COMMUNICATION SKILLS TEACHING SESSIONS:
A LEARNER-CENTRED APPROACH                 

One to one teaching in general practice 

The focus here is on video teaching, but this plan could be adapted for any consultation observed by the trainer

Establishing initial rapport

·       Welcome

·       Explore and discuss how this session might fit in with the registrar’s overall learning

·       Outline a temporal plan for the session, explain the aims and signpost methods of the session

Really helpful to have the plan of the session on a paper so that the learner can keep a structure in their heads and what happens when

·         Demonstrate interest and concern 

Identifying the learner’s ongoing agenda

 Learner-centred exercise

·        Is there anything you would particularly like to cover/look at/rehearse today?

·        Anything from the last session, problems arising from last session which you would like help with?

+-Patient-centred exercise

·       Any particular problems that your patients might be experiencing in relation to your consulting at the moment 

Introduce/revise the framework/structure/objectives and skills of the Calgary-Cambridge guide

·        Is there anything here you would like to focus on today?

·        Introduce trainer’s agenda if appropriate 

Set the scene for the experiential work

·         Registrar and trainer together negotiate which consultation to look at depending on whether the learner has watched the tape

     (if not look at a random consultation) 

Option to identifying the individual’s agenda

Ask the learner if they would like to tell you about the problem for them on the tape now, or whether they would rather discuss their agenda after watching the tape. 

If they do want to talk about the consultation first; the following questions may be helpful

·         What would be the particular issues or difficulties for you here that you would like to work on? (try to get the learner to hone them down)

·         What would you like to practice and refine and get feedback on

·         What are your personal objectives for this session – put on flip chart/paper

·         How can I help you best

·         What would you like feedback on

Watching the tape or consultation

·         Set up room, and make sure the equipment is working

·         Suggest, if appropriate, that one of you might look at the consultation from the patient’s point of view

·         Both you and the learner write down specific words and actions as an aid to descriptive feedback; if using video, jot down exact times or counter numbers

·         After watching the interview, allow the learner several moments to collect their thoughts and identify the one or two most important points they would like to bring up in feedback, making sure to provide a balance between what worked and what was problematical

·         Check/clarify any matters of fact; eg. points at which the tape was inaudible

·         Trainer to consider where to place feedback on what worked well 

Acknowledge the learner’s feelings

·         how do you feel? 

·         how did that go? 

Refine the individual’s agenda and desired outcome

·         can we go back to your agenda on the flipchart before the role-play? has it changed?

·         how do you feel in general about the role-play in relation to your desired outcome?

·         Facilitator to listen, clarify, summarize, check

Allow time for this – it may lead naturally onto the learner’s agenda 

Feedback and re-rehearsal

·         Start with the learner: options

o        tell me what went well, specifically in relation to the objectives that you defined? 

o        what went less well in relation to your specific objectives? 

o        or "you obviously have a clear idea of what you would like to try." 

o        would you like to have another go?

o        what do you want feedback on? 

·       Trainer give descriptive feedback

·       If the learner  makes a suggestions, ask them if they would like to try this out or if

o        practise and re-rehearse new techniques after your suggestions

you can try out mini roleplays or just specific phrases here

o        make sure to balance positive and negative feedback

o        try reverse role play

o        offer suggestions yourself/demonstrate the skills yourself when appropriate 

Tape review, skills spotting, generalising away

·       use the tape to demonstrate specific phrasing/behaviours

·       look at the micro-skills of communication and the exact words used 

Introduce trainer’s agenda/teaching points

·       Add in trainer’s ideas and thoughts

·       Appropriately introduce theory, research and wider discussion 

Check learner’s agenda has been covered

·       Clarify with learner that his agenda has been covered

·       Be very careful to balance what worked well and what didn’t work so well by the end

Continue the process with the next consultation 

 ·         Rounds of what learnt

·         Summary from trainer, relate to structures/guides

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