This document provides an overview of SPIKES, a framework for delivering serious medical news to patients. SPIKES stands for Setup, Perception, Invitation, Knowledge, Emotion, Summarize and Strategize. It outlines six steps clinicians should take when having difficult conversations: 1) Prepare for the discussion, 2) Understand the patient's perspective, 3) Get permission to share information, 4) Share the medical facts, 5) Attend to the patient's emotional reaction, and 6) Make a plan moving forward. The document also includes examples of scripts to practice applying the SPIKES model through role playing serious news discussions.
This document provides guidance on effective communication skills when discussing difficult topics with patients or relatives. It outlines 5 key parts of a discussion: introduction, receiving, giving, agreement and planning, and confirming. For each part, it provides tips on body language, listening techniques, addressing concerns, establishing understanding, and confirming plans. The purpose is to have participants practice these skills in simulated scenarios covering childhood obesity, alcohol abuse, non-accidental injury, and breaking bad news, to assess their communication abilities.
The document provides guidance on how to effectively communicate bad news to patients and their families. It discusses defining bad news, anxieties around delivering it, and outlines a 5-stage process for doing so: 1) Set the scene by preparing the environment and having relevant information; 2) Build alignment by understanding perspectives and experiences; 3) Impart information at an appropriate level and pace while allowing time for emotions; 4) Check understanding and address questions in a supportive manner; 5) Discuss future plans and follow up support. The overall message is to deliver news empathetically and ensure patients and families feel heard, informed and valued throughout the process.
Keep detailed records of medical staff contact information and hospital management. Ask questions of the treatment team and have a loved one assist by taking notes and helping remember answers. Do not wait four days for biopsy results if cancer is suspected, as timeliness can impact survival. Carefully track all medications, dosages, and frequencies to ensure continuity of care when discharged.
The document discusses different types of questions, statements, and communication patterns that can be used during a patient interview to facilitate discussion and obtain necessary health information. It covers open-ended versus closed questions, clarifying questions, leading questions to avoid, and approaches like a funnel, inverted funnel, or hourglass pattern to structure the interview. Common traps to avoid include giving advice, using jargon, interrupting, or asking "why" questions. The goal is to effectively obtain a patient history through respectful questioning.
The document discusses several aspects of self-concept and how they relate to communicating effectively with clients. It covers Peplau's four steps of self-concept development, characteristics of a healthy self-concept, functions of body image, strategies for communicating with clients with body image issues, and how perception, cognition, and self-talk can impact self-concept and interactions. Specific cognitive distortions like all-or-nothing thinking and personalizing are discussed, along with approaches for recognizing and challenging cognitive distortions.
This document discusses best practices for delivering bad news to patients. It notes that delivering bad news is stressful for physicians due to feelings of anxiety, responsibility, and fear of upsetting patients. It recommends gathering information from patients about their expectations beforehand. When delivering the news, physicians should provide clear, plain language information and check for understanding. They should acknowledge and support patients' emotional reactions with empathic responses. After delivering the news, physicians should assess patients' readiness to discuss treatment plans and answer any questions before summarizing and following up. The goal is to reduce stress for both patients and physicians while ensuring patients receive information and support.
This document discusses effective communication of bad news in healthcare settings. It provides guidelines and frameworks for delivering difficult information to patients in a compassionate manner. The SPIKES protocol recommends six steps: setting up the interaction, assessing the patient's perception, obtaining permission to share, providing knowledge and information, addressing emotions empathetically, and developing a strategy and summarizing. Other tips include using plain language, conveying news gradually, acknowledging emotions, exploring treatment options, and encouraging questions. The overall goal is to inform patients while also supporting them emotionally.
This document provides guidance on effective communication skills when discussing difficult topics with patients or relatives. It outlines 5 key parts of a discussion: introduction, receiving, giving, agreement and planning, and confirming. For each part, it provides tips on body language, listening techniques, addressing concerns, establishing understanding, and confirming plans. The purpose is to have participants practice these skills in simulated scenarios covering childhood obesity, alcohol abuse, non-accidental injury, and breaking bad news, to assess their communication abilities.
The document provides guidance on how to effectively communicate bad news to patients and their families. It discusses defining bad news, anxieties around delivering it, and outlines a 5-stage process for doing so: 1) Set the scene by preparing the environment and having relevant information; 2) Build alignment by understanding perspectives and experiences; 3) Impart information at an appropriate level and pace while allowing time for emotions; 4) Check understanding and address questions in a supportive manner; 5) Discuss future plans and follow up support. The overall message is to deliver news empathetically and ensure patients and families feel heard, informed and valued throughout the process.
Keep detailed records of medical staff contact information and hospital management. Ask questions of the treatment team and have a loved one assist by taking notes and helping remember answers. Do not wait four days for biopsy results if cancer is suspected, as timeliness can impact survival. Carefully track all medications, dosages, and frequencies to ensure continuity of care when discharged.
The document discusses different types of questions, statements, and communication patterns that can be used during a patient interview to facilitate discussion and obtain necessary health information. It covers open-ended versus closed questions, clarifying questions, leading questions to avoid, and approaches like a funnel, inverted funnel, or hourglass pattern to structure the interview. Common traps to avoid include giving advice, using jargon, interrupting, or asking "why" questions. The goal is to effectively obtain a patient history through respectful questioning.
The document discusses several aspects of self-concept and how they relate to communicating effectively with clients. It covers Peplau's four steps of self-concept development, characteristics of a healthy self-concept, functions of body image, strategies for communicating with clients with body image issues, and how perception, cognition, and self-talk can impact self-concept and interactions. Specific cognitive distortions like all-or-nothing thinking and personalizing are discussed, along with approaches for recognizing and challenging cognitive distortions.
This document discusses best practices for delivering bad news to patients. It notes that delivering bad news is stressful for physicians due to feelings of anxiety, responsibility, and fear of upsetting patients. It recommends gathering information from patients about their expectations beforehand. When delivering the news, physicians should provide clear, plain language information and check for understanding. They should acknowledge and support patients' emotional reactions with empathic responses. After delivering the news, physicians should assess patients' readiness to discuss treatment plans and answer any questions before summarizing and following up. The goal is to reduce stress for both patients and physicians while ensuring patients receive information and support.
