CSA scenarios with REAL CSA actors As close to the CSA exam as possible

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QUICK REFERENCE:

Negotiating a Management Plan By Nazmul & Muhammed Akunjee

QUICK POINTERS Patients are partner in the decision making process

o Do not give the patient unilateral plans. You will certainly be marked down for doing this. Avoid words such as I: I think you need a chest X-ray, bloods & some medicationsthen I can see you again in 5 wks

o Use vocabulary that is sharing such as we: How about if we organise an X-ray or we can

Avoid explaining all of the management plan in one single go

o Registrars have a tendency of running through the whole management plan over 2-3mins hoping the patient at the end will latch on to an area they prefer. This wastes time & may confuse the patient:

We can treat your high cholesterol by doing exercise for at least 30 minutes for 5 days a week. Make sure your exercise is enough to just make you breathless. You can also lose weight and change your lifestyle by eating less fatty foods. Make sure you do not fry your meat, rather grill it... Also make sure you eat 5 fruit and vegetables a day. Also you can take a tablet that reduces your cholesterol. It works on the liver particularly at night etc. Are your ok with that?

o Break down the management plan in to chunks that consist of options briefly mention them and allow the patient to choose which area they want to further explore;

You have presented with what I think is raised cholesterol.

In order to get it better or reduce it, there are things you can do such as cutting out fatty food, or increasing exercise.

But there are things we can do such as taking tablets. Which would you like to discuss about today?

o In complex topics where there are a number of areas that can be discussed ask the patient to guide you to which they want to focus on i.e. contraception pill.

There are a number of things we can talk about the contraceptive pill. What areas do you want me to go through with you or focus on?

CSA scenarios with REAL CSA actors As close to the CSA exam as possible

Individualised feedback from course facilitators & CSA actors on your performance

Contact us: csaprep123@gmail.com visit us www.csaprep.co.uk CSA course cases ideas concerns and expectations - CSA prep 2011

Offer and explain your recommendation with logical reasoning

o The patient attends the GP for advice rather than the other way round. Do not be so patient centred that you lose focus what is medically appropriate for the patient: Doctor, I have a mild headache but I want an MRI scan for it! Dr No problem! We are hear to do what you want!

o Offer the patient the appropriate medical advice that is evidence based and in keeping with up-to-date medical practice without imposing or forcing it on them. Your options include. and . However, I would recommend trying this first. How do you feel about that?

o Explain the pro and cons for each and reinforce your professional opinion if necessary.

Show active listening, involve and encourage the patient to air their views

o Encourage the patient to air their views: How do you feel about it? o Listen to the patient and their preference. Keep a close eye on their non-verbal cues: I dont like tablets,

they dont agree with me, or I am so busy I dont have time to change my diet, are there other options

INVOLVE THE PATIENT How do you feel about that? How does that sound to you?

Which way would you like to proceed?

Is there anyone of these that you are not keen on?

OFFER TREATMENT OPTIONS BREIFLY MENTION EACH OPTION ALLOWING PATIENT TO EXPLORE THEM

There are a number of things that can be done to help you. Some of these include do nothing lifestyle changes such as diet, exercise or taking tablets

- I would recommend taking some tablets and seeing how it goes? How about if we try the diet first? The reason for this is

SIGNPOST Is it OK if we have a chat about how we deal with some of things you mentioned

Shall we have a chat about how we go from here