Brief model presentation. ⢠Exercise #1: Building a clinical scenario. ⢠Exercise #2: Teaching from a video. ⢠Implementation and use of the communication wheel ...
SPIN THE WHEEL TO BETTER COMMUNICATE !
Sophie Galarneau MD, CCMF Olivier Jamoulle, MD, FRCP M-Thérèse Lussier, MD, BSc, MSc, FCMFC Claude Richard, PhD, MA September 29th 2014, Amsterdam
• We do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization.
• Marie-‐Thérèse Lussier and Claude Richard have received honorary, outside of this workshop, for their work on health communica?on from Astra Zeneca and Merck. Sophie Galarneau MD, CCMF Olivier Jamoulle, MD, FRCP M-Thérèse Lussier, MD, BSc, MSc, FCMFC Claude Richard, PhD, MA September 29th 2014, Amsterdam
The Professional Health Communica4on Wheel
A TEACHING TOOL
Workshop objectives At the end of the workshop, the par?cipant will have: • Familiarized herself/himself to the wider conceptual model of professional health communica?on and its components • Experimented the use of the “Professional Health Communica?on Wheel” in different teaching ac?vi?es • Discussed the applicability of the “Professional Health Communica?on Wheel” in their own teaching seRng
Workshop structure
• Welcome and presentation of participants • Brief model presentation • Exercise #1: Building a clinical scenario • Exercise #2: Teaching from a video • Implementation and use of the communication wheel in teaching activities • Conclusion
Attendees
• • • • • • • •
Residents ? Students ? Physicians ? Nurses ? Social workers ? Other professions ? Communication skills teachers ? Program directors ? Others ?
Professional Health Communication Wheel
Generic functions and dimensions of communication
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Medical interview fundamentals: the Calgary-Cambridge Guides
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Medical interviews across the spectrum of clinical practices
Medical communication: its many forms and expressions
Claude Richard1, Marie-Thérèse Lussier1,2, Sophie Galarneau2 et Olivier Jamoulle3 1 2
3
Équipe de recherche en soins de première ligne, CSSS Laval, Laval, Canada Family medicine and Emergency department, Faculty of Medicine, Université de Montréal, Montreal, Canada Pediatric department, CHU Sainte-Justine, Université de Montréal, Montreal, Canada
* Drawing on the work by Von Fragstein M, Silverman J, Cushing A et al. UK Consensus Statement on the content of communication curricula in undergraduate medical education. Medical Education 2008; 42: 1100-1107.
Introduction
• First aim of the tool – To represent (gather in one tool/piece/glance?) all aspects of health communica?on in the medical prac?ce • Not only the doctor-‐pa?ent medical encounter
– To show « as simply as possible » the complexity of communica?on issues for the clinician
The model: 4 Meta-categories 1. Generic functions and dimensions of communication 2. Medical interview fundamentals: •
The Calgary-Cambridge Guides
3. Medical interviews across the spectrum of clinical practices 4. Medical communication: its many forms and expressions
Building (crea?ng?) a case-‐scenario
EXERCICE # 1
Situation/Context • Your Program Director asks you to prepare a communication skills teaching session for residents. • During a recent survey, the residents from your program have identified they needed more training on breaking bad news.
Task You have decided to work on the (announcement?) diagnosis of genital herpes. Use the wheel to create: 1) A simple case (medical student/clerk or junior resident) 2) A complex case (senior resident) SPIN THE WHEEL 2X2!
Group Discussion • Sharing examples? • Which part of the wheel did you change to raise the level of difficulty of the case? • What is the utility of the wheel to create scenarios?
Teaching from a video
EXERCICE #2
Wheel Use during Direct Observation • Melissa is a resident in pediatrics (R4) at the ambulatory clinic of a pediatric university hospital. She is seeing a 5 year old boy with asthma for a follow-up visit after a ER visit. Compliance to treatment at home is an issue. • You will watch the last part of the encounter with the mother to give Melissa feedback on her communication skills when explaining and planning the treatment and follow-up.
Task 1) Observe the interview 2) Use the communication wheel to structure/ prioritize your feedback to Melissa
Video
Feedback to Melissa • What will you say to Melissa? • How did the wheel help you? Or didn’t help?
Feedback to Melissa
Video Feedback example to Melissa
Context of care • Relationship is influenced by: – The nature of the problem and the chronicity – The setting and the type of the consultation
• Exemple: – Acute and severe problem = « Expert-in-charge » – Chronic and simple problem = « Facilitator »
Another Use of the Wheel • To build a communication skills teaching curriculum for any residency program • To follow the progress of the communication competency during the residency (from junior to senior) – To define milestones (the expected ability in communication skills at each stage of expertise)
• Appropriate tool to fit with new CanMEDS roles 2015 from the Royal College of Physicians and Surgeons of Canada
Communication Curriculum in a Pediatric Program • R1 – Calgary-Cambridge model and approach – Children 0-5 years old and 6-12 years old – ER, hospitalization unit
• R2 – Adolescents – Specific populations – IC unit
• R3 – Problematic situations (dealing with emotions…) – Sensitive topics (intimacy issues…)
• R4 – Disclosing unexpected complications and errors
Integrating the communication wheel to teaching
Advantages and Limitations
Use and Advantages 1. Supervisor and learner Supervision tool ! Analysis grid ??? ! Shared vocabulary and conceptual framework ! Overlapping of different variables (age, gender, context of care...) ! Explicit curriculum for the learner ! Useful tool for the resident to prepare a teaching session with a video
Use and advantages 2. Faculty Teaching tool ! Helps to create scenarios for teaching sessions and role plays ! Maps the communication skills
3. Program director Curriculum guide ! Supports the development of a program curriculum for the communication competency ! Adjusts the communication skills to the program specificity
Limitations • Descriptive model – Doesn’t tell you how or what to teach
• Easier to use in a clinical setting than to teach communication challenges between health professionals • Doesn’t give justice to the complexity of all interactions a clinician faces – But does do justice to a multitude of communication situations in practice
Conclusion • The communication wheel gives a structure for professional health communication teaching • The wheel may helpful to build teaching session on communication skills • The wheel helps to structure but doesn’t tell how to teach • The wheel may hone intervention on communication feedback • It allow to “play” with the different aspects of a case, it is a game changing tool.