The computer in the consultation

What is it useful for?

Access to old patient information Ability to record info systematically and

retrievably Access to information to share with

patient Access to information for doctor

Knowledge flows (old)

Expert-client: traditional. The expert dispenses knowledge that has been acquired elsewhere

Expert Client

Initial

training

cpd

colleagues

Knowledge flows (new)

Expert-client: triadic. The same information source is potentially available to expert and client at the same time. The question is how much of this can the client make use of.

Expert Client

?

Disadvantages?

Takes doctor’s attention Distracts patient Doc may be preoccupied with keyboard

skills Comes between doctor and patient Patient may find it mystifying Confidentiality problems

Aim of session

Identify and learn skills to help maintain rapport with the patient while using the computer in the consultation

Specific competencies in areas of rapport, information giving, explanation and planning (adapted from Calgary-Cambridge framework)

Maintaining rapport

Adapt behaviour to relative position of doctor, patient and computer

Open posture while using computer Indicate (verbally and non verbally) when

paying attention to screen Structure consultation so patient unlikely to

talk while doc uses computer Respond to patient cues while attending to

computer

Involving the patient

Explain why the computer is being used Negotiate with patient when computer

used as an information source Let patient read info from the screen

when appropriate

Explanation and planning

Check patient can see screen clearly Remain quiet, give patient time to read text Check patient has understood text Give patient opportunity to ask questions On crowded screen, point out relevant info