Consultation Skills

Consultation Skills

• Client Case: The client is Mr. Green, with his pet, Missy, a 2-year-old female terrier. Missy is scheduled for a neutering consultation today.
• Student Learning Objectives: Students will recognize the importance of relationship-centered care, describe the stages and themes of the Calgary-Cambridge guide, and apply its skills to a routine consultation.
• Relationship-Centered Care: This approach engages clients in shared decision-making, considering their perspective and the human-animal bond to achieve the best outcomes for the animal.
• Benefits of Relationship-Centered Care for Clients: Improved client satisfaction and trust.
• Benefits of Relationship-Centered Care for Patients: Improved assessment accuracy and better compliance with treatment.
• Benefits of Relationship-Centered Care for Vets: Improved outcomes and shorter consultation times.
• Importance of Consultation Skills: 9% of consultation time is spent gathering information, consultations are 13% longer when veterinarian-centered, and clients are 4 times more likely to add information at the end if they feel heard, while 15.3 seconds is the average time a vet interrupts a client. 10% of vets do not employ open questions, and 59% do not use empathetic statements during consultations; 78.9% of diagnostic errors in human medicine are related to patient/medical encounters, with 56.3% of human medical errors are specific to history taking.

Calgary-Cambridge Guide

• Preparation: Create a professional, safe environment and check previous patient history.
• Initiating the Session: Establish rapport by greeting, introducing, and having a casual conversation with the client and patient. Use "chit-chat" like conversations about the journey, etc. Identify the reason for the consult using open-ended questions. Listen actively (Golden Minute), and ask follow-up questions to identify concerns.
• Gathering Information: Obtain medical and patient perspectives and background information, including past medical history and home management. Use open-ended questions and move on to closed questions to fill in any information gaps. Obtain client perspective. The process of questioning must be client-centric.
• Physical Examination: Explain the process step-by-step. Make sure the client and patient are comfortable during the physical examination.
• Explanation and Planning: Summarize the information, share understanding of patient's illness, and share a shared decision-making process for treatment. Explain options, their costs, and how the client gets to take informed decisions.
• Closing the Session: Summarize the agreed plan, confirm client understanding (e.g., "Can you repeat the plan?"), and check client satisfaction. Plan any additional care or follow-ups, including when the next check-up will be. Provide clear information on the closing of the consult.

Building a Relationship

• Non-verbal communication, including eye contact and open body language.
• Develop rapport: Establish a connection with the client and provide empathy and support. Incorporate the animal by greeting and interacting respectfully.

Providing Structure

• Signposting: Explain the structure of the consultation, such as how questions will be asked and a timeline for the consultation. For example, say, "I will start with general questions followed by more specific questions regarding Buster's routines...".
• Attending to the flow: Structure to a logical sequence, such as history, clinical examination, ensuring adherence to time constraints (10-15 minutes for companion animals in the UK).

"Missy" - Giving Information and Closing

• Discuss the neutering procedure with Mr. Green.
• Ensure shared decision-making.
• Ensure that Mr. Green understands the information.
• Discuss closing the session effectively.

This quiz focuses on the essential consultation skills needed for effective veterinary practice, specifically in a case involving Mr. Green and his dog Missy. Students will learn the significance of relationship-centered care, the Calgary-Cambridge guide stages, and how to enhance client and patient interactions during consultations.