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Commentary

Asking the open question

You might recognise this as Ideas, Concerns and Expectations from Pendleton et al's Consultation Model:

 

  1. Discover the reasons for the patient’s attendance, including:
    • the nature and history of the problem/s
    • their aetiology
    • the patient's ideas, concerns and expectations
    • the effects of the problems- the psychosocial impact.
  2. Consider other problems
    • continuing problems
    • at risk factors.
  3. Choose with the patient an appropriate Action for each problem
  4. Achieve a Shared Understanding of the problem with the patient
  5. Involve the patient in the Management and to encourage them to accept appropriate responsibility
  6. Use Time and Resources appropriately
  7. Establish or maintain a relationship with the patient which helps to achieve the other tasks

From this we gain the concept of ICE- unfortunately this can be over-embraced and habits of struggling candidates believe they should be 'ICEing' their patients, so the intention of being interested in the patient's perspective and their motivations gets overtaken by a task-driven approach to consulting. 

 

 

 

How many different ways could you ask a question about the patient's ideas, the patient's concerns, or the patient's expectations, WITHOUT saying the banned words of "Ideas", "Concerns" & "Expectations?"

Make sure the sentence flows naturally- it's obvious to the patient and examiners when it doesn't work when you say it.


 

 

 

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