Tutorial 2 - Problem solving and Risk

Question 1

How can we manage risk during a consultation?

Answer 1

• Verbally checking
• Safety netting

Question 2

Defintion of

Risk?

Uncertain?

Uncertainty?

Answer 2

• Risk: chance of (or of bad) consequences, loss etc.
• Uncertain: not able to be relied on; not known or definite
• Uncertainty (personal): state of being not completely confident or sure of something

Risk implies chance – perhaps that can be quantified.
Uncertainty implies not known or not definite – maybe that cannot be determined completely.

Question 3

Risks of childbearing around the world?

Answer 3

Lifetime Risk of Death in Childbearing

(includes risk per pregnancy and likely number of pregnancies.)

North america: 1/3750

Europe: 1/1895

Africa: 1/15….

Question 4

Why do we need resilience?

Answer 4

• Lack of skills for dealing with uncertainty can lead to burn out and depression.
• Personal growth and control often result from getting through uncertainty.

Question 5

In what two concepts can we think of decision making?

Answer 5

• Degree of uncertainty
• Speed of the change

Question 6

How does Neighbour minimise risk in a GP consultation?

Answer 6

• He ensures that both the doctor and the patient are agreeing what the issue is today by summarising and verbally checking. Often a patient will add or correct information “Oh…did I not mention the rash..?”
• He hands over to the patient at the end to check all issues have been addressed– “Does that cover it?”
• He ‘Safety Nets’ – I think this is a flu like illness and should get better, but what if the patient were to deteriorate. ‘Do they know who to contact if that happens? Have I advised them which symptoms wold be concerning if they were to arise?’
• He Housekeeps – ‘That was a difficult and long consultation. Have I documented it well? Have I dictated the referral I promised? Do I need to pause and allow myself to focus for the next consultation? Do I need a coffee!?’

Question 7

Give an example of hypothetico-deductive reasoing:

Answer 7

• You get into your car, turn the key and it does not start.
• There are many possible reasons why.
• There are a few probable reasons however.- no petrol, flat battery. However if there was no petrol, at least the electrics would come on. It’s probably the battery then.
• This is hypothetico-deductive reasoning