Patient centredness in the MRCGP video examination: analysis of large cohort

Campion, Peter; Foulkes, John; Neighbour, Roger; Tate, Peter

doi:10.1136/bmj.325.7366.691

Cited by 64 publications

(46 citation statements)

References 2 publications

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“…78 79 Making such assumptions in the context of medical training seems unreliable, and to forgo the challenge of analysing, debating, and attempting to shape the values and goals of medicine for the easier reductive route to technical method appears to promise only limited solutions, as evidenced by the disappointing performances documented. 1 It would also seem less than abundant in the qualities of courage and honesty that are embodied in the foundations on which we depend, and in which ultimately physician, patient, and society must place their trust.…”

Section: Patient Centred Medicine Re-viewedmentioning

confidence: 99%

Patient centred medicine: reason, emotion, and human spirit? Some philosophical reflections on being with patients

Evans¹

2003

Med Humanities

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The ideal of patient centred medicine remains only partially realised. Within modern Western society, the highly individualistic culture and religious decline linked with medicine's reluctance to relinquish an outmoded form of scientific rationalism can act as reductive influences, stifling conceptual development. Some examples of the recent literature on communication skills in medicine are analysed to discern the underlying philosophy. A rationalist stance invites an examination of the possible nature of rationality. Another example accepts the need to accommodate the emotional and the unconscious. Issues of human suffering with an inherent spiritual dimension seem to remain excluded. The need to move beyond a duality of reason and emotion to embrace the existential and spiritual is suggested as a theoretical prerequisite for developing a more inclusive concept of patient centred medicine, which only then may be realised. Some brief examples are considered of the sort of notions and types of discourse that might effectively inform “teaching” of communication skills.

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Section: Patient Centred Medicine Re-viewedmentioning

confidence: 99%

Patient centred medicine: reason, emotion, and human spirit? Some philosophical reflections on being with patients

Evans¹

2003

Med Humanities

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“…In clinical epileptology, information provision about treatment options is part of the evidence-based guidance for high quality care [7]; and patient engagement is critical for the negotiation of anti-epileptic drug (AED) adherence [8] or the referral of patients with nonepileptic seizures (NES) for psychotherapy [9]. However, observational studies have found low levels of patient participation in decision-making [10][11][12][13][14][15], and patients often report a lack of negotiation about treatment options [15][16]. A study of AED treatment decisions found that the process was perceived to be clinician-dominated [17].…”

Section: Introductionmentioning

confidence: 99%

Offering patients choices: A pilot study of interactions in the seizure clinic

Toerien

Shaw

Duncan

et al. 2011

Epilepsy & Behavior

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Using Conversation Analysis (CA), we studied conversations between one UK-based epilepsy specialist and thirteen seizure patients in whom there was uncertainty about the diagnosis, and for whom different treatment and investigational options were being considered. In line with recent communication guidance, the specialist offered some form of choice to all patients: in eight cases, a course of action was proposed, to be accepted or rejected, and in the remaining five a "menu" of options was offered. Even when presenting a menu, the specialist sometimes conveyed his own preferences in how he described the options, and in some cases the menu was used for reasons other than offering choice (e.g. to address patient resistance). Close linguistic and interactional analysis of clinical encounters can show why doctors may feel they are offering choices when patients report that the decision was clinician-dominated.

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“…Practitioners, and in particular general practitioners, have considerable experience with videoed consultation practice (Campion et al, 2002). This is a new phenomenon for the consumer.…”

Section: Resultsmentioning

confidence: 99%

A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

et al. 2010

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This is the unspecified version of the paper.This version of the publication may differ from the final published version. alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The empirical study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), text and narrative (to depict the stories of interactions) and a reflexive mode (to develop the conceptual framework for analysis).. The analytic framework is derived from a lifeworld conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care Permanent repository linkinteractions. The videod interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony.The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patientcentred care and impact on health outcomes.

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Patient centredness in the MRCGP video examination: analysis of large cohort

Cited by 64 publications

References 2 publications

Patient centred medicine: reason, emotion, and human spirit? Some philosophical reflections on being with patients

Patient centred medicine: reason, emotion, and human spirit? Some philosophical reflections on being with patients

Offering patients choices: A pilot study of interactions in the seizure clinic

A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

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