Transitions
A transition is a key part of a consultation, similar to joints in the body, linking one section to another.
1. A look back
‘So we’ve discussed symptoms…
‘Thank you for sharing your concerns about your difficulties sleeping’.
2. A look forward
‘Is it alright if we now talk about the diagnosis?’
3. A look back and then forward…
‘So we’ve discussed symptoms. Is it alright if we move on to a couple more questions about how you’ve managed them so far?’
A benefit of transitions is that you get the opportunity to continue to show attention to the patient or relative while still directing things forward:
For example,
‘Thank you for sharing your symptoms. That information helps me to understand what might be going on. I’d like to move to a possible diagnosis now…’.
You can also use signposts as a way to encourage the patient to open up more.
‘You’ve done really well to share that information with me about (your condition/your concerns). Before I move on to (your diagnosis/the treatment options) … is there anything else you think might be helpful for me to understand?’
Conclusion
Using signposts will help you to demonstrate a solid performance on these exam criteria
Information giving
Taking the patient’s perspective
Relationship building
There is also a hidden benefit to using a good signpost statement: they are easy to identify in the three minutes of preparation time if you see the overall flow of the consultation. While you have to practice remembering to use them, they are pretty easy to say. Most importantly: they give you a chance to focus on the patient or relative, particularly if you combine them with a request to move on.
Finding ways to make yourself tap into the patient or relative’s state of mind at that point will help you to relax in the test.
Being more relaxed means that you are more likely to tap into the confidence you already have as a healthcare professional, and you will RELAX and RESPOND to the patient or relative in front of you.
You can do it!