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lslect038

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<title>Introduction to DISC (Developing Interview Skills in the Consultation)</title></titleStmt>

<publicationStmt><distributor>BASE and Oxford Text Archive</distributor>

<idno>lslct038</idno>

<availability><p>The British Academic Spoken English (BASE) corpus was developed at the

Universities of Warwick and Reading, under the directorship of Hilary Nesi

(Centre for English Language Teacher Education, Warwick) and Paul Thompson

(Department of Applied Linguistics, Reading), with funding from BALEAP,

EURALEX, the British Academy and the Arts and Humanities Research Board. The

original recordings are held at the Universities of Warwick and Reading, and

at the Oxford Text Archive and may be consulted by bona fide researchers

upon written application to any of the holding bodies.

The BASE corpus is freely available to researchers who agree to the

following conditions:</p>

<p>1. The recordings and transcriptions should not be modified in any

way</p>

<p>2. The recordings and transcriptions should be used for research purposes

only; they should not be reproduced in teaching materials</p>

<p>3. The recordings and transcriptions should not be reproduced in full for

a wider audience/readership, although researchers are free to quote short

passages of text (up to 200 running words from any given speech event)</p>

<p>4. The corpus developers should be informed of all presentations or

publications arising from analysis of the corpus</p><p>

Researchers should acknowledge their use of the corpus using the following

form of words:

The recordings and transcriptions used in this study come from the British

Academic Spoken English (BASE) corpus, which was developed at the

Universities of Warwick and Reading under the directorship of Hilary Nesi

(Warwick) and Paul Thompson (Reading). Corpus development was assisted by

funding from the Universities of Warwick and Reading, BALEAP, EURALEX, the

British Academy and the Arts and Humanities Research Board. </p></availability>

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<recording dur="00:52:21" n="6105">

<date>16/09/2003</date><equipment><p>video</p></equipment>

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<item n="speechevent">Lecture</item>

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<item n="module">Developing Interview Skills in the Consultation</item>

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<u who="nf0621"><kinesic desc="projector is on showing slide" iterated="n"/> welcome <pause dur="4.7"/> today <pause dur="1.1"/> we're talking about <pause dur="0.9"/> communication skills <pause dur="2.3"/> it's the core part <pause dur="0.7"/> of what you learn <pause dur="0.6"/> if you want to become <pause dur="0.2"/> a doctor <pause dur="2.5"/> ninety-five per cent <pause dur="0.2"/> of doctors <pause dur="0.5"/> spend most of their days <pause dur="0.7"/> talking to people <pause dur="1.0"/> one way or another <pause dur="1.8"/> ninety-eight per cent of doctors <pause dur="1.0"/> have to be able to consult <pause dur="1.6"/> even if you're a pathologist you have to talk to the relatives of the people you cut up <pause dur="2.1"/> and you have to be able to talk to other doctors as well <pause dur="1.7"/> so this is absolutely <pause dur="0.3"/> crucial <pause dur="1.0"/> now one of the first things about communication skills that we teach you all <pause dur="0.2"/> is that first of all <pause dur="1.2"/> you should introduce yourselves <pause dur="0.4"/> and so <pause dur="1.6"/> we're going to introduce ourselves <pause dur="0.7"/> because in the next few years you're going to become <pause dur="0.2"/> fairly familiar <pause dur="0.5"/> with all these names <pause dur="0.6"/> that are <pause dur="0.4"/> in front of you here <pause dur="1.5"/> and we thought we'd give you this opportunity to find out <pause dur="0.4"/> who we are <pause dur="0.9"/> and we're all going to introduce ourselves <pause dur="0.3"/> to you so that <pause dur="0.7"/> all of you will be taught by us <pause dur="0.8"/> probably most of us <pause dur="0.4"/> before you qualify <pause dur="0.9"/> even if not directly in

