Communication

Question 1

What is the powerful other?

Answer 1

• They believe that you are in charge of their healthcare and resist all strategies to take control of their own health.
• They only follow advice is it fits with their agenda.

Question 2

What is the external controller?

Answer 2

• Don’t believe in their own health and tend to accept being told what to do in order for them to accept or reject in the way they seem fit.
• Don’t want to partake in decision making and often have covert/overt mental health issues.

Question 3

What is the internal controller?

Answer 3

• They believe that they are fundamentally responsible for their own health.
• They like dialogue, explanation and critical thinking but their argument doesn’t have to be rationale.

Question 4

What is the health belief model?

Answer 4

• The idea that everyone has different investments in their own health and this therefore affects how they interact in terms of their treatment and shared decision making.

Question 5

What is the locus of control?

Answer 5

• This is what we tell ourselves about our own health and what is going to happen to it in the future.

Question 6

What is the rule of 1/3’s?

Answer 6

• Idea that 1/3 patients won’t follow advice at all, 1/3 of patients will follow the advice and do it adequately enough to be effective and the other 1/3 of patients will take the advice but not following it adequately enough.

Question 7

What does ICE stand for?

Answer 7

• Ideas, concerns, expectations.

Question 8

What makes up a basic clerking structure?

Answer 8

• Presenting complaint
• History of presenting complaint
• PMH
• Family history
• Social history
• Systemic review

Question 9

What should happen when taking a history?

Answer 9

• Open questions
• Observe both non verbal and verbal queues.
• Have good clinician body language

Question 10

What are investigations and examinations for?

Answer 10

• Testing hypothesis

- Therapeutic

Question 11

What is system 1?

Answer 11

• Quick, automatic response
• Recognise and move straight to decision.
• Affected by age, experience, hard wiring and experience.
• Has more influence than system 2 and guides the consultation.
• Can lead to confirmation bias

Question 12

What is system 2?

Answer 12

• Slower, more analytical approach
• Developed by education, training and critical thinking.
• Process of calibration.

Question 13

What is symptom based diagnosis?

Answer 13

• Patients present with symptoms and not a condition.

- Think about systems involved, time of onset and severity.

Question 14

What is framing effect?

Answer 14

• Who/what based on previous history.

Question 15

What is anchoring bias?

Answer 15

• Holding onto early salient features

Question 16

What is confirmation bias?

Answer 16

• Finding answers to support an early hypothesis.

Question 17

What is search satisfying?

Answer 17

• Finding one answer and ignoring others.

Question 18

What is availability bias?

Answer 18

• Easily re call based on previous experience.

Question 19

What is representativeness?

Answer 19

• Several features to one answer, but it’s unlikely.

Question 20

What is priming?

Answer 20

• Preparing for an answer by giving certain information.

Question 21

What is the law of small number?

Answer 21

• Small numbers with significance being over emphasised.

Question 22

What other types of bias are there?

Answer 22

• Blind spot, overconfidence and sensory inattention.

Question 23

What is empathy?

Answer 23

• Understanding and sharing the feelings of others.

Question 24

What is relative risk?

Answer 24

• The ratio of the probability of an outcome of an event occurring in a population that is exposed in comparison to the event occurring in a population that isn’t exposed.

Question 25

What is absolute risk?

Answer 25

- The change in the outcome of given treatment or activity in comparison to another treatment or activity.

Question 26

What is number needed to treat?

Answer 26

- The number of patients that need to be treated in order to prevent one additional bad outcome. - It is the inverse of the relative risk reduction

Question 27

What is The Bolam Test?

Answer 27

- Looks at whether what happens would be seen as proper in the eyes of a skilled and responsible body of peers. - Whether what happened was correct for the profession at the stage and level of the clinician - Would they do the same?

Question 28

What is The Mental Capacity Act?

Answer 28

- Governs the descision making in adults who don't have the ability to make the desisions themselves, for example patients with mental health issues, learning difficulties, dementia or other physical issues.