This document discusses effective communication of bad news in healthcare settings. It provides guidelines and frameworks for delivering difficult information to patients in a compassionate manner. The SPIKES protocol recommends six steps: setting up the interaction, assessing the patient's perception, obtaining permission to share, providing knowledge and information, addressing emotions empathetically, and developing a strategy and summarizing. Other tips include using plain language, conveying news gradually, acknowledging emotions, exploring treatment options, and encouraging questions. The overall goal is to inform patients while also supporting them emotionally.
This document discusses effective communication strategies for breaking bad news to cancer patients. It begins by defining communication and its importance in healthcare. It then discusses why communicating with cancer patients is complex, involving emotional reactions, expectations, family involvement, and balancing hope. It outlines common psychological reactions patients experience after receiving a cancer diagnosis. The document then recommends a six-step strategy called SPIKES for breaking bad news sensitively and provides behaviors to avoid, such as blocking, lecturing, and premature reassurance. The goal is to gather information from patients, provide understandable information, support patients emotionally, and develop a treatment plan together.
The document provides guidance on effectively delivering bad news to patients. It defines bad news as information that seriously impacts one's view of the future. Examples include terminal illnesses like cancer or Alzheimer's disease. The document recommends using the SPIKES protocol to structure difficult conversations. SPIKES stands for setting up the conversation in a private setting, understanding the patient's perception, obtaining permission to share details, providing knowledge of the diagnosis in small portions with empathy, and summarizing the discussion while checking for understanding.
The Mood Disorder Questionnaire (MDQ) is a brief self-report screening tool for bipolar disorder that takes about 5 minutes to complete. It was developed by psychiatrists and researchers to evaluate bipolar disorder in a timely manner. To screen positive, a respondent must answer "yes" to 7 or more of 13 symptom questions, "yes" to having several symptoms at the same time, and indicate their symptoms caused a "moderate" or "serious" problem. Studies show it is best at detecting bipolar I but less sensitive for bipolar II or NOS. In clinical and general populations, sensitivity ranges from 0.28 to 0.73 and specificity from 0.67 to 0.97 depending on the
12 what is pain and suffering and how do you prove itJames Publishing
Pain and suffering are often the most difficult aspects of a personal injury case to prove. There are some ways you can help your attorney calculate your pain and suffering, and prove its existence to a jury. Here are just a few ways: Record the day-to-day events of your convalescence and recovery in a daily diary. Record the day-to-day events of your convalescence and recovery in a daily diary. You want to show the full impact your injury has had on your ability to enjoy and live your life. Did you used to regularly participate in a sport or some other type of physical recreational activity? The lost ability to perform these activities can negatively impact both your emotional and physical health.
Lecture 14 & 15 truth telling and breaking bad news (BBN)Dr Ghaiath Hussein
A lecture on truth telling & breaking bad news (BBN) delivered to Alfarabi Medical College undergraduate medical students in the week starting 04.12.2016
This document discusses effective communication skills for clinical practice. The aim is to give patients adequate time to express themselves and gather needed information for diagnosis and treatment. Good communication includes active listening, using clear language, summarizing, reflecting, clarifying, appropriate silence and body language. It facilitates open expression of feelings. Special situations require breaking bad news sensitively, handling difficult patients, shared decision making and clear presentations. Effective communication improves patient satisfaction and outcomes.
This document discusses difficult patient consultations. It begins by outlining common causes of difficult consultations, which can be due to difficult patients, doctors, communication issues, or environmental factors. It then describes different types of difficult patients, such as psychotic, depressed, talkative, withdrawn, angry, demanding, or manipulative patients. The document provides guidance on dealing with demanding patients, such as listening fully, considering their needs, setting limits, and avoiding arguments. Overall it stresses the importance of empathy, respect, flexibility and maintaining a strong patient relationship even during difficult consultations.
A talk I gave in Al-Zaem Al-Azhary university on Thursday, 15/5/2014
Outline:
What do we mean by breaking bad news (BBN)?
Which news is bad? really bad? Like really, really bad !
Why should we care about BBN?
Ethical
Professional
Legal
BBN as part of the Communication Cycle/Pathway
Practical approaches to BBN:
SPIKES
ABCDE
BREAKS
The Do Not's in BBN
This e-learning guide teaches trainees how to effectively break bad news to patients. It discusses that breaking bad news is a complex communication skill that requires additional training. The guide outlines strategies for preparing, sharing information, and showing empathy when delivering bad news, and stresses the importance of planning follow-up support. Trainees are instructed to practice applying these strategies through formative tasks.
This sermon is the first in a series on mental health issues called Overcome. This week we look at anxiety. What is anxiety? What does the Bible say about anxiety? What are we called to do with anxiety in the church today?
This document provides information about using modal verbs to express different levels of certainty or possibility when making conclusions or guesses. It discusses the uses of must, have to, may, might, could, can't to express levels of certainty from 100% to 0%. Examples are given of using these modal verbs to draw conclusions about a patient's medical condition based on test results and observations. The document also discusses using modal verbs in questions and short answers. Practice examples involve looking at microscope images and x-rays and making guesses about what they depict at different levels of certainty.
This document provides information about using modal verbs to express different levels of certainty or possibility when making conclusions or guesses. It discusses the uses of must, have to, may, might, could, can't to express levels of certainty from 100% to 0%. Examples are given of using these modal verbs to draw conclusions about a patient's medical condition based on test results and observations. The document also discusses using modal verbs in questions and short answers. Practice examples involve looking at microscope images and x-rays and making guesses about what they depict at different levels of certainty.
Most people with back or neck pain go to their primary care doctors as a first step in finding treatment. But many other health care providers are often involved in the treatment of back pain.
Although you are not likely to meet all of them, this tool introduces you to what they do, the treatments they provide, and the places they work.
