中医国际接诊能力实训课件

《中医临床技能实训》

——中医国际接诊能力实训《中医临床技能实训》CommunicationSkillsinEnglishfortheMedicalPractitionerCommunicationSkillsinEnglisWhattobelearned?

todevelopthelanguageskillsinEnglishtomaintainharmonybetweendoctorsandtheirpatientsenablingmedicalpractitionerstocarryouttheirdutiesinEnglishmoreeffectivelyandwithgreaterconfidence.Whattobelearned?todeveloWhatiscommunication?Whatiscommunication?voicemanagementverbalcommunicationculturalawarenessnon-verbalcommunicationactivelisteningPFilmvoicemanagementverbalcommuni中医国际接诊能力实训课件中医国际接诊能力实训课件Step1Receivingthepatient(接诊)LearningoutcomesGreetpatientsandputthemateaseIntroduceyourselfandyourroleAstheopeningquestionandsettheagendafortheinterviewStep1Receivingthepatient(Puttingyourselfinthepatient’sshoes!!Establishing

initialcontactStep1ReceivingthepatientPuttingyourselfinthepatienGreetingandputtingyourpatientateaseStep1Receivingthepatient

GreetthepatientandobtaintheaddressIntroduceyourselfandclarifyyourroleExplainthepurpose&agendaofinterviewObtainpermissionforspecialcircumstanceGreetingandputtingyourpatiConveyingwarmthwelcomingorunwelcoming?ShowingawelcomingvoiceAwelcomingvoiceisshownthroughamoderatedpitchandspeed,andagentleriseandfallintonationpattern.e.g.Goodevening.MsFinley,isn'tit?e.g.I'mDrCameron.IhopeI'mnotdisturbingyou.Step1ReceivingthepatientConveyingwarmthwelcomingoruAskingtheopeningquestion:Sowhat’stheproblem?what’sup?Step1ReceivingthepatientAskingtheopeningquestion:SoDifferenttypesofopeningquestions1.YourGPhasexplainedthesituation,butIwonderifyoucouldtellmeinyourownwords?2.Whatwouldyouliketodiscusstoday?3.AmIrightinthinkingyou’vecomeforbaby[Killian’s]routinecheck-up?4.Howarethingswiththe[newtables]?5.Whatbringsyouheretoday?6.HastherebeenanyimprovementsinceIsawyoulast?7.Howareyoufeelingtoday?8.Ihaveyournotesfromyourdoctor,butcouldyoutellmewhat’sbeenhappening?9.So,whathaveyoucometoseemeabouttoday?10.So,howis[littleRhana]doing?Step1ReceivingthepatientDifferenttypesofopeningqueTheFellow-upquestionstoensurethepatienttobeabletoexpresshimselffully

Isthereanythingelseyouwouldliketodiscusstoday/whileyou’reheretoday?Isanythingelsebotheringyouatthemoment?Doyouhaveanyotherissuesyou’dliketoaddresstoday?Step1ReceivingthepatientTheFellow-upquestionstoensSettingtheagenda:LanguageforsettingtheagendaShallwe/Let’sstartwith[theheadache]?Shallwestartbydiscussing/lookingat[theheadaches]?We’llcomebackto[thearthritis]later/afterthat.We’lltalkabout[thearthritis]later/afterthat.Ifthat’sallright/OKwithyou?Doesthatsoundallright/OK?Step1ReceivingthepatientEndofStep1Settingtheagenda:LanguagefStep2Thepresentingcomplaint(主诉)