the next few months <pause dur="0.9"/> so we thought you'd like to know who we are <pause dur="1.5"/> so <pause dur="0.9"/> this is our <pause dur="0.5"/> Department of Undergraduate G-P Education at the moment <pause dur="0.2"/> we have two senior lecturers <pause dur="0.2"/> <gap reason="name" extent="1 word"/> and <gap reason="name" extent="1 word"/> <pause dur="1.3"/> and <pause dur="1.1"/> as of <pause dur="0.9"/> two weeks' time we have ten <pause dur="0.5"/> part-time G-P lecturers <pause dur="0.9"/> all of us are <pause dur="1.7"/> more than half-time more than two-third time G-Ps <pause dur="0.9"/> in the week <pause dur="0.6"/> and <pause dur="0.6"/> all of us <pause dur="1.0"/> spend most of our time <pause dur="0.3"/> actually at the coalface <pause dur="1.7"/> so if my <pause dur="0.3"/> people could come up <pause dur="0.2"/> please <pause dur="1.0"/> and <pause dur="0.5"/> we'll let <gap reason="name" extent="1 word"/> <pause dur="2.1"/> now <pause dur="0.8"/> the most important members of our team as far as you're concerned <pause dur="0.4"/> are <pause dur="1.2"/> <gap reason="name" extent="2 words"/> who's our undergraduate administrator <pause dur="1.5"/> and <gap reason="name" extent="2 words"/> <pause dur="0.3"/> her assistant who's i think officially called the secretary <pause dur="1.6"/> these two ladies <pause dur="0.7"/> are <pause dur="0.6"/> the heart of our department <pause dur="0.6"/> and they run everything and you will be going to see them and phoning them <pause dur="0.9"/> lots and lots <pause dur="1.6"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> but now <pause dur="0.3"/> <gap reason="name" extent="1 word"/> <pause dur="0.6"/> all yours </u><pause dur="3.1"/> <u who="nm0622" trans="pause"><kinesic desc="changes slide" iterated="n"/> i'm the director of G-P Undergraduate Medical Education at <gap reason="name" extent="1 word"/> Medical

School <pause dur="0.3"/> and we're all <pause dur="0.3"/> members of the Department of <pause dur="0.5"/> Undergraduate General Practice Education <pause dur="0.9"/> <gap reason="name" extent="1 word"/> asked us to give <pause dur="0.2"/> # an amusing theme about ourselves and <pause dur="0.2"/> a message therefore about communication <pause dur="0.8"/> my wife says that my interest in cricket has become an obsession <pause dur="0.5"/> and this is myself actually <pause dur="0.4"/> on a very rare occasion <pause dur="0.4"/> going out <pause dur="0.2"/> to bat <pause dur="0.9"/><kinesic desc="changes slide" iterated="n"/> and i wanted my communication <pause dur="0.4"/> theme to # surround <pause dur="0.7"/> cricket because <pause dur="0.3"/> to be successful in cricket <pause dur="0.5"/> requires <pause dur="0.2"/> teamwork <pause dur="0.5"/> it can't be <pause dur="0.6"/> a solo <pause dur="0.3"/> effort <pause dur="0.7"/> and if you think of the team it's more than just <pause dur="0.4"/> the players <pause dur="1.1"/> if you make the analogy with <pause dur="0.2"/> you as doctors in the future you're going to be the major players <pause dur="0.4"/> in the N-H-S but there are a lot of other players as well <pause dur="0.7"/> there's the ground staff <pause dur="0.6"/> the umpires <pause dur="0.2"/> the scorers the fixture secretary publicity <pause dur="0.6"/> those who make the teas <pause dur="0.4"/> and many others so there are many others in the N-H-S team <pause dur="0.4"/> as well as doctors <pause dur="0.9"/> and we'll all have different skills which <gap reason="name" extent="1 word"/>'s just alluded to some of us may be pathologists some of us may be <pause dur="0.5"/> G-Ps so

similar to the cricket team there are those that are good at batting <pause dur="0.4"/> some at bowling some at fielding <pause dur="0.9"/> but <pause dur="0.3"/> success is not through individuals <pause dur="0.2"/> for us to be successful we've got to communicate <pause dur="0.9"/> <kinesic desc="changes slide" iterated="n"/> and <pause dur="0.6"/> thinking particularly of the university we have teamwork in teaching that's why <pause dur="0.3"/> we're introducing ourselves as a team <pause dur="0.3"/> in order to make it a success we've got to communicate <pause dur="0.7"/> for you as students during your four years to be successful <pause dur="0.3"/> you've got to be able to communicate <pause dur="0.5"/> both as pairs and within groups during seminar work <pause dur="0.4"/> particularly in relation to problem based learning <pause dur="0.8"/> that requires teamwork <pause dur="0.7"/> and similarly when you go into practice <pause dur="0.3"/> people don't work on their own nowadays they work in teams both in the community <pause dur="0.6"/> and in hospital <pause dur="0.7"/> so <reading>effective teamwork depends on good communication to enable mutual understanding of needs <pause dur="0.5"/> whether on <pause dur="0.2"/> or off the field</reading> <pause dur="0.7"/><kinesic desc="changes slide" iterated="n"/> so the amusing bit for me is <pause dur="0.4"/> i have the long walk out from the pavilion on to the <vocal desc="laughter" iterated="y" n="ss" dur="1"/>