This document provides guidance for a training session on effectively sharing bad news with patients. It begins with reminders to turn off electronics and participate in debriefing. The document then defines bad news, outlines challenges and supports to sharing it, and presents the SPIKES model - a 6 step protocol for setting, assessing perception, inviting questions, providing knowledge, addressing emotions, and summarizing a strategy. A video demonstrates the SPIKES model and is followed by a discussion. The document concludes by thanking those involved in its development.
The document discusses effective communication strategies for reducing stress. It begins by introducing the limbic system and prefrontal cortex regions of the brain involved in emotional responses and higher-level thinking. It then presents a dialogic communication model involving reflection, invitation to expand, and empathy to maintain appropriate social behavior. The model is practiced in pairs and processed as a group. Deep breathing exercises are also presented to help relax the body and reduce stress. The document concludes by providing information about health screenings and coaching services offered by the presenter.
This document provides guidance on effectively breaking bad news to patients. It outlines two approaches - SPIKES and BREAKS. SPIKES involves setting up the environment, assessing the patient's perception, obtaining permission to share information, providing knowledge and information, exploring emotions and empathizing, and summarizing. BREAKS involves building rapport and background knowledge, exploring the situation, announcing the news, considering reactions, and summarizing. Key recommendations include giving information in small chunks, addressing emotions, having follow up discussions, and avoiding false reassurance or abandoning the patient.
This document discusses strategies for dealing with difficult patients. It begins by exploring what can make interactions difficult, such as fear, conflict, surprise, and change. It then discusses why we tend to avoid difficult interactions and notes that the label of "difficult" is subjective. The document outlines tips for minimizing difficult interactions, such as knowing your purpose and using assertive, cooperative language. It provides examples of responding assertively in patient interactions. The document also examines factors that can influence doctor-patient communication and strategies for dealing with difficult patients, such as understanding their perspective, apologizing, and taking responsibility. It stresses the importance of physician self-care as well.
Situé au coeur de l'Estuaire et à la porte de la Vallée de la Seine, le territoire Le Havre Pointe de Caux Estuaire occupe une position stratégique en façade maritime. Son schéma de cohérence territoriale précise les grandes orientations prospectives du territoire et prévoit son organisation spatiale en harmonisant les politiques d'aménagement.
Approuvé en février 2012, le SCoT va être révisé à l'horizon 2017. Les élus ont entamé l'élaboration de la révision en juin 2014. Une série de fiches thématiques est publiée pour accompagner les réflexions.
Au sommaire de la fiche n°7, document synthétique de 4 pages intitulé Notre capital humain, une ressource pour notre attractivité :
- SCoT, un outil pour la cohésion sociale et territoriale,
- Démographie, cohésion, formation, des préoccupations majeures pour notre territoire,
- Les 5 dimensions du développement territorial,
- Les enjeux démographiques.
2015: Wounds in the Geriatric Population-SalasSDGWEP
This document discusses wound care in the geriatric population. It outlines risk factors for wounds in older adults and describes assessing and managing different wound types like pressure ulcers, venous stasis ulcers, and diabetic foot ulcers. Standard wound treatments involve addressing underlying causes, cleaning the wound bed, and dressing changes. If wounds do not improve with standard care after 4 weeks, advanced therapies may be considered, such as skin substitutes, growth factors, and negative pressure wound therapy to aid healing. The goal is to diagnose and correct risk factors while managing the wound to assess progress and determine if specialized treatments could help non-healing or chronic wounds.
This document discusses effective communication strategies for breaking bad news to cancer patients. It begins by defining communication and its importance in healthcare. It then discusses why communicating with cancer patients is complex, involving emotional reactions, expectations, family involvement, and balancing hope. It outlines common psychological reactions patients experience after receiving a cancer diagnosis. The document then recommends a six-step strategy called SPIKES for breaking bad news sensitively and provides behaviors to avoid, such as blocking, lecturing, and premature reassurance. The goal is to gather information from patients, provide understandable information, support patients emotionally, and develop a treatment plan together.
The document provides guidance on effectively delivering bad news to patients. It defines bad news as information that seriously impacts one's view of the future. Examples include terminal illnesses like cancer or Alzheimer's disease. The document recommends using the SPIKES protocol to structure difficult conversations. SPIKES stands for setting up the conversation in a private setting, understanding the patient's perception, obtaining permission to share details, providing knowledge of the diagnosis in small portions with empathy, and summarizing the discussion while checking for understanding.
The Mood Disorder Questionnaire (MDQ) is a brief self-report screening tool for bipolar disorder that takes about 5 minutes to complete. It was developed by psychiatrists and researchers to evaluate bipolar disorder in a timely manner. To screen positive, a respondent must answer "yes" to 7 or more of 13 symptom questions, "yes" to having several symptoms at the same time, and indicate their symptoms caused a "moderate" or "serious" problem. Studies show it is best at detecting bipolar I but less sensitive for bipolar II or NOS. In clinical and general populations, sensitivity ranges from 0.28 to 0.73 and specificity from 0.67 to 0.97 depending on the
12 what is pain and suffering and how do you prove itJames Publishing
Pain and suffering are often the most difficult aspects of a personal injury case to prove. There are some ways you can help your attorney calculate your pain and suffering, and prove its existence to a jury. Here are just a few ways: Record the day-to-day events of your convalescence and recovery in a daily diary. Record the day-to-day events of your convalescence and recovery in a daily diary. You want to show the full impact your injury has had on your ability to enjoy and live your life. Did you used to regularly participate in a sport or some other type of physical recreational activity? The lost ability to perform these activities can negatively impact both your emotional and physical health.
Lecture 14 & 15 truth telling and breaking bad news (BBN)Dr Ghaiath Hussein
A lecture on truth telling & breaking bad news (BBN) delivered to Alfarabi Medical College undergraduate medical students in the week starting 04.12.2016
This document discusses effective communication skills for clinical practice. The aim is to give patients adequate time to express themselves and gather needed information for diagnosis and treatment. Good communication includes active listening, using clear language, summarizing, reflecting, clarifying, appropriate silence and body language. It facilitates open expression of feelings. Special situations require breaking bad news sensitively, handling difficult patients, shared decision making and clear presentations. Effective communication improves patient satisfaction and outcomes.
