Commentary
Asking the open question
You might recognise this as Ideas, Concerns and Expectations from Pendleton et al's Consultation Model:
- 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.
- Consider other problems
- continuing problems
- at risk factors.
- Choose with the patient an appropriate Action for each problem
- Achieve a Shared Understanding of the problem with the patient
- Involve the patient in the Management and to encourage them to accept appropriate responsibility
- Use Time and Resources appropriately
- 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.