Learningoutcomes

EncouragepatientstoexpressthemselvesintheirownwordsTakeanaccuratehistoryofthepresentingcomplaintAskabouttheintensityanddegreeofpainUsetechniquessuchasfacilitation,repetitionandclarificationStep2ThepresentingcomplainDoctor-centeredapproach

orPatient-centeredapproachStep2ThepresentingcomplaintDoctor-centeredapproach

orPQuestiontypesOpenquestions(what,why,wheretypequestion)Closedquestion(yes,nooraspecificpieceofinformation)Step2ThepresentingcomplaintQuestiontypesOpenquestionsDoctorsareencouragedtoavoidthefollowingquestiontypesMultiplequestionsseveralquestionsaskedatthesametimeLeadingquestionsthose‘lead’thepatienttowardsaparticularanswerTagquestionstendtoguidepatientsintheirresponseStep2ThepresentingcomplaintDoctorsareencouragedtoavoiCategorizethefollowingquestions

CClosedLLeadingMMultipleOOpenTTag

Presentingcomplain:hay-fever-typesymptoms1. Doesthesneezingstartwhenthedogisinthehouse?C,L2. Hashebeenwheezingaswell?_________3. Sothesymptomsarethereallthetime,arethey?______4. Ishegettingtheseattackswhilehe’soutside,too?Dotheycomeonsuddenlywithnowarning?Whattypicallyhappens?__________5. Didyourson’sallergystartafteryouboughtthedog?___6. Andyou’vealreadytakenhimtoseeyourGPaboutthisproblem,haven’tyou?_________Step2ThepresentingcomplaintCLMCCLCCLTCategorizethefollowingquestRewritethosesentences1.Whendoesthesneezingstart/doyoustartsneezing?2.Doeshesufferfrom/Doyouhaveanyothersymptomsatall?3.Howoftendoesheexperiencethesymptoms/doyousneeze?4.Canyouexplainwhattypicallyhappenswhenyoursonhas/youhaveanattack?5.Tellmehowyou(son’s)allergystarted?6.Howhaveyoubeentreatingyourallergytillnow?Step2ThepresentingcomplaintRewritethosesentences1.WheHowtodescribethepain---MetaphorStep2ThepresentingcomplaintHowtodescribethepain---MematchtheadjectiveswiththeailmentsStep2Thepresentingcomplaintmigraine(偏头痛)urinaryinfectionperiodpainchestpainheartattackheadachetoothacheindigestionpinsandneedlestensionheadacheshootingpainburningsensationcrushingsensationgrippingpainpoundingfeelingcrampingpainstabbingpaintinglingsensationblindingheadachethrobbingpainmatchtheadjectiveswiththeAskthepatientiftheyhaveeverexperiencedamigraine,badtoothacheorabrokenlegandthenaskthemtocomparethecurrentpaintothat.Step2ThepresentingcomplaintAskthepatientiftheyhaveeSevenAttributesofaSymptomLocationQualityQuatity/SeverityTimingSetting(inwhichitoccurs)Aggravating/alleviatingAssociatedmanifestationsStep2ThepresentingcomplaintSevenAttributesofaSymptomLClarification(阐述)Facilitation(鼓励)&

Repetition(重复)Decidewhethereachoftheseisanexampleofclarification,facilitationorrepetition.Step2ThepresentingcomplaintEndofStep2Clarification(阐述)FacilitatioStep3PastmedicalandfamilyhistoryLearningoutcomesRequestthepatients’pastmedicalhistoryTakeeffectivenotesduringaninterviewwriteaneffectivepatientnoteStep3Pastmedicalandfamily

ThecomponentsofthePMH(PastMedicalHistory)PastillnessesChildhoodillnessesImmunisationsSurgicalproceduresAccidentsandinjuriesAllergiesPregnanciesMedicationStep3PastmedicalandfamilyhistoryThecomponentsPastillnessesTheuseofpasttensesandprepositionstoobtainaPrecisemedicationhistory

Step3PastmedicalandfamilyhistoryTheuseofpasttensesandpreStandardmedicalabbreviationsHTNMbyocigCXRMRIAbdrh/olfFHwICUhypertensionmaleblackyear(s)oldcigaretteschestX-raymagneticresonanceimagingabdomenrighthistoryofleftfemalefamilyhistorywhiteIntensivecareunitStep3PastmedicalandfamilyhistoryStandardmedicalabbreviationsWriteaneffectivepatientnoteStep3PastmedicalandfamilyhistoryWriteaneffectivepatientnotStep3PastmedicalandfamilyhistoryEndofStep3Step3Pastmedicalandfamily《中医临床技能实训》