This document discusses difficult patient consultations. It begins by outlining common causes of difficult consultations, which can be due to difficult patients, doctors, communication issues, or environmental factors. It then describes different types of difficult patients, such as psychotic, depressed, talkative, withdrawn, angry, demanding, or manipulative patients. The document provides guidance on dealing with demanding patients, such as listening fully, considering their needs, setting limits, and avoiding arguments. Overall it stresses the importance of empathy, respect, flexibility and maintaining a strong patient relationship even during difficult consultations.
A talk I gave in Al-Zaem Al-Azhary university on Thursday, 15/5/2014
Outline:
What do we mean by breaking bad news (BBN)?
Which news is bad? really bad? Like really, really bad !
Why should we care about BBN?
Ethical
Professional
Legal
BBN as part of the Communication Cycle/Pathway
Practical approaches to BBN:
SPIKES
ABCDE
BREAKS
The Do Not's in BBN
This e-learning guide teaches trainees how to effectively break bad news to patients. It discusses that breaking bad news is a complex communication skill that requires additional training. The guide outlines strategies for preparing, sharing information, and showing empathy when delivering bad news, and stresses the importance of planning follow-up support. Trainees are instructed to practice applying these strategies through formative tasks.
This sermon is the first in a series on mental health issues called Overcome. This week we look at anxiety. What is anxiety? What does the Bible say about anxiety? What are we called to do with anxiety in the church today?
This document provides information about using modal verbs to express different levels of certainty or possibility when making conclusions or guesses. It discusses the uses of must, have to, may, might, could, can't to express levels of certainty from 100% to 0%. Examples are given of using these modal verbs to draw conclusions about a patient's medical condition based on test results and observations. The document also discusses using modal verbs in questions and short answers. Practice examples involve looking at microscope images and x-rays and making guesses about what they depict at different levels of certainty.
This document provides information about using modal verbs to express different levels of certainty or possibility when making conclusions or guesses. It discusses the uses of must, have to, may, might, could, can't to express levels of certainty from 100% to 0%. Examples are given of using these modal verbs to draw conclusions about a patient's medical condition based on test results and observations. The document also discusses using modal verbs in questions and short answers. Practice examples involve looking at microscope images and x-rays and making guesses about what they depict at different levels of certainty.
Most people with back or neck pain go to their primary care doctors as a first step in finding treatment. But many other health care providers are often involved in the treatment of back pain.
Although you are not likely to meet all of them, this tool introduces you to what they do, the treatments they provide, and the places they work.
This document provides guidance for a training session on effectively sharing bad news with patients. It begins with reminders to turn off electronics and participate in debriefing. The document then defines bad news, outlines challenges and supports to sharing it, and presents the SPIKES model - a 6 step protocol for setting, assessing perception, inviting questions, providing knowledge, addressing emotions, and summarizing a strategy. A video demonstrates the SPIKES model and is followed by a discussion. The document concludes by thanking those involved in its development.
The document discusses effective communication strategies for reducing stress. It begins by introducing the limbic system and prefrontal cortex regions of the brain involved in emotional responses and higher-level thinking. It then presents a dialogic communication model involving reflection, invitation to expand, and empathy to maintain appropriate social behavior. The model is practiced in pairs and processed as a group. Deep breathing exercises are also presented to help relax the body and reduce stress. The document concludes by providing information about health screenings and coaching services offered by the presenter.
This document provides guidance on effectively breaking bad news to patients. It outlines two approaches - SPIKES and BREAKS. SPIKES involves setting up the environment, assessing the patient's perception, obtaining permission to share information, providing knowledge and information, exploring emotions and empathizing, and summarizing. BREAKS involves building rapport and background knowledge, exploring the situation, announcing the news, considering reactions, and summarizing. Key recommendations include giving information in small chunks, addressing emotions, having follow up discussions, and avoiding false reassurance or abandoning the patient.
This document discusses strategies for dealing with difficult patients. It begins by exploring what can make interactions difficult, such as fear, conflict, surprise, and change. It then discusses why we tend to avoid difficult interactions and notes that the label of "difficult" is subjective. The document outlines tips for minimizing difficult interactions, such as knowing your purpose and using assertive, cooperative language. It provides examples of responding assertively in patient interactions. The document also examines factors that can influence doctor-patient communication and strategies for dealing with difficult patients, such as understanding their perspective, apologizing, and taking responsibility. It stresses the importance of physician self-care as well.
Situé au coeur de l'Estuaire et à la porte de la Vallée de la Seine, le territoire Le Havre Pointe de Caux Estuaire occupe une position stratégique en façade maritime. Son schéma de cohérence territoriale précise les grandes orientations prospectives du territoire et prévoit son organisation spatiale en harmonisant les politiques d'aménagement.
Approuvé en février 2012, le SCoT va être révisé à l'horizon 2017. Les élus ont entamé l'élaboration de la révision en juin 2014. Une série de fiches thématiques est publiée pour accompagner les réflexions.
Au sommaire de la fiche n°7, document synthétique de 4 pages intitulé Notre capital humain, une ressource pour notre attractivité :
- SCoT, un outil pour la cohésion sociale et territoriale,
- Démographie, cohésion, formation, des préoccupations majeures pour notre territoire,
- Les 5 dimensions du développement territorial,
- Les enjeux démographiques.
2015: Wounds in the Geriatric Population-SalasSDGWEP
This document discusses wound care in the geriatric population. It outlines risk factors for wounds in older adults and describes assessing and managing different wound types like pressure ulcers, venous stasis ulcers, and diabetic foot ulcers. Standard wound treatments involve addressing underlying causes, cleaning the wound bed, and dressing changes. If wounds do not improve with standard care after 4 weeks, advanced therapies may be considered, such as skin substitutes, growth factors, and negative pressure wound therapy to aid healing. The goal is to diagnose and correct risk factors while managing the wound to assess progress and determine if specialized treatments could help non-healing or chronic wounds.
