Qwertyuiopasdfghjklzxcvbnmqwerty uiopasdfghjklzxcvbnmqwertyuiopasd fghjklzxcvbnmqwertyuiopasdfghjklzx STUDENT WORKBOOK cvbnmqwertyuiopasdfghjklzxcvbnmq (NAME:____________________________________) wertyuiopasdfghjklzxcvbnmqwertyui (SRN ) opasdfghjklzxcvbnmqwertyuiopasdfg hjklzxcvbnmqwertyuiopasdfghjklzxc vbnmqwertyuiopasdfghjklzxcvbnmq wertyuiopasdfghjklzxcvbnmqwertyui opasdfghjklzxcvbnmqwertyuiopasdfg hjklzxcvbnmqwertyuiopasdfghjklzxc vbnmqwertyuiopasdfghjklzxcvbnmq wertyuiopasdfghjklzxcvbnmqwertyui opasdfghjklzxcvbnmqwertyuiopasdfg hjklzxcvbnmrtyuiopasdfghjklzxcvbn mqwertyuiopasdfghjklzxcvbnmqwert yuiopasdfghjklzxcvbnmqwertyuiopas dfghjklzxcvbnmqwertyuiopasdfghjklz xcvbnmqwertyuiopasdfghjklzxcvbnm : ____________________________
MEDICAL COMMUNICATION 2014
How to use this workbook?
This book will be used to document your activity during the block. You should report all your task including student projects and basic clinical skills on the worksheet given. given. Each task will refer to a specific worksheet. Several worksheet will also be your guidance in role playing or presentation as it provides the checklist of specific skills trained. The worksheet should be signed by the facilitator. Student should asked for signature after accomplishing student projects or skills training. This process ensure us that the learning process will give enough learning opportunity to the student. Your facilitator and or your friend will give score on certain worksheet. In Basic clinical skill you are allowed to asked for repetition and be assessed by your best perfomance, but try to keep with the time limit. For several items there be also a note coloumn, coloumn, you should make a note on your own perfomance in that space. The score given will will be used as formative assessment and also summative assessment. Student workbook and all attached material subjected to student projects should be collected by the head of the group to secretary of Medical Communication by theend of this block.
Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #1 Student Project 1: Reading assignment: Skills in Communicating with Patient
Your answer : 1. Calgary-Cambridge Observation Guide adalah buku yang mengulas tentang gambaran umum mengenai
kurikulum yang berhubungan dengan kemampuan berkomunikasi dan bagaimana menggunakan kemampuan tersebut untuk meraih informas dari pasien secara runtut dan lengkap. Ada 4 hal penting yang berpengaruh dalam kemampuan ini yaitu: a.
Structure
: Cara mengatur agar komunikasi tersebut tertata dengan baik dan efisien
b.
Skills : Untuk memahami kemampuan yang harus kita kuasai
c.
Validity
: Realitas dan kepastian data yang didapatkan oleh dokter haruslah sepaham dengan
pasien agar tidak terjadi salah penafsiran d.
Breadth
: Mengetahui jangkauan dari komunikasi tersebut
Adapun manfaat dari Calgary-Cambridge Observation Guide adalah dapat memberikan tuntunan serta dasar dasar dalam meraih informasi secara runtut, tepat, luas dan jelas yang dapat menciptakan kondisi kondusif antara dokter-pasien 2.
Calgary-Cambridge Observation Guide merujuk kepada 4 hal yang berpengaruh dalam keterampilan berkomunikasi sebagai seorang dokter yaitu: Structure
: Bagaiana cara mengatur agar komunikasi tersebut tertata dan mampu membantu untuk meraih
informasi? Skills
: Apa saja kemampuan yang harus ditingkatkan dan dikembangkan ?
Validity
: Apa bukti bahwa kemampuan ini dapat memberikan perbedaan dalam komunikasi antar dokter
dan pasien? Breadth 3.
: Seberapa luas cakupan dari data tersebut diraih?
Terdiri atas 5 runtutan kegiatan dasar dari Calgary-Cambridge Observation Guide yang tersetruktur yaitu: a.
Initiating the session
b.
Gathering information
c.
Building the relationship
d.
Explanation and planning
e.
Closing the session
Dan alasan dari mengapa struktur ini dibentuk adalah agar hubungan dokter dengan pasien dapat terjalin lebih erat sehingga mampu menimbulkan dampak positif dari pemeriksaan agar mampu saling bekerja sama. Adapun sering kali di kenyataan kita melihat bahwa hubungan dokter pasien hanya sekedar saja dan kurang bersinergi, maka dari itu keterikatan baik antara dokter pasien dirasa perlu dan Calgary-Cambridge Observation Guide dapat membantu dalam memudahkan mempelajari dan menerapkan struktur struktur komunikasi dasar tersebut 4.
