Advanced Communication Skills VMS1002 - PDF

A D VA N C E D C O M M U N I C AT I O N SKILLS VMS1002 EMILY AUGER LEARNING OBJECTIVES By the end of this session, students should be able to: Explain the skills involved in shared decision making and recognise common challenges encountered. Recognise the importa...

A D VA N C E D C O M M U N I C AT I O N SKILLS VMS1002 EMILY AUGER LEARNING OBJECTIVES By the end of this session, students should be able to: Explain the skills involved in shared decision making and recognise common challenges encountered. Recognise the importance of gaining an understanding of the client’s perspective. Define micro skills of communication such as signposting, Ask-Tell-Ask, and chunking and checking. SHARED DECISION MAKING Two-way exchange between the veterinary surgeon and the client 1. Understanding the client Identify client preferences Create a partnership Assess client’s knowledge 2. Providing information suitable for the client Tailor information and use understandable language Use of resources e.g. visual aids Establishing mutual understanding 3. Decision making Educate clients about their options Work together towards a treatment plan (vet recommendations vs. client autonomy) WHEN SHOULD WE USE SDM? Shared decision making can be used in all consultations, some specific examples would be: Behavioural consultations End of life care Cardiopulmonary resuscitation Preventative treatments Antimicrobials HOW TO APPROACH SHARED DECISION MAKING Acting from a place of authority Paternalistic Making decisions for other people Identifying with others Empathetic Understanding their point of view Responding with care Sympathetic Acknowledging their experience Acknowledging challenges Realistic Finding solutions in a practical sense SHARE APPROACH Seek client participation S “Now that we’ve identified the problem, it’s time for us to think about what to do next” Help client explore and compare treatment options H “Here are some choices we could consider.” Assess your client and patient values and preferences A “As you think about our options, what’s important to you?” Reach a decision with your client R Now that we’ve had a chance to discuss your options, which treatment do you think is right for Buster?” Evaluate your client’s decision E “Let’s plan on reviewing Buster and this treatment plan next week.” SDM: CHALLENGES Disconnect between information provided by vet and what is needed by client: Does the vet understand the client’s perspective? Is the information suitable for the client? How to decide on options presented? Veterinary surgeon barriers: Time constraints Multiple owners involved Language barriers What would you do if it was your pet? CLIENT PERSPECTIVE What are the client’s ideas? Ideas “You wanted to talk about neutering Missy. What are your current thoughts?” What are your client’s concerns? Concerns “What worries do you have about the operation?” What are the client’s expectations? Expectations “When were you hoping to get Missy’s procedure done?” C L I E N T C O N S I D E R AT I O N S Socioeconomic Ethical beliefs Legal responsibilities Cultural ideas Treatment goals Literacy Emotions Human-animal bond Client personality Patient personality CHUNKING AND CHECKING Providing Provide a small amount of information Pausing To allow time for your client to process this information Checking Confirm your client’s understanding before moving on ASK-TELL-ASK Ask Tell Ask What do you know Three pieces of Do you have any about diabetes? information questions? Can you tell me Do you know what Resources – what you arthritis means? handouts, models understand about epilepsy now? SIGNPOSTING Setting the agenda Clear plan when starting the consult Outlining thought process for diagnosis or Differentials treatment plans Acknowledging but then moving on from less Pivoting urgent concerns Warning shot Prepare client for bad news Skilled interruption When you need to focus discussion LEARNING OBJECTIVES By the end of this session, students should be able to: Explain the skills involved in shared decision making and recognise common challenges encountered. Recognise the importance of gaining an understanding of the client’s perspective. Define micro skills of communication such as signposting, Ask-Tell-Ask, and chunking and checking. FURTHER READING AND REFERENCES Janke, N. et al. (2021) Pet owners’ and veterinarians’ perceptions of information exchange and clinical decision-making in companion animal practice. PloS one. [Online] 16 (2), e0245632–e0245632. Janke, N. et al. (2021) Evaluating shared decision-making between companion animal veterinarians and their clients using the Observer OPTION 5 instrument. Veterinary record. [Online] 189 (8), e778-. Cary, J. (2021) Implementing shared decision making in veterinary medicine. Veterinary record. [Online] 189 (8), 320–322. Leblang, C. et al. (2022) A structured approach to Shared Decision Making training and assessment of knowledge, attitudes and perception of second year medical students. Medical education online. [Online] 27 (1), 2044279–2044279.