This document discusses the ethical dilemma of whether or not to disclose a terminal diagnosis or hospice admission to a patient at the request of their family. While families may ask staff to withhold this information to protect the patient, ethically the patient's wishes should be respected. The document recommends asking the patient directly what they want to know and having an open conversation with the family to prepare them. It also notes that bad news should be disclosed to patients with intellectual disabilities in a way tailored to their understanding and processed in multiple steps. The best approach is to determine the patient's preferences while involving family.
Modernize for Engagement: The 5 Steps to Breathing Life Back into Stale Content!Human Capital Media
The average L&D organization spends $18,000 to produce one hour of content. Within a short time period, the value of this content depreciates as the subject matter becomes inaccurate, designs become dated, or technology advancements make the content completely inaccessible with current tools.
Attend our webinar, “The 5 Steps to Breathing Life Back into Stale Content!”, to learn how to maximize your training ROI and start developing a strategy for revitalizing legacy content and preparing content for future usability.
As a gift for attending the webinar, InfoPro Learning will deliver a free Content Asset Repository Worksheet, which your team can use to easily catalog learning assets (the first step in content modernization).
Attend this webinar to learn how to:
Calculate the total cost of your training portfolio
Catalog your learning assets using a free tool by InfoPro Learning
Extend the shelf-life of your existing content
Develop new content for future re-usability
Distributed high-quality image manipulation and review in a virtual collabora...ETCenter
Taking advantage of centralized processing and storage, new dispersed workflows are now possible. Colorfront's cloud initiative enables virtual world wide collaboration for high end motion picture and television production.
Breaking bad news strategies (A case study on Mattel recall)Hoang Minh Chau
Breaking bad news strategies: A case study on Mattel recall.
Done by Hoang Minh Chau, Mike Mirucki, Shahazeen Shaheer, Flavio Gomez & Mohammed Shieraz.
University of Bradford @ MDIS, Singapore.
October 2008.
This document discusses the benefits of pair programming based on research studies and experiences. It finds that pairs produce higher quality code with fewer defects in less time compared to individuals. While difficult to adopt initially, pairs are more consistent, communicative, and productive due to learning from each other, courage to tackle challenges, and not wanting to let their partner down. Regular pairing helps programmers become a cohesive team and scale collaboration effectively.
This introductory guide covers the basic functions and operation of the AeroCheck+ instrument. It describes the various keys including power, cursor keys, balance key, freeze key and menu/back key. It also outlines how to open the end panels, access quick menus and main menu, and use advanced functions such as auto phase, loop, trace, record and replay, dual frequency auto mixing, and guides.
Situé au cœur de l'Estuaire et à la porte de la Vallée de la Seine, le territoire Le Havre Pointe de Caux Estuaire occupe une position stratégique en façade maritime. Son schéma de cohérence territoriale précise les grandes orientations prospectives du territoire et prévoit son organisation spatiale en harmonisant les politiques d'aménagement.
Approuvé en février 2012, le SCoT va être révisé à l'horizon 2017. Les élus ont entamé l'élaboration de la révision en juin 2014. Une série de fiches thématiques est publiée pour accompagner les réflexions.
Au sommaire de la fiche n°2, document synthétique de 4 pages intitulé Mobilités voyageurs, pour se déplacer, jouons collectif :
Comment organiser la mobilité de demain ?
- Les acteurs de la mobilité,
- Les enjeux mobilité pour le territoire,
- Le ferroviaire : la priorité pour les passagers et le fret.
The document outlines the SPIKES protocol for delivering bad medical news to patients, which involves preparing information, understanding the patient's perspective, obtaining permission to disclose details, providing knowledge of the medical condition, exploring the patient's emotions, and summarizing next steps. It discusses examples of conditions considered bad news and benefits of skillfully breaking news. The document also considers cultural factors relevant to applying this protocol in Sri Lanka.
Coderetreat is a day-long, intensive practice event, focusing on the fundamentals of software development and design. By providing developers the opportunity to take part in focused practice, away from the pressures of 'getting things done', the coderetreat format has proven itself to be a highly effective means of skill improvement. Practicing the basic principles of modular and object-oriented design, developers can improve their ability to write code that minimizes the cost of change over time.
Administración y seguridad de redes: Portafolio de evidenciaslopezaimeemini
Este documento contiene el portafolio de evidencias de una alumna de ingeniería en tecnologías de la información y comunicaciones del Instituto Tecnológico de Salina Cruz. Incluye actividades realizadas por la alumna en la materia de administración y seguridad de redes durante el periodo de enero a junio de 2016. Entre las actividades se encuentran entrevistas, diagramas de red, y planes de mantenimiento para redes.
The document discusses unit testing with the Spock testing framework. It introduces Spock and outlines key concepts like the three pillars of good unit tests, Spock idioms, mocks and stubs, and continuous integration. Spock provides an expressive testing language based on Groovy that makes tests more readable, maintainable and trustworthy. Examples demonstrate how to write feature methods, use blocks, verify interactions, stub implementations, test exceptions, integrate with Spring, and perform HTTP calls and data-driven testing with Spock.
Giving bad news to patients is a complex communication task that requires special skills. Doctors must [1] prepare thoroughly, [2] address the patient's emotions with empathy, and [3] develop a management plan with the patient's input. Strategies like SPIKES provide a framework to [1] set up the conversation, [2] assess the patient's perspective, [3] obtain their invitation to know, [4] give knowledge and information, [5] address emotions, and [6] summarize and develop a strategy. Managing patients after a pregnancy loss also requires sensitivity, as they experience grief, guilt, and isolation.
This document summarizes different approaches to breaking bad news to patients and their families in clinical practice. It discusses the importance of being honest with patients, as medical ethics have shifted away from concealing information from them. It also addresses why breaking bad news is a difficult task and outlines cognitive coping strategies patients may use. The document then evaluates factors patients and their families consider when rating the delivery of bad news and presents several approaches clinicians can use to effectively communicate serious diagnoses and prognoses, including the ABCDE, SPIKES, and SAAIQ Emergency approaches. It concludes by emphasizing the need for focused training on breaking bad news.