Initiating the session -
Membangun hubungan awal
-
Mencaritahu alasan berkonsultasi
Gathering information -
Menggali lebih dalam masalahnya
-
Menemukan kesepahaman dengan pasien perihal masalahnya
-
Melakukan komunikasi secaa tersrtuktur
Building the relationship -
Mengembangkan hubungan dengan pasien
Student workbook – Medical Communication; 1st semester – 2014
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-
Melibatkan pasien dalam anamnesa lanjutan
Explanation and planning -
Memberikan penjelesana yang detail dan lengkap terhadap pasien
-
Memastikan kepahaman pasien dan mampu mengerti apa yang disampaikan
-
Sepaham dalam informasi agar tidak salah tafsir ata berbeda persepektif
-
Merencanakan dan membuat keputusan
Closing the session 5.
Manfaat bagi Dokter:
Dapat membantu dokter untuk melakukan pencarian informasi dari pasien secara lengkap, terstruktur, dan jelas sehingga dalam pemeriksaan agar tidak ada yang terlewat dan mampu menentukan diagnose yang tepat. Tidak hanya itu, dapat juga untuk meningkatkan hubungan dokter pasien dan memberikan rasa puas dan nyaman selama pasien berkonsultasi dengan dokter tersebut Manfaat bagi Pelajar:
Dapat menjadi acuan belajar dan gambaran bagaimana sebenarnya komunikasi yang baik dapat dibentuk dan dilaksanakan sehingga di kenyataan nanti dapat membuat kita paham akan pentingnya komunikasi yang baik antara dokter dengan pasiennya. Kita juga akan mampu bagaimana cara menempatkan diri dalamsituasi kondisi yang akan sering kita alami nanti selama melakukan praktek dan menjadi seorang yang profesional Manfaat bagi Fasilitator
Dapat membantu fasilitator untuk menyatukan kemampuan kemampuan dasar yang harus dimiliki oleh seorang dokter dalam hal komunikasi dengan pasien secara baik dan benar dalam pembelajaran baik di kelas maupun SGD, materi yang disampaikan nanti juga dapat lebih terarah dan memudahkan pelajar untuk memahami dan menerapkan kemampuan kemampuan tersebut 6.
Kita dapat membuat 70 individual skills tersebut lebih sederhana dengan membentuk suatu konsep konsep dasar dan inti dari struktur tersebut karena cukup tidak efektif dan efisien bila setiap hari semasa praktik kita melakukan hal ini, maka dari itu kita harus menentukan suatu skala prioritas dan dasar dasar yang mampu bersifat fleksibel dalam praktek sehari hari, tidak harus selalu sempurna namun akan tepat sasaran dan efektif bila dilaksanakan. Maka dari itu pengkondisian dan pengetahuan tentang situasi dapat sangat membantu dalam menentukan skala prioritas dan pengaplikasian dari konsep konsep dasar ini
7.
Setiap orang harus memiliki gayanya sendiri dalam melakukan komunikasi dengan pasien. Tidak mungkin kita menyamakan orang 1 dengan lainnya harus memiliki gaya dalam melakukan komunikasi tersebut, maka dar itu setiap orang harus menemukan gayanya sendiri sehingga dari pihak dokter mampu merasa nyaman dalam menggali data. Gaya disini juga bukan berarti bebas tanpa aturan tapi harus sesuai dengan struktur struktu tersebut dan tujuan utama dari komunikasi ini tetap terjaga kuat yaitu membangun hubungan dokter pasien yang erat sehingga mampu bersinergi dalam menemukan solusi semasa berkonsultasi di praktek. Komunikasi juga bisa menjadi lebih fleksibel, santai dan tenang sehingga rasa nyaman tersebut tidak hanya dirasakan oleh dokter namun juga dirasakan oleh si pasien.