cricket square <pause dur="0.4"/> a relatively short time <pause dur="0.3"/> at the crease depending whether i'm facing to begin with or whether i have a few balls while my partner at the other end is facing <pause dur="0.7"/> and then unfortunately <pause dur="0.4"/> the long walk <pause dur="0.3"/> back to the pavilion <vocal desc="laughter" iterated="y" n="ss" dur="1"/><pause dur="1.6"/> pass on to <pause dur="0.2"/> <gap reason="name" extent="1 word"/> </u><gap reason="break in recording" extent="uncertain"/> <u who="nf0623" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/> thank you <pause dur="0.6"/> # i'm <gap reason="name" extent="1 word"/>'s sort of other half in the academic department in that # i'm codirector <pause dur="0.6"/> # <pause dur="0.2"/> i haven't made you a beautiful slide because as my group from this morning will know i'm i'm rather keen on art and i have a new digital camera and i haven't quite got my act together <pause dur="0.7"/> # <pause dur="0.9"/> i've been here since January <pause dur="0.2"/> # <pause dur="0.4"/> and i was at U-C-L prior to that # <pause dur="0.4"/> my major interest is obviously in communication and consultation skills <pause dur="0.5"/> # which is also a research interest for for many years i was head of the international unit which is <pause dur="0.4"/> involved in primary care development projects abroad <pause dur="0.5"/> # <pause dur="0.4"/> and that i think has made me more aware of of of communication it's it's brought a lot of lessons back <pause dur="0.2"/> for me to the U-K which i use in my daily

practice <pause dur="0.7"/> # <pause dur="1.6"/> these projects are quite expensive and it's led me to reflect on <pause dur="0.5"/> # looking at what we've actually done whether we've actually done anything in fact for the patients # in terms of primary care development <pause dur="0.6"/> and i've been looking at patient centred instruments # which is a research interest i <pause dur="0.3"/> intend to pursue <pause dur="0.5"/> # along with a little bit of international work that that i'm doing here <pause dur="0.7"/> # so hopefully # you'll see more and more of that as as the course progresses <pause dur="0.2"/> thank you </u><gap reason="break in recording" extent="uncertain"/> <u who="nf0621" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/> okay here you are <gap reason="name" extent="1 word"/> <unclear>we'll leave it</unclear> there </u><pause dur="0.4"/> <u who="nm0624" trans="pause"> okay <pause dur="2.0"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> well will the miracle happen when i need to press it </u><u who="nf0621" trans="overlap"> yeah <vocal desc="laughter" iterated="y" n="ss" dur="1"/></u><pause dur="0.2"/> <u who="nm0624" trans="pause"> yeah </u><u who="nf0621" trans="latching"> yes it will </u><u who="nm0624" trans="latching"> okay thank you <pause dur="0.2"/> # my name is <gap reason="name" extent="2 words"/> <pause dur="0.2"/> and # i'm one of the part-time lecturers here <pause dur="0.7"/>

yes i do believe in miracles # because for one <pause dur="0.2"/> i became a doctor <pause dur="0.6"/> # <vocal desc="laughter" iterated="y" n="ss" dur="1"/><pause dur="1.4"/> if i can do it <pause dur="0.2"/> i think anybody can <pause dur="1.1"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> i mean clearly # talking about communication skills i mean that's the theme <pause dur="0.6"/> # you <pause dur="0.2"/> obviously have some <pause dur="0.2"/> attributes in communication because that's what we test in the interview <pause dur="0.9"/> but <pause dur="0.5"/> the course is <pause dur="0.4"/> and our aim is <pause dur="0.6"/> in particular <pause dur="0.2"/> to develop some of those attributes <pause dur="0.5"/> and fine tune them so that you become very successful doctors <pause dur="0.9"/> right <pause dur="1.9"/> <kinesic desc="changes slide" iterated="n"/> now <pause dur="0.3"/> miracles do happen and one of them happened to me very recently <pause dur="0.2"/> i was on holiday in Toronto <pause dur="0.8"/> and after twenty-five years i met a drinking partner <pause dur="0.8"/> <vocal desc="laughter" iterated="y" n="sl" dur="1"/> now can you believe <pause dur="0.3"/> that two people could be attending <pause dur="0.4"/> two different <pause dur="0.5"/> weddings in at the same venue <pause dur="0.6"/> and be outside the hall at the same time <pause dur="0.4"/> across the road <pause dur="0.8"/> so a very