This document discusses how to give patients bad medical news. It notes that bad news can drastically alter a patient's view of the future and cause emotional responses like denial, despair, anger, bargaining, and depression. Giving bad news is difficult for doctors as it undermines their role as healer and upsets both them and the patient. The document recommends being direct with patients about their diagnosis, treatment plan, and prognosis while allowing them to process the information at their own pace. It provides guidelines for opening, exploring, and closing the difficult conversation with empathy, honesty and support.
HIV and Psychiatry , Neuropsychiatric aspects of HIV , AIDS , Breaking bad news in HIV , Psychiatric intervention in HIV , Neuropsychiatric complications of HIV and AIDS
There is an evident deficiency on how best to break bad news in medicine. This is an essential communication skill that our patients expect of us. It is an essential requisite of Good Medical Practice. This presentation is part of a course held at Al Hammadi Hospital, Suwaidi, Riyadh, KSA on Breaking Bad News. 2017
This document discusses best practices for communicating bad news to patients. It emphasizes that patients have a right to know their diagnosis but the most important consideration is how the news is delivered. The document recommends using a 6-step S-P-I-K-E-S protocol: setting the scene, understanding the patient's perspective, inviting the patient to share how much they want to know, providing knowledge of the disease, addressing the patient's emotions, and summarizing next steps. The goal is to convey the news with honesty, empathy and appropriate hope by carefully preparing, using clear language, acknowledging emotions and offering ongoing support.
Communication skills in clinical practice for undergraduatessyahnaz74
The document provides information on effective communication skills for clinical practice. It discusses:
1) The importance of communication and key principles like establishing rapport, allowing time, sending clear messages, and having positive attitudes.
2) The need for communication skills during medical consultations to obtain complete diagnoses by understanding patients' physical, emotional and social concerns.
3) Recommendations for positive behaviors like addressing patients respectfully, making them comfortable, focusing on them, and using open-ended questions.
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2) The need for communication skills during medical consultations to obtain complete diagnoses by understanding patients' physical, emotional and social concerns.
3) Recommendations for building trust at first contact through addressing patients respectfully, making them feel comfortable, focusing on them, and asking open-ended questions.
Therapeutic communication is a face-to-face interaction between healthcare providers and patients that aims to advance the physical and emotional well-being of patients. It has three main purposes: collecting information about a patient's illness, assessing and modifying their behavior, and providing health education. Effective therapeutic communication requires active listening skills, observing both verbal and nonverbal cues, and interpreting the information collected in a sensitive manner. Mastering listening and observation skills is important for understanding patients and identifying their needs.
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Evidence shows that many patients consider empathy the number-one quality of a good doctor.
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The doctor needs to be able to put himself in the shoes of his patient and understand the situation from patient’s point of view.
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OBJECTIVES:
If I were starting an adolescent treatment center what would I want to make sure adolescents and families learn?
Identify and Describe How Families Arrive at your door.
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This document provides guidance on effective communication skills for clinical conversations involving difficult news or emotions. It outlines several protocols to structure such conversations, including C-L-A-S-S, S-P-I-K-E-S, C-O-N-E-S, and E-V-E. The C-L-A-S-S protocol focuses on context, listening, acknowledging emotions, developing a shared strategy, and summarizing. The S-P-I-K-E-S protocol addresses setting up conversations, understanding the patient's perspective, inviting discussion, sharing knowledge, exploring emotions, and summarizing. The C-O-N-E-S protocol is for delivering
This document provides an introduction to counseling and active listening skills for physicians. It defines counseling, discusses the biopsychosocial model and functions of primary care counseling. It also outlines the key concepts of the Rogerian client-centered counseling model, including the attitudes of genuineness, unconditional positive regard and empathy. Finally, it discusses various active listening skills like attending, bracketing, leading, reflecting content and feelings, focusing, and probing to fully understand the patient's perspective. The overall summary is that counseling incorporates techniques and interpersonal skills to address psychosocial factors influencing a patient's health or condition.
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This document discusses managing difficult conversations in healthcare. It identifies that difficult conversations arise when emotion, behavior, or cognition are not adequately addressed. It provides tips for identifying necessary conversations and improving listening skills. Recommendations are given for managing one's own behavior, assessing a patient's understanding, addressing emotions through empathy, and using silence purposefully. The goal is to have crucial yet caring conversations to improve healthcare situations.
We all have emotions. By being aware of what triggers yours you can aim to increase positive emotions by IMPROVING the moment, and decrease distress by preventing things that make you more vulnerable to anxiety, depression and irritability.
1) The student nurse encountered a patient, Mrs. X, suffering from severe back pain due to a slipped disc who wanted to manage her pain with heat packs instead of morphine as it allowed her to feel more in control and active with her husband.
2) During a discussion with the duty nurse, Mrs. X confronted the nurse about respecting her decision to use heat packs over morphine, which surprised the student nurse.
3) Upon reflection, the student nurse realized they made assumptions about pain management and did not truly listen to understand Mrs. X's perspective, priorities and goals for managing her chronic pain. This experience highlighted the importance of truly listening to patients' narratives and preferences.
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This document provides an overview of heart failure (HF), including definitions, epidemiology, pathophysiology, diagnosis, and treatment. Some key points:
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This document provides an overview of a talk on what general physicians should know about vision and the eye. It discusses key topics like defining blindness, common causes of blindness worldwide, aging and blindness, how to evaluate vision parameters, and how the eye can provide insights into general health and systemic diseases. The document outlines goals of understanding basic eye concepts, evaluation, and common eye diseases, but not detailed anatomy or management of conditions. It emphasizes that each patient's vision loss is unique based on their condition and individual factors.
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Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
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• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
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Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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3. Goals of Care
Conversations:
A Five Part Series
1 Delivering Serious News
2 Reframing: We’re in a Different
Place
3 Mapping the Future: Clarifying
Priorities
4 Aligning with Patient Values
5 Conducting a Family Meeting
4. Why is Delivering Serious
News Hard?