You may write on another paper if the box does not accomodate your answer Date Completed :
Facilitator Sign.:
Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #2 Student Project2: Basic concepts of history taking and review of the system
Complaint/disease:
ANEMIA BULAN SABIT
Anemia sel sabit adalah penyakit turunan berupa kelainan hemoglobin(hemoglobinopati), yaitu terbentuknya hemoglobin S yang fungsinya terganggu sehingga sel darah merah berbentuk bulan sabit. Anemia sel sabit merupakan kelainan genetik terkait gen resesif. Anemia sel sabit adalah gangguan resesif autosomal yang disebabkan pewarisan dua salinan gen hemoglobin defektif, masing-masing satu dari orang tua. Hemoglobin yang cacat tersebut, yang disebut hemoglobin S (HbS), menjadi tidak elastis dan berbentuk seperti bulan sabit. Sel darah merah pada anemia sel sabit ini kehilangan kemampuan untuk bergerak dengan mudah melewati pembuluh yang sempit dan tersangkut dalam pembuluh darah. Hal ini menyebabkan penyumbatan aliran darah ke jaringan berikutnya. Meskipun bentuk sel sabit ini bersifat reversible atau dapat kembali ke bentuk semula jika saturasi hemoglobin kembali normal, sel sabit sangat rapuh dan banyak yang sudah hancur di dalam pembuluh yang sangat kecil, sehingga menyebabkan anemia. Dalam keadaan normal, sel darah merah mempunyai waktu hidup 120 hari. Jika menjadi tua, sel pemakan dalam sumsum tulang, limpa dan hati dapat mengetahuinya dan akan merusaknya. Jika suatu penyakit menghancurkan sel darah merah sebelum waktunya (hemolisis), sumsum tulang berusaha menggantinya dengan mempercepat pembentukan sel darah merah yang baru, sampai 10 kali kecepatan normal. Jika waktu
penghancuran sel darah merah melebihi waktu
pembentukannya, maka akan terjadianemia hemolitik .
Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #2 Student Project2: Basic concepts of history taking and review of the system
Complaint/disease:
ANEMIA BULAN SABIT A.
Informasi Awal
Tanggal Pemeriksa
: 4 Januari 2014
Identitas Pasien Nama
: I Ketut Andreas
Jenis Kelamin
: Laki-laki
Umur
: 16 tahun
Alamat
: Jl. Salak no. 217, Denpasar, Bali
Pekerjaan
: Pelajar
Agama
: Hindu
Status
: Belum menikah
Sumber Data
: Pasien sendiri
Reliabilitas
: Pasien dalam kondisi sadar, tidak mabuk dan memorinya baik
B.
Keluhan Utama
: Mudah lelah, letih dan lesu
C.
Penyakit Sekarang
1.
Lokasi
: Seluruh tubuh
2.
Kualitas
: Badan menjadi cepat lelah dan wajah terlihat lesu
3.
Kuantitas
: Bisa ringan yaitu hanya mengalami kelelahan, namun bisa juga parah yang
akan mengakibatkan pingsan atau badan tidak seimbang 4.
Onset
: Kondisi fisik yang mudah lemah semenjak lahir
5.
Durasi
: Terjadi secara episodik sementara atau episodik permanen dalam kurun
waktu yang tidak menentu, bisa lama atau cepat 6.
Frequensi
: Dalam sehari sering kali mengalami kelelahan meskipun tidak bekerja
begitu berat 7.
Setting
: Dalam periode tertentu penderita akan merasakan kondisi tubuhnya lelah,
letih, dan lesu. Kondisi ini terjadi secara teratur dan dapat menghilang serta datang kembali 8.
Faktor pemberat
: Dehidrasi, kurang konsumsi zat besi, terlalu banyak beraktifitas, beban
pikiran dan stress, konsumsi minuman alkohol Faktor peringan
: Makanan dengan zat besi tinggi, kandungan cairan cukup, istirahat yang
cukup dan olahraga secara teratur 9.
Gejala yang menyertai
: Rasa sakit secara episodik yang dapat hilang dan datang, pembengkakan
ekstremitas, sering kali terjadi infeksi, keterlambatan pertumbuhan pada masa kanak kanak dan gangguan pengelihatan
Obat yang dikonsumsi saat ini
: obat obat yang mengurangi kemampuan metabolisme tubuh
terhadap zat besi seperti halnya antasida, aspirin dan anti-inflamasi D.
Riwayat Penyakit
1.
Riwayat penyakit kecil
:
a.
Orang tua karier atau penderita anemia bulan sabit
b.
Kekurangan konsumsi zat besi yang memperparah keadaan tubuh
Student workbook – Medical Communication; 1st semester – 2014
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c. 2.
Saat bayi terlambat deteksi dan menyebabkan gangguan kognitif
Riwayat penyakit dewasa : a.
Medis
: Anemia, flu, demam tinggi, pneumonia
b.
Operasi
:-
c.
Obstetrik
:-
d.
Psikiatri
: Gangguan dalam beraktifitas akibat cepatnya tubuh terasa lelah, letih dan lesu
sehingga menghambat kehidupan sehari-hari. Akibat ketidakteraturan hidup, penderita sering kali merasakan stres dan dapat memperburuk kondisi penyakitnya E.
: Riwayat keluarga dari penderita sickle cell anemia atau anemia bulan
Riwayat Keluarga
sabit ini adalah ayah yang seorang penderita anemia bulan sabit dan seorang ibu karier gen pembawa penyakit anemia bulan sabit F.