quiet <pause dur="0.4"/> sort of <pause dur="0.2"/> voice says <gap reason="name" extent="1 word"/> <pause dur="1.0"/> and i thought nobody knows me here so i ignored it <pause dur="3.4"/> <vocal desc="laughter" iterated="y" n="ss" dur="3"/> a slightly louder one came <gap reason="name" extent="1 word"/> <pause dur="0.8"/> and there was a guy smiling across the way <pause dur="0.8"/> and it made my day i have to say it made my year i suppose <pause dur="0.3"/> to see somebody after twenty-five years who you were so close and it's amazing that sometimes you let go of your relationships <pause dur="0.3"/> and relationships are very important for G-Ps <pause dur="0.3"/> thank you </u><gap reason="break in recording" extent="uncertain"/> <u who="nm0625" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/> i'm <gap reason="name" extent="2 words"/> i'm a G-P in # <pause dur="0.2"/> <gap reason="name" extent="1 word"/> <pause dur="0.9"/> and as as <gap reason="name" extent="1 word"/>'s sort of outlined <pause dur="0.6"/> # you'll come across me both in the Communication Skills module which is what you're doing in this phase one <pause dur="0.7"/> and then later <pause dur="0.7"/> # we get involved in Clinical Methods which again is # departmental <pause dur="0.8"/> and practice based <pause dur="1.1"/> the reason i've <trunc>sh</trunc> <pause dur="0.5"/> selected this slide to show you is is partly to illustrate that we do have

lives <pause dur="0.6"/> outside this building <pause dur="0.5"/> but also to # <pause dur="0.6"/> sort of highlight that communication is not always verbal <pause dur="1.3"/> and it is important to be able <pause dur="0.4"/> to recognize and appreciate non-verbal communication <pause dur="0.8"/> # <pause dur="0.2"/> and also recognize that different things <pause dur="0.3"/> mean different <pause dur="1.0"/> # <pause dur="0.5"/> different things depending on the circumstances that <pause dur="0.2"/> that you find yourself in <pause dur="0.5"/> i mean does does anybody here go diving or <pause dur="0.3"/> scubaing or <pause dur="1.5"/> so the people who don't what <pause dur="0.2"/> i mean the message there is </u><pause dur="0.2"/> <u who="sf0626" trans="pause"> go up </u><pause dur="0.6"/> <u who="nm0625" trans="pause"> go up yes <pause dur="0.2"/> # <vocal desc="laugh" iterated="n"/><pause dur="1.1"/><kinesic desc="changes slide" iterated="n"/> not having a great time <pause dur="0.7"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> which is <pause dur="0.7"/> more represented by that <pause dur="0.8"/><vocal desc="laughter" iterated="y" n="ss" dur="1"/> okay <pause dur="0.5"/> thank you </u><gap reason="break in recording" extent="uncertain"/> <u who="nf0627" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/> first # bad communication error is i work in <gap reason="name" extent="1 word"/> not in <gap reason="name" extent="1 word"/> <shift feature="voice" new="laugh"/>so <shift feature="voice" new="normal"/><vocal desc="laughter" iterated="y" n="sl" dur="1"/> </u><u who="nf0621" trans="overlap"> i'm sorry </u><u who="nf0627" trans="overlap"> i apologize for that </u><u who="nf0621" trans="overlap">