We feel responsible
We feel sad ourselves
We don’t know the right words to say
Emotions are strong and we don’t
know how to respond
5. What We Will Learn
SPIKES: A ‘Talking Map’
Tools for responding to patient emotion
6. How We Will Learn
Define skills (lecture)
Observe skills in action (videos)
Practice
7. SPIKES: A Talking Map for Serious News
Setup
Perception
Invitation
Knowledge
Emotion
Summarize/Strategize
8. SPIKES: Setup
Have a plan in mind
Who should be in the room
Conducive setting
– Find a private space
– Sign out pager or set to vibrate
Tissue
Allot adequate time
9. SPIKES: Perception
Ask current understanding
– “Tell me what you understand is going on
with your illness?”
– “What have the other doctors told you?”
10. SPIKES: Invitation
How much information does the patient want?
Ask permission
– “Is now a good time to talk?”
11. SPIKES: Knowledge
Fire a warning shot
– “The test did not come back as we were hoping”
Be clear and direct
– Short, discrete, chunks
– “The biopsy showed that you have cancer”
Shut up!!!
– Pause after giving information
12. SPIKES: Emotion
After hearing serious news, nearly everyone
has an emotional reaction
Clinicians must attend to that emotion
BEFORE moving on to anything else
Tools for responding to emotion:
– Naming
– Acknowledging
13. Naming Emotion
Naming emotions helps patients
– Know they’ve been heard
– Identify what they are feeling
Best done as a suggestion or humble question
– “Some people would be angry”
– “I’m wondering if you’re feeling sad.“
15. Acknowledging Emotion
A statement that conveys the clinician is trying
to understand what the patient is going
through
– “It must be hard”
You can’t truly understand patient
experience, but you can show that you’re
trying
Therefore, NEVER say:
17. SPIKES: Summarize and Strategize
Make a plan for next steps
Be as concrete as possible
– “We’ll get a CT scan on Tuesday, and I’ll see
you the next day so we can discuss options”
Confirm that you and patient are on same
page
– “To make sure I explained things well,
could you tell me in your own words what
20. Review drill as a group
Divide into pairs to practice the drill
Practice two drill scripts (person with bigger feet goes
first)
Switch roles
Debrief with one another
– How did it feel to say the words?
Drill Instructions
21. Drill: Perception
Clinician Patient
No one’s really told us
anything.
Yes, that would be really
helpful.
What’s your
understanding of what’s
going on with your
illness?
Would you like me to
share what I know?
22. Drill: Invitation/Knowledge
Clinician Patient
I suppose as good as any.
What is it?
In my liver AND my lung?
How can that be?
I just can’t believe this.
Is now an okay time to talk
about the tests?
I’m afraid I have bad news.
The cancer has come back
in your liver and lung.
I know this is quite a shock.
24. How did it feel to say the words?
One thing clinician noticed
One thing patient noticed
Drill: Debrief
25. Drill: Emotion/Name
Patient Clinician
It sounds like you’re feeling
overwhelmed.
I’ve just been going to all these
doctors appointments and
getting all these tests, and I
don’t know…
Yes, exactly, so much is going
on and I don’t know what to
26. Drill: Emotion/Acknowledge
Patient Clinician
I can’t even imagine what it’s
like for you to be going
through this.
No one’s really telling me what’s
going on. Is this treatment
working or not?
It’s just so scary. I’m really
worried.
30. SPIKES: A ‘Talking Map’ for delivering serious
news
Responding to patient emotion
– Name
– Acknowledge
What’s one thing you’re going to try this
week?
Summary
31. Goals of Care Conversations
Goals of Care Conversations training materials were
developed and made available for public use through
a U. S. Department of Veterans Affairs contract with
VitalTalk.
[Order VA777-14-P-0400]
Materials are available for download from
VA National Center for Ethics in Health Care at
vaww.ethics.va.gov/goalsofcaretraining.asp.
31
Editor's Notes
FACILITATOR NOTES:
Before the Training
Familiarize yourself with the content and flow of your session / run through your complete slide deck
Practice for timing and transitions
Have hand-outs ready for distribution
Have white board (or flip chart) and markers available
Test your access to the slides and video functionality in advance
Arrive at the room early
When You Arrive
If you are going to video for feedback on BE A SMARTER COOKIE, ask a colleague to record a 10 min segment that you choose. Position that person close enough to ensure adequate audio pick-up and that others in the room are not videotaped.
Watch the Time: Make sure you have a clock in your line of vision that displays time visibly
Arrange the room: If you have a large room and few attendees, ask people to move to the front
Keep in mind:
Speak up - make sure the whole room can hear
Look up - keep focus on the audience; not your notes
Get Started
Introduce yourself
Base your introduction on the one you created and refined in the VA Facilitator preparation training
State the vision and purpose of this VA initiative, and how this training relates
Tell a short (3-4 sentence) personal story about your experience with delivering serious news, what you’ve learned, and why this motivates you to train others
FACILITATOR NOTES:
“Today’s session is the first of five trainings that we will do over the next XX weeks (months)”
Raise the question to the group (and facilitate a few responses):
“Why call it serious news?”
After the responses, emphasize the following point:
To call it “bad news” implies only one outcome and one way of looking at it. There is lots of different kinds of news that patients receive, and it is not always perceived as universally bad.
Serious news is a more global term for any news that has important repercussions, one way or the other.
FACILITATOR NOTES:
Ask the group the question (“Why is delivering serious news hard?”) before clicking through the bullets and see what kinds of responses they generate.
For each group member response:
Acknowledge the idea (perhaps restate it)
Thank them
Do not start into a discussion on each idea – keep it moving quickly and then after hearing 3-4 responses, go through the bullets.
FACILITATOR NOTES:
One of the hard parts about any difficult conversation is not knowing how to get from “here” to “there.” We will provide you with a step by step “Talking Map” that provides you a guide to get there. It’s called SPIKES, which is an acronym for the six steps.
One of the other tough parts is responding to the inevitable emotion that emerges in these conversations. So, we will also learn two tools that will help you respond.
FACILITATOR NOTES:
This session will take less than an hour (MAKE SURE TO FINISH ON TIME!)
We will start with a brief “mini-lecture” in which I define and outline the skills that we’ll learn.
I’ll then show you several videos that give you examples of what these look like in action.