Riwayat Sosial dan Personal :
Penderita tumbuh di keluarga yang erat kaitannya dengan penyakit anemia bulan sabit, ayah penderita adalah penderita anemia bulan sabit dan ibunya adalah seorang karier. Rumah tinggal dari pasien cukup nyaman dan layak untuk dihuni. Gaya hidup dari penderita yang kurang gemar berolahraga dan kurang memperhatikan aspek gizi dari suatu makanan malah memperburuk kondisi dari penderita. Dan akibat sering mudah lelah, letih dan lesu, penderita jadi kurang berinteraksi dengan teman sebayanya yang memiliki kondisi fisik lebih fit dan sehat ketimbangnya G.
Review Sistem
1.
General
: Wajah sayu dan berat badan menurun
2.
Kulit
: Kulit menjadi pucat, kusam dan terasa lebih gelap dan tidak cerah, dan disertai
dengan bibir pecah pecah 3.
HEENT
: Sering mengalami pusing seperti diputar-putar
4.
Leher
: Terasa susah digerakkan dan kaku
5.
Dada
:-
6.
Pernafasan
: Sesak nafas
7.
Peredaran Darah : Tekanan darah rendah
8.
Pencernaan
: Terjadinya penurunan keinginan untuk makan, infeksi saluran pencernaan dan
gangguan penyerapan makanan pada GIT 9.
Urinary
10. Genital
: Infeksi saluran kencing dan gagal ginjal :-
11. Musculoskeletal : Lemah dan tidak dapat memikul beban yang berat 12. Psychiatric
: Moodnya sering tidak terkontrol, mudah tersinggung dan kesulitan untuk
berkonsentrasi 13. Neurologis
: Sering mengantuk dan menjadi lebih pelupa
14. Hematologis
: Kekurangan asupan sel darah merah akibat rusaknya dan cell deathnya terjadi lebih
cepat dari normalnya 15. Endokrin
: Keringat dingin
You may write on another paper if the box does not accomodate your answer Date Completed :
Facilitator Sign.:
Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #3a Topic: initiating the session Basic Clinical Skill
Calgary – Cambridge Observation Guide (Instruction: the score of your perfomance will be filled by your facilitator. Write down your opinion of your perfomance, feedback from your group and facilitator in the comment coloumn)
No
Skills
Score 1
0
Comment 2
Initiating the session
1
1.
GREET patient and obtain patient’s name
2.
INTRODUCE SELF and clarifies role
3.
DEMONSTRATES interest and RESPECT, attend to physical comfort
4.
IDENTIFIES AND CONFIRMS PATIENT’S PROBLEM LIST OR ISSUES
5.
NEGOTIATES AGENDA taking both patient’s and doctor’s perspective into account
References: Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press (Oxford) Silverman JD, Kurtz SM, Draper J (1998) Skills for Communicating with Patients. Radcliffe Medical Press (Oxford)
Score = total score x 100 10
Date Completed : Score : Comment :
EvaluatorSign.
Student workbook – Medical Communication; 1st semester – 2014
:
Page 8/20
Worksheet #3b Topic: gathering information Basic Clinical Skill
Calgary – Cambridge Observation Guide (Instruction: the score of your perfomance will be filled by your facilitator. Write down your opinion of your perfomance, feedback from your group and facilitator in the comment coloumn)
No
Score 0 1 2
Skills Initiating the session
1
1.
GREET patient and obtain patient’s name
2.
INTRODUCE SELF and clarifies role
3.
DEMONSTRATES interest and RESPECT, attend to physical comfort
4.
IDENTIFIES AND CONFIRMS PATIENT’S PROBLEM LIST OR ISSUES
5.
NEGOTIATES AGENDA taking both patient’s and doctor’s perspective into account
Gathering Information 6.
ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the present in own words (clarifies reason for presenting now)
7.
LISTEN ATTENTIVELY, allows patient to complete statement without interruption and leaves space for patient to think before answering or go on after pausing 8. FACILITATES PATIENT’S RESPONSES VERBALLY AND NON VERBALLY (use encouragement, silence, repetition, paraphrasing, interpretation) 9. USE concise, EASILY UNDERSTOOD QUESTIONS AND COMMENTS, avoids jargon 10. CLARIFIES PATIENT’S STATEMENT which are vague or need amplification 11.
2
DETERMINES AND ACKNOWLEDGES PATIENT’S IDEAS
12.
EXPLORES CONCERNS (including worries, effects on lifestyle) regarding each problem 13. DETERMINE PATIENT’S EXPECTATIONS regarding each problem 14.
ENCOURAGES EXPRESSION OF FEELING AND THOUGHT
15.
18.