oh that's my <shift feature="voice" new="laugh"/>fault <shift feature="voice" new="normal"/></u><u who="nf0627" trans="latching"> <vocal desc="laughter" iterated="y" n="sl" dur="1"/> don't worry </u><pause dur="0.4"/> <u who="nf0621" trans="pause"> # </u><u who="nf0627" trans="overlap"> i was going to say the should we put the <pause dur="0.2"/> the photograph up at this stage <pause dur="1.5"/><kinesic desc="changes slide" iterated="n"/> now this will give you a laugh <pause dur="0.2"/> <vocal desc="laughter" iterated="y" n="sl" dur="1"/> <pause dur="0.6"/> the <pause dur="0.2"/> <vocal desc="laughter" iterated="y" n="sl" dur="2"/> my husband said the way to get a laugh is show a wedding photograph and you're bound to get one with that hat on <shift feature="voice" new="laugh"/>so <shift feature="voice" new="normal"/><vocal desc="laughter" iterated="y" n="ss" dur="1"/> <pause dur="0.4"/> it is actually me # a hundred years ago <pause dur="0.3"/> <vocal desc="laughter" iterated="y" n="ss" dur="2"/> on my wedding day <pause dur="0.7"/> and i thought it might be interesting especially for the girls in the audience because i got married as a medical student and some of you might have been wondering about marriage and children and the rest of it <pause dur="0.4"/> # so now i <pause dur="0.3"/> then i was a medical student and getting married <pause dur="0.3"/> now i'm <pause dur="0.4"/> a <pause dur="0.2"/> daughter still <pause dur="0.2"/> and a wife and a mother as

well as being a G-P and a lecturer so you really can have everything that you want <pause dur="0.4"/> it's quite possible <pause dur="0.5"/> and i thought when i looked at that if you look at the eyes and it my <trunc>me</trunc> my communication message is eye contact is really important <pause dur="0.4"/> and if you look at my eyes i'm looking in the right direction <pause dur="2.3"/> <vocal desc="laughter" iterated="y" n="ss" dur="5"/> and i and i think that is the story of my life <vocal desc="laughter" iterated="y" n="ss" dur="6"/> i really do </u><gap reason="break in recording" extent="uncertain"/> <u who="ss" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/> aah </u><u who="nm0628" trans="overlap"> hello i'm # i'm <gap reason="name" extent="2 words"/> <pause dur="0.6"/> this here <pause dur="0.3"/> is my little new daughter <gap reason="name" extent="2 words"/> who's now sixteen weeks old </u><pause dur="0.4"/> <u who="ss" trans="pause"> aah </u><u who="nm0628" trans="overlap"> and that was the day she was born there <vocal desc="laughter" iterated="y" dur="1"/> <pause dur="0.5"/> so # <pause dur="0.5"/> i was just about i'm <pause dur="0.9"/> i just # wanted to illustrate some non-verbal communication can anybody what

what's <pause dur="0.3"/> what am i thinking here do you reckon <pause dur="0.6"/> <vocal desc="laughter" iterated="y" n="sl" dur="2"/> oh by the way that is my wife not <vocal desc="laughter" iterated="y" n="sl" dur="4"/> <pause dur="0.5"/> can anybody read what my face is thinking there i this is why i use this i think </u><pause dur="0.3"/> <u who="sm0629" trans="pause"> <unclear>well it's</unclear> how did we both get into the same shirt </u><pause dur="0.2"/> <u who="nm0628" trans="pause"> yeah <vocal desc="laughter" iterated="y" n="ss" dur="4"/> it's it's it's very sad isn't it <pause dur="4.2"/> <kinesic desc="applause" iterated="y" n="sl" dur="5"/> <trunc>y</trunc> yeah it it's especially with my size as well <vocal desc="laughter" iterated="y" n="ss" dur="1"/> isn't it <pause dur="1.6"/> yeah any any other offers <vocal desc="laughter" iterated="y" n="ss" dur="2"/> <pause dur="2.6"/> it's a mixture of extreme <trunc>p</trunc> pride and absolute terror if you notice <vocal desc="laughter" iterated="y" n="ss" dur="1"/> the sort of <pause dur="0.5"/> a grimace on my face as well so # <pause dur="0.4"/> anyway this is what actually happens to you if you have a kid <pause dur="0.9"/> <kinesic desc="changes slide" iterated="n"/> <vocal desc="laughter" iterated="y" n="sl" dur="2"/> </u><u who="ss" trans="overlap">

