well do you think you developed rapport with this patient? How did you do this?
- (How) did you reach agreement on what the problem was?
- What do you think the problem or diagnosis was?
- How did you help the patient understand what the problem was?
- What interventions did you use during the consultation?
- What resources did you use with this patient? Were there other resources that you needed but did not have? Have you had a look in your Resource List?
- What other types of interventions do you think might have been useful?
- What homework did you give the patient?
- What arrangements did you make for follow up?
Bring these materials and the recording of the consultation with you to the next tutorial with your Supervisor.