PICK UP VERBAL AND NONVERBAL CLUES i.e. body language, speech, facial expression, affect, CHECKS OUT and acknowledges as appropriate SUMMARIZES AT THE END OF A SPECIFIC LINE OF INQUIRY to verify own interpretation of what patient has said, to ensure no important data were omitted PROGRESSES, USING TRANSLATON STATEMENTS; includes rationale for next session STRUCTURE interview in LOGICAL SEQUENCE
19.
ATTEND TO TIMING and keeping interview on task.
16. 17.
References: Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press (Oxford) Silverman JD, Kurtz SM, Draper J (1998) Skills for Communicating with Patients. Radcliffe Medical Press (Oxford)
Score = total score x 100 38
Date Completed : Score : Comment :
EvaluatorSign.
Student workbook – Medical Communication; 1st semester – 2014
:
Page 9/20
Comment
Worksheet #4 Topic: Building relationship Basic Clinical Skill
Calgary – Cambridge Observation Guide (Instruction: the score of your perfomance will be filled by your facilitator. Write down your opinion of your perfomance, feedback from your group and facilitator in the comment coloumn)
No
Score 0 1 2
Skills
Comment
Initiating the session 1
1.
GREET patient and obtain patient’s name
2.
INTRODUCE SELF and clarifies role
3.
DEMONSTRATES interest and RESPECT, attend to physical comfort
4.
IDENTIFIES AND CONFIRMS PATIENT’S PROBLEM LIST OR ISSUES
5.
NEGOTIATES AGENDA taking both patient’s and doctor’s perspective into account
Gathering Information 6.
ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the present in own words (clarifies reason for presenting now)
7.
LISTEN ATTENTIVELY, allows patient to complete statement without interruption and leaves space for patient to think before answering or go on after pausing 8. FACILITATES PATIENT’S RESPONSES VERBALLY AND NON VERBALLY (use encouragement, silence, repetition, paraphrasing, interpretation) 9. USE concise, EASILY UNDERSTOOD QUESTIONS AND COMMENTS, avoids jargon 10. CLARIFIES PATIENT’S STATEMENT which are vague or need amplification 11.
2
DETERMINES AND ACKNOWLEDGES PATIENT’S IDEAS
12.
EXPLORES CONCERNS (including worries, effects on lifestyle) regarding each problem 13. DETERMINE PATIENT’S EXPECTATIONS regarding each problem 14.
ENCOURAGES EXPRESSION OF FEELING AND THOUGHT
15.
18.
PICK UP VERBAL AND NONVERBAL CLUES i.e. body language, speech, facial expression, affect, CHECKS OUT and acknowledges as appropriate SUMMARIZES AT THE END OF A SPECIFIC LINE OF INQUIRY to verify own interpretation of what patient has said, to ensure no important data were omitted PROGRESSES, USING TRANSLATON STATEMENTS; includes rationale for next session STRUCTURE interview in LOGICAL SEQUENCE
19.
ATTEND TO TIMING and keeping interview on task.
16. 17.
Building relationship 20.
3
DEMONSTRATES APPROPRIATE NON-VERBAL BEHAVIOUR, e.g. eye contact, posture and position, movement, facial expression, use of voice, if read or write does with appropriate manner. 21. DEVELOPING RAPPORT (accepts legitimacy of patient’s view and feeling, is not judgmental, uses empathy, acknowledge patient’s view and feeling, provide support by expressing concerns, understanding, willingness to help, partnership and deals sensitively) 22. INVOLVING THE PATIENT (shares thinking, explain rationale of question, examination, procedure, explain process and ask permission during examination) References: Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press, Oxford Silverman JD, Kurtz SM, Draper J (1998) Skills for Communicating with Patients. Radcliffe Medical Press (Oxford)
Score = total score x 100 44
Date Completed : Score : Comment :
EvaluatorSign.
Student workbook – Medical Communication; 1st semester – 2014
:
Page 10/20
Worksheet #5 Topic: explanation and planning, closing the session Basic Clinical Skill
Calgary – Cambridge Observation Guide (Instruction: the score of your perfomance will be filled by your facilitator. Write down your opinion of your perfomance, feedback from your group and facilitator in the comment coloumn)
No
Skills
Score 0 1 2
Initiating the Session 1
1.
GREET patient and obtain patient’s name
2.
INTRODUCE SELF and clarifies role
3.
DEMONSTRATES interest and RESPECT, attend to physical comfort
4.
IDENTIFIES AND CONFIRMS PATIENT’S PROBLEM LIST OR ISSUES
5.
NEGOTIATES AGENDA taking both patient’s and doctor’s perspective into account
Gathering Information 6.
ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the present in own words (clarifies reason for presenting now)
7.