However, learning communication is like learning to improve at a sport, or a musical instrument. You only get better with practice, and we’ll have a chance to do that, in a very easy and not-scary way.
FACILITATOR NOTES:
SPIKES is a talking map for delivering serious news. It is comprised of 6 steps, each named with the first letter of this acronym. These are setup, perception, invitation, knowledge, emotion and summarize/strategize. We’ll go through each of these steps one by one in the next few slides.
FACILITATOR NOTES:
Walk the audience through each of these bullets.
FACILITATOR NOTES:
Emphasize to the audience that they should ALWAYS learn what the patient knows before giving information.
You may want to run through some of the reasons why this is useful.
For example, if they already know what you’re going to tell them, you can save a lot of time.
Or, if you find out that they have a VERY different understanding of things, what you are sharing will be more of a shock.
FACILITATOR NOTES:
It is also helpful to find out how much (or what kind) of information a patient wants.
Asking for permission before moving forward always make a patient feel like they have more control over the conversation and is very helpful.
FACILITATOR NOTES:
Walk through these bullets. A few key points to share:
When sharing serious news, do not give a long lecture or huge amounts of detail. Information should be provided in short, digestible chunks.
A rule of thumb is not to give more than two or three pieces of information at a time.
Use sixth grade English in communicating. Avoid medical jargon.
If delivering bad news, it can be quite useful to just pause after the news for as long as the patient needs. If they are silent for over a minute or two, you may want to say something like:
“I think I just dropped some pretty big news on you – would you like to share what you’re thinking?”
FACILITATOR NOTES:
This is the most important point of SPIKES.
If the learners walk away with nothing else, we want them to understand that emotional reactions are normal and common, and MUST be attended to by the clinician communicating the serious news.
Much better to only attend to the emotion, than to miss it and cover lots of other “facts”
FACILITATOR NOTES:
There are two ways to respond to patients’ emotion reactions: Naming and Acknowledging.
Naming is when you state what emotion you think the patient may be experiencing.
FACILITATOR NOTES:
Set up the video carefully:
“Here is an example of a doctor responding to an angry patient.”
Pay close attention to the words used, and we’ll discuss what you saw at the end”
After the video, turn to the audience and ask:
What specifically did the doctor do that you liked?
Or…
What words did the c?
Make sure that they catch all the things that happen here:
Doctor names the emotion, including patient’s lack of trust
Doctor does not get defensive, but rolls with the pushback
You may also want to ask: What was the effect of what the doctor said on the patient?
Acknowledging is anything you say that makes it clear you recognize the patient is having an emotional reaction
FACILITATOR NOTES:
Note the language used in the last bullet point. Instead of asking patient to repeat back what you said (which can sound patronizing), the language on the slide can be more effective. It puts the onus on the clinician if the patient doesn’t understand.
FACILITATOR NOTES:
Set up the video briefly (e.g, “Here is an example of a doctor telling a prostate cancer patient that his PSA has increased. You’ll see him start out the conversation by assessing understanding before giving the news, and then checking in later. The middle part of the conversation is left out of the clip. Pay close attention and we’ll discuss what you saw after we’ve watched”)
After the video, turn to the audience and ask:
What specifically did the doctor do that you liked?
or
What words did the doctor use that you liked?
Make sure that they catch all the things that happen here:
Doctor asks understanding
Doctor gives information and at end of discussion, checks understanding
FACILITATOR NOTES:
Tell the group: “Now that you’ve heard and seen what these skills look like, let’s practice them”
Ask the group, “How do athletes or musicians practice?”
Facilitate the responses, and then (if they haven’t gotten there on their own), talk about drills. Something like,
“Even the world’s best athletes or musicians do drills every day. Basketball players practice shot after shot and pass after pass. Professional musicians play 30-60 minutes of scales every day – even though they know them by heart. Drills build and retain muscle memory, and also allow us to learn new things”
We’re going to practice using the words we’ve been talking about, and we’re going to make it really easy for you by giving you exact words to say.
It may seem easy, or even silly, but it’s just like “a great basketball player practicing layups” (or choose another similar analogy that you’re comfortable with)
FACILITATOR NOTES:
Walk the group through the drill instructions. At the end, ask if there are any questions and make sure there is complete clarity in the room about how to do this.
Ask the group to divide into pairs.
Hand out the drill sheets.
Read the first two drills out loud – or, better yet – have two learners in the audience read them out loud for you.
Then, have the people that just demonstrated, switch roles and do the two drills again.
Then, explain that after these two drills, you’ll debrief.
FACILITATOR NOTES:
These first two drills are for the Perception and Invitation of SPIKES.
Read the drill out loud. Or, better yet, ask two people in the group to read it out loud for the group.
FACILITATOR NOTES:
Either read, or have the two learners read out loud this drill as well.
FACILITATOR NOTES:
Ask them to switch roles and show again.
When done demonstrating the drill…..go back to slide 21 and ask everyone to do the two drills in their groups of two.
Walk around the room and observe how they are doing, and when it looks like everyone has completed both drills, call for the switch.
FACILITATOR NOTES:
Ask each of the dyads to answer these questions just to each other. Give them 2-3 minutes to run through this exercise.
FACILITATOR NOTES:
Now demonstrate the next two drills by reading them out loud, or having two learners read them out loud.
Both drills are for responding to emotion – one by using Naming, the other by Acknowledging.
FACILITATOR NOTES:
Demonstrate this drill
FACILITATOR NOTES:
Ask everyone to switch roles
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Ask them to talk with their partners and answer the three questions:
How did it feel to say the words?
One thing the clinician noticed
One thing the patient noticed
Then lead a group discussion about their reactions to practicing these words.
FACILITATOR NOTES:
This is the debrief where deeper learning takes place.
Ask everyone to write about each of these questions for 1-2 minutes.
Then, lead a group discussion asking people to volunteer something they wrote in response to one of these questions.
FACILITATOR NOTES:
Summarize very quickly and then ask everyone to write down on a piece of paper the one thing they’re going to try out this week, and keep that paper in their wallet/purse/pocket.
Then thank the group, express appreciation for their willingness to practice and engage, and close the session.