——中医国际接诊能力实训《中医临床技能实训》ExaminingapatientExaminingapatientAttheendofthisunityouwillbeableto:giveeffectiveinstructionsinapatient-friendlymannerLearningoutcomes:AttheendofthisunityouwiLeadin:Putyourselvesinthepatient’sshoes.Howdoyoufeelbeforebeingexamined?*anxious*Nervous*overexposed*humiliated*embarrassedLeadin:HowdoyoufeelbeforCommunicationSkillsEmbarrassmentNervousnessFearPatient-friendly

CommunicationSkillsPatient-fr*Takeoffyourshoes*Lieback*Raiseyourunderclothesinheight*Restyourarmsbyyourside*Relax*TakeoffyourshoesListentoConsultationindetailandcompletethedoctor’sinstructions.1.____________________forme,please,Julie.2.__________________toliftyourleftlegashighasyoucan.3.________________________offyourshoesandyourtights.4.________________________yourskirtoveryourknee.5.________________________ifitstartstofeeluncomfortable.UsingindirectlanguageforinstructionIfyoucouldstandupI’djustlikeyouto(please,)IfyoucouldtakeWouldyoumindjustliftingIwantyoutotellmeListentoConsultationindetaWhydoyouthinkthedoctortendtouseindirectlanguage(modal)forinstruction?Directlanguage:toodirect;asacommandratherthananinstruction;abruptandimpolite.Indirectlanguage:softentheinstruction;itcomeacrossmoreasarequest;morepolite;lessenanxietyandfear.Whydoyouthinkthedoctorte*Takeoffyourshoes*Lieback*raiseyourunderclothesinheight*Restyourarmsbyyourside*Relax*Wouldyouminddoing…*I’djustlikeyoutodo…*(please,)Ifyoucoulddo…*Iwantyoutotellmeifitstartstofeeluncomfortable.Roleplay*Takeoffyourshoes*WouldyouAsdoctors,howcanyougiveinstructionsinapatient-friendlymanner?IndirectlanguagesoftenerSimple/informalinstructionAsdoctors,howcanyougiveiA.CircumductionB.AdductionC.PronationD.InhaleE.ExhaleMedicaltermsSimpletermsMakesmallcircleswith(yourarm)b.Rotate/turninwardc.Turnyourpalmdownd.Breatheine.BreatheoutA.CircumductionMedicaltermsReadthedialogueandunderlinealltheinstructionswritteninaformalstyle.Thefirstoneisdoneforyou.Replacetheformalwordswithfollowinglessformalequivalents(situp,breathein,nose,breatheout).Presentingcomplaint:asthmaPatient(wheezingheavily)Doctor:MrsDaniels,canyousitintheuprightpositionforme,please?Icanseeyou’rehavingdifficultiestoday.I’mjustgoingtolistentoyourchest.Patient:Sure.Doctor:Good.Now,Iwantyoutoinhalethroughyournasalpassage.Inhaledeeply…That’sit.Nowexhale.Andagain…inhale…andexhale.

ReadthedialogueandunderlinAsdoctors,howcanyougiveinstructionsinapatient-friendlymanner?IndirectlanguagesoftenerSimple/informalinstructionAsdoctors,howcanyougiveiReadaloudthefollowinginstructions,thendecidewhateffectthewordjustcreates?A:I‘djustlikeyoutoliftyourleg.I‘dlikeyoutoliftyourleg.B:1.Onemoreexaminationleft.2.Justonemoreexaminationleft.C:Itlookslikeaminorfracture.Itjustlookslikeaminorfracture.ReadaloudthefollowinginstrItisimportanttousesoftenerssuchas“just”toestablishandmaintaingoodinterpersonalrelationsinEnglish-speakingcultures.Anabsenceofsoftenerscanconveyalackof