LISTEN ATTENTIVELY, allows patient to complete statement without interruption and leaves space for patient to think before answering or go on after pausing 8. FACILITATES PATIENT’S RESPONSES VERBALLY AND NON VERBALLY (use encouragement, silence, repetition, paraphrasing, interpretation) 9. USE concise, EASILY UNDERSTOOD QUESTIONS AND COMMENTS, avoids jargon 10. CLARIFIES PATIENT’S STATEMENT which are vague or need amplification 11.
2
DETERMINES AND ACKNOWLEDGES PATIENT’S IDEAS
12.
EXPLORES CONCERNS (including worries, effects on lifestyle) regarding each problem 13. DETERMINE PATIENT’S EXPECTATIONS regarding each problem 14.
ENCOURAGES EXPRESSION OF FEELING AND THOUGHT
15.
18.
PICK UP VERBAL AND NONVERBAL CLUES i.e. body language, speech, facial expression, affect, CHECKS OUT and acknowledges as appropriate SUMMARIZES AT THE END OF A SPECIFIC LINE OF INQUIRY to verify own interpretation of what patient has said, to ensure no important data were omitted PROGRESSES, USING TRANSLATON STATEMENTS; includes rationale for next session STRUCTURE interview in LOGICAL SEQUENCE
19.
ATTEND TO TIMING and keeping interview on task.
16. 17.
Building relationship 20.
3
DEMONSTRATES APPROPRIATE NON-VERBAL BEHAVIOUR, e.g. eye contact, posture and position, movement, facial expression, use of voice, if read or write does with appropriate manner. 21. DEVELOPING RAPPORT (accepts legitimacy of patient’s view and feeling, is not judgmental, uses empathy, acknowledge patient’s view and feeling, provide support by expressing concerns, understanding, willingness to help, partnership and deals sensitively) 22. INVOLVING THE PATIENT (shares thinking, explain rationale of question, examination, procedure, explain process and ask permission during examination)
Explanation and planning 23.
4
PROVIDING THE CORRECT TIME, AMOUNT AND TYPE OF INFORMATION (give at appropriate time, chunks and checks, assess patient’s starting point, ask other information needed) 24. AIDING ACCURATE RECALL AND UNDERSTANDING (organize explanation, uses explicit categorisation or sign posting, uses repetition and summarizing, uses concise easily understood language, uses visual methods, checks patient’s understanding) 25. ACHIEVING A SHARED UNDERSTANDING: INCORPORATING THE PATIENT’S PERSPECTIVE (relate’s explanation to patient’s illness framework, provide opportunities and encourage patient, elicit patient’s beliefs, reactions and
Student workbook – Medical Communication; 1st semester – 2014
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Comment
26.
feelings re informationgiving) PLANNING: SHARED DECISION MAKING (share thinking as appropriate, involves patient, encourage patient to contributes, negotiate plan, offers choice, checks if accepts plans or concern has been addressed)
Closing the session 5
27.
FORWARD PLANNING (contracts, safety nets)
28.
ENSURING APPROPRIATE POINT OF CLOSURE (summarises, final checks)
References: Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press (Oxford) Silverman JD, Kurtz SM, Draper J (1998Skills for Communicating with Patients. Radcliffe Medical Press (Oxford)
Score = total score x 100 56
Date Completed : Score : Comment :
Evaluator Sign. :
Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #6 Topic: specific issues: breaking bad news
Calgary – Cambridge Observation Guide (Instruction: the score of your perfomance will be filled by your facilitator. Write down your opinion of your perfomance, feedback from your group and facilitator in the comment coloumn. Preparation is assumed had properly done. The role play should begin from initiating the session )
No
Score 0 1 2
Skills Preparation
1
1. 2. 3. 4.
SET UP APPOINTMENT, uninterrupted time PRIVATE and comfortable place INVITE accompanying person as appropriate SELF PREPARATION emotionally and factually, resume all clinical information to share and prepared of patient’s background
Initiating the session 2
5.
GREET patient
6.
SUMMARIZE where things have reach to date
7.
FOLLOW UP what happened since the last time
8.
NEGOTIATES AGENDA
Building relationship 9.
3
DEMONSTRATES APPROPRIATE NON-VERBAL BEHAVIOUR, e.g. eye contact, posture and position, movement, facial expression, use of voice, do not be afraid to show emotion or distress. 10. DEVELOPING RAPPORT (deals sensitively, read non verbalcues, allow for shut down, encourage expression of feelings, accepts legitimacy of patient’s view and feeling, is not judgmental, uses empathy, provide support by expressing concerns, understanding, willingness to help,and partnership)
Explanation and planning 11.
