Traditional medical teaching tends to be reductive in nature - any
curriculum, used on its own, will reinforce this tendency.
This planner was devised to counteract this and to provide a
framework within which any chosen subject could be explored.
The planner consists of a series of questions, not all of which will
be appropriate to every topic and, if applied systematically, little of
importance will be left out. The words on the right-hand side of the
planner merely act as a quick reference guide to the contents of each
section.
Questions
|
Key concepts
|
The historical
context
|
|
|
Is this a new issue?
What is the national picture and incidence? |
incidence |
What factors have caused change?
What changes have and will occur? |
changing pattern |
Aetiology
|
|
|
Pathological? Sociological?
Do we need to discuss this? |
causes |
Patient care
|
|
|
Is the problem fully assessed in physical, psychological and
social terms? |
problem assessment |
|
Are the patient's perceptions and anxieties explored ? |
patient's beliefs |
|
What are the effects on the family, friends and society? |
effects on others |
What are the problems with selective history taking?
selective physical examination?
selective investigations? |
selectivity
clinical diagnosis |
| |
|
|
How will emergency care be affected by competence and
facilities? |
emergency care |
Does patient management involve surgery, drugs, psychotherapy,
nursing or anything else?
What are the problems with these areas of patient management? |
patient management |
|
Is the family involved? |
patient's family |
|
How can the team help? |
team support |
|
Should the problem be followed up? If so, how? |
|
|
Is there a place for health education, screening, case finding,
or any other preventive activity? |
education & prevention |
|
How can we monitor the care we are giving? |
audit |
Medico-legal
|
|
|
What are the legal, contractual and insurance considerations? |
obligations |
|
What are the ethical considerations? |
ethics |
Communication
|
|
With whom do we need to communicate?
Do any special skills need to be learned? |
consultation skills
|
|
Where and how do we communicate? |
settings |
|
Will any changes occur in relationships between the patient, the
doctor, and the team? |
practice team |
|
Are meetings necessary and who should facilitate them? |
meetings |
|
How do patients acquire responsibility for their own
management? |
patient responsibility |
|
Is there a role for support groups? |
support groups |
Organisation
|
|
|
Should there be a protocol and what should be in it? |
protocol |
What is the responsibility of each team member?
Where are the lines of accountability? |
accountability |
|
What equipment and facilities are necessary? |
equipment & facilities |
|
Will change affect people, affect time, affect finances, affect
systems? |
change
personnel management |
|
What recording system is needed? How do we protect
confidentiality? |
records & confidentiality |
|
Is the organisation acceptable to the patient? |
acceptability |
|
Is time and its management a problem for anyone? |
time management |
|
How do patients obtain access? |
access |
Professional values
|
|
|
What are the implications of our attitudes,
prejudices and values?
How do material and psychological rewards affect our behaviour?
Are there cultural, racial and sexual considerations? |
attitudes
prejudices
values
rewards |
|
How do we respect patient dignity and confidentiality? |
patient respect |
|
Do we monitor and protect our own physical and mental health? |
health |
|
How do we support other members of the team? |
support |
|
How do we demonstrate that we accept responsibility? |
responsibility |
Personal and professional growth
|
|
Can the doctor identify her own strengths, weaknesses and
emotional needs?
How does she cope with her own anxieties? |
strengths
weaknesses |
Does she seek peer review?
Does she improve performance by assessment?
Does she support the educational and personal needs of those
around her? |
seeking excellence |
|
Does she accept change? |
accepting change |