4
PROVIDING THE CORRECT TIME, AMOUNT AND TYPE OF INFORMATION (give warning shot, basic information first, chunks and checks , assess patient’s starting point, gauge how much patient wish to know ) 12. AIDING ACCURATE RECALL AND UNDERSTANDING (organize explanation, uses explicit categorisation or sign posting, uses repetition and summarizing, use language carefully, checks patient’s understanding ) 13. ACHIEVING A SHARED UNDERSTANDING: INCORPORATING THE PATIENT’S PERSPECTIVE (relate’s explanation to patient’s illness framework, provide opportunities e.g. keep pausing and encourage patient, elicit patient’s beliefs, reactions and feelings re informationgiving) 14. PLANNING: SHARED DECISION MAKING (give hoped tempered with realism, , identify plan, negotiate plan, checks if accepts plans or concern has been addressed, copartnership)
Closing the session 5
15. 16.
FORWARD PLANNING (contracting for further appointment, do no trush to treatment, safety nets, identify support system, offer to see spouse or others) ENSURING APPROPRIATE POINT OF CLOSURE (summarises, final checks)
References: Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press (Oxford) Silverman JD, Kurtz SM, Draper J (1998) Skills for Communicating with Patients. Radcliffe Medical Press (Oxford)
Score = total score x 100 32
Date Completed : Score : Comment :
Facilitator Sign. :
Student workbook – Medical Communication; 1st semester – 2014
Page 13/20
Comment
Worksheet #7 Topic: Skills in Communicating with Patient Basic Clinical Skill (Simulated Patient)
Calgary – Cambridge Observation Guide One (Instruction: the score of your perfomance will be filled by your facilitator. Write down your opinion of your perfomance, feedback from your group and facilitator in the comment coloumn)
No
Skills
Score 0 1 2
Initiating the session 1
1.
GREET patient and obtain patient’s name
2.
INTRODUCE SELF and clarifies role
3.
DEMONSTRATES interest and RESPECT, attend to physical comfort
4.
IDENTIFIES AND CONFIRMS PATIENT’S PROBLEM LIST OR ISSUES
5.
NEGOTIATES AGENDA taking both patient’s and doctor’s perspective into account
Gathering Information 6.
ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the present in own words (clarifies reason for presenting now) 7. ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the present in own words (clarifies reason for presenting now) 8. LISTEN ATTENTIVELY, allows patient to complete statement without interruption and leaves space for patient to think before answering or go on after pausing 9. FACILITATES PATIENT’S RESPONSES VERBALLY AND NON VERBALLY (use encouragement, silence, repetition, paraphrasing, interpretation) 10. USE concise, EASILY UNDERSTOOD QUESTIONS AND COMMENTS, avoids jargon 11. CLARIFIES PATIENT’S STATEMENT which are vague or need amplification
2
12.
DETERMINES AND ACKNOWLEDGES PATIENT’S IDEAS
13.
EXPLORES CONCERNS (including worries, effects on lifestyle) regarding each problem 14. DETERMINE PATIENT’S EXPECTATIONS regarding each problem 15.
ENCOURAGES EXPRESSION OF FEELING AND THOUGHT
16.
19.
PICK UP VERBAL AND NONVERBAL CLUES i.e. body language, speech, facial expression, affect, CHECKS OUT and acknowledges as appropriate SUMMARIZES AT THE END OF A SPECIFIC LINE OF INQUIRY to verify own interpretation of what patient has said, to ensure no important data were omitted PROGRESSES, USING TRANSLATON STATEMENTS; includes rationale for next session STRUCTURE interview in LOGICAL SEQUENCE
20.
ATTEND TO TIMING and keeping interview on task.
17. 18.
Building relationship 21.
3
DEMONSTRATES APPROPRIATE NON-VERBAL BEHAVIOUR, e.g. eye contact, posture and position, movement, facial expression, use of voice, if read or write does with appropriate manner. 22. DEVELOPING RAPPORT (accepts legitimacy of patient’s view and feeling, is not judgmental, uses empathy, acknowledge patient’s view and feeling, provide support by expressing concerns, understanding, willingness to help, partnership and deals sensitively) 23. INVOLVING THE PATIENT (shares thinking, explain rationale of question, examination, procedure, explain process and ask permission during examination)
Explanation and planning 24.
4
25.
26.
PROVIDING THE CORRECT TIME, AMOUNT AND TYPE OF INFORMATION (give at appropriate time, chunks and checks, assess patient’s starting point, ask other information needed) AIDING ACCURATE RECALL AND UNDERSTANDING (organize explanation, uses explicit categorisation or sign posting, uses repetition and summarizing, uses concise easily understood language, uses visual methods, checks patient’s understanding) ACHIEVING A SHARED UNDERSTANDING: INCORPORATING THE PATIENT’S PERSPECTIVE (relate’s explanation to patient’s illness framework,
Student workbook – Medical Communication; 1st semester – 2014
Page 14/20
Comment
provide opportunities and encourage patient, elicit patient’s beliefs, reactions and feelings re informationgiving) 27. PLANNING: SHARED DECISION MAKING (share thinking as appropriate, involves patient, encourage patient to contributes, negotiate plan, offers choice, checks if accepts plans or concern has been addressed)
Closing the session 5
28.
FORWARD PLANNING (contracts, safety nets)
29.
ENSURING APPROPRIATE POINT OF CLOSURE (summarises, final checks)
References: Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press (Oxford) Silverman JD, Kurtz SM, Draper J (1998) Skills for Communicating with Patients. Radcliffe Medical Press (Oxford)
Score = total score x 100 58
Date Completed : Score : Comment :
Facilitator Sign. :
Student workbook – Medical Communication; 1st semester – 2014
Page 15/20
Worksheet #8 Student Project 4: Writing letters/notes and CV
Faculty of Medicine Udayana University Jalan P.B. Sudirman Denpasar – Bali Indonesia
5 January 2015
Endocrinology Department British Unity Hospital England
Dear Dr. James Black.
Re : Mr. Haryanto, Age : 55 year old. I am referring to you this patient with the following history and findings for further assessment and management.
This man has an enlargement of pancreas which caused by tumor. Relevant Magnetic Resonance Imaging (MRI), blood and urine tests have been done in Denpasar and with this letter, the test results are attached.
I thank you for your attention and assistance.
Yours sincerely,
dr. Gede Aditya Ersa Krisnawan, S. Ked
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Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #8 Student Project 4: Writing letters/notes and CV
Faculty of Medicine Udayana University Jalan P. B. Sudirman Denpasar – Bali Indonesia
5 January 2015
Radiologist Jalan Sudirman no. 12 Denpasar
Dear Dr. Bambang
Re : Mr. Johari, Age : 55 year old. Jalan Padma no. 25 Denpasar 80223 I am referring to you this patient with the following history and findings for general abdominal Magnetic Resonance Imaging (MRI), including the pancreas.
This man has an acute colicky abdominal and yellowish skin.
I thank you for your attention and assistance.
Yours sincerely,
dr. Gede Aditya Ersa Krisnawan, S. Ked
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Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #8 Student Project 4: Writing letters/notes and CV
To Whom It May Concern
This is to certify that I have been today examnied Mr. Riyanto, 43 year old. Home address: Jalan Kartika no. 3, Denpasar and I have found him to be unfit on duty due to being ill (with headache, weaken of body and easily get tired) from 15 up to 18 December 2014. Date to ressume day: 20 November 2013.
Denpasar, 14 December 2015 The examining physician
dr. Gede Aditya Ersa Krisnawan, S. Ked
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Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #8 Student Project 4: Writing letters/notes and CV
Curicullum Vitae
Name
: Gede Aditya Ersa Krisnawan
Address
: Jalan Noja Perumahan Citramas Blok B-23, Denpasar
Telephone Number
: 082236596821
Date of Birth
: 3 March 1989
Professional Interest
: Emergency Department of BROS International Hospital, Denpasar
Current Position/Employment Educational Background
: Employment at Mercure Sanur Hotel Clinic :
TK Saraswati 3 Denpasar, 1996 SD Saraswati 5 Denpasar, 2002 SMP Negeri 1 Denpasar, 2005 SMA Negeri 1 Denpasar. 2008 Udayana University, Bachelor at Faculty of Medicine, 2013 Professoional Experience
: Working at 1 Hotel Clinic, Mercure Sanur Hotel Clinic
Publication of Journal
: “Medulla Spinalis Transplantation as A Method to Cure HIV/ AIDS” at Essential Journal, Udayana University, 2011
Paper Delivered at Conference
: Presentator at “Scaling Up Nutrition” Seminar Nasional, Udayana University, 2009
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Student workbook – Medical Communication; 1st semester – 2014
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Worksheet #9 Student Project 5: Presentation in S cientific Meeting and Discussion
CHECK LIST PRESENTATION SKILL Presenter:.............................................................. Presentation topic:................................................. Item
Good (2)
Ok (1)
Need work (0)
Comments (include spesific problems)
STRUCTURE Opening (opening remark, introduction, objectives) Preview (topic outline) View (interesting and appropriate content, define terms and concepts, sign posting, relate each part) Review (summarize important point) Closing (thanking the audience) Organization (appropriate organization strategy) AUDIO VISUAL AID Large and clear Properly labeled Unnecessary writing eliminated Citation included PERFOMANCE Enthusiasm and confidence Pace Clarity Gesture Interaction with the audience Competency
Score = total score x 100 32
Date Completed : Score :
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Student workbook – Medical Communication; 1st semester – 2014
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