aah </u><pause dur="0.6"/> <u who="nf0621" trans="pause"> so there's Homer Simpson i A-K-A me with little <gap reason="name" extent="1 word"/> <pause dur="0.4"/> absolutely blotto on my lap it's absolutely knackering but # <pause dur="0.8"/><vocal desc="laughter" iterated="y" n="ss" dur="1"/> but anyway that's me # i am a human being <pause dur="0.3"/> # by the way the way not to get a stomach like that is not to put a stone a year on in medical school <vocal desc="laughter" iterated="y" n="ss" dur="2"/> that's what i did <pause dur="1.1"/> it's it's mainly the curry every night after the beer <shift feature="voice" new="laugh"/>avoid it <shift feature="voice" new="normal"/>like the plague <vocal desc="laughter" iterated="y" n="ss" dur="1"/> <shift feature="voice" new="laugh"/>but #<shift feature="voice" new="normal"/> <pause dur="0.6"/> but anyway i'm a G-P in <gap reason="name" extent="3 words"/> up the road a little village and one of the part-time lecturers here and i teach mainly the <trunc>commu</trunc> # the <pause dur="0.4"/> Clinical Method course a little bit later on so <pause dur="0.4"/> you'll be coming across me so it's nice to meet you all and i'll pass on thanks a lot </u><gap reason="break in recording" extent="uncertain"/> <u who="nf0621" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/> this is me <pause dur="1.4"/> and <pause dur="0.2"/> i thought i wasn't going to overload it with too many # bytes <pause dur="0.4"/><kinesic desc="changes slide" iterated="n"/> of information so <pause dur="0.9"/> i just <vocal desc="laughter" iterated="y" n="ss" dur="5"/> thought we'd # <pause dur="5.6"/> we'd go

back to the <pause dur="0.3"/> necessity for verbal <shift feature="voice" new="laugh"/>skills in <shift feature="voice" new="normal"/>consultation <pause dur="0.7"/> and just to remind you <pause dur="2.3"/> <kinesic desc="changes slide" iterated="n"/> and now </u><gap reason="break in recording" extent="uncertain"/> <u who="nf0630" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/> i'm <gap reason="name" extent="2 words"/> <pause dur="0.2"/> i'm the only <pause dur="0.2"/> lecturer here that has to ask you not only is the microphone working and can you hear me but can you actually see me over the lectern <vocal desc="laughter" iterated="y" n="ss" dur="1"/> 'cause i am quite short <pause dur="0.6"/> # <pause dur="0.4"/> as it said i'm a G-P in <gap reason="name" extent="3 words"/> as well which probably a lot of people have just moved to <gap reason="name" extent="1 word"/> and you don't know where it is <pause dur="0.4"/> it's actually the little village outside <gap reason="name" extent="3 words"/> which is very famous obviously for a chap who used to write plays and things <pause dur="0.5"/> # and he's also very famous <pause dur="0.2"/> # for acting so i thought it was only fair <pause dur="0.4"/> that perhaps me and one of the partners at work should do a little sketch for you now this is even more humiliating than doing G-P videos so <vocal desc="laughter" iterated="y" n="ss" dur="1"/> when you come and whinge to me about having to do videos just bear in mind what <event desc="starts video" iterated="n"/><kinesic desc="video plays" iterated="y" dur="3:15"/> i've had to go through to do this <pause dur="0.2"/> okay </u><pause dur="3:05.0"/><event desc="stops video" iterated="n" n="nf0630"/> <kinesic desc="applause" iterated="y" n="ss" dur="7"/> <u who="nf0621" trans="pause"><kinesic desc="changes slide" iterated="n"/>

right <pause dur="0.4"/> our next lecturer <vocal desc="laughter" iterated="y" n="ss" dur="1"/> </u><pause dur="1.7"/> <u who="nm0631" trans="pause"> hello <pause dur="0.9"/> # my name's <gap reason="name" extent="2 words"/> i'm a G-P in south <gap reason="name" extent="1 word"/> at a place called <gap reason="name" extent="1 word"/> and which is why i was a bit late so i apologize for that <pause dur="0.6"/> that's me <pause dur="1.5"/><vocal desc="laughter" iterated="y" n="ss" dur="1"/> # <pause dur="0.7"/> i don't really have any teaching points about that i just thought that was quite sweet <pause dur="0.5"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> although i guess # <pause dur="1.0"/> if there is anything to learn about it it's if you do have any bad habits # <pause dur="0.4"/> try and lose them as early as possible 'cause i'm still suffering from my family affliction <pause dur="0.6"/><vocal desc="laughter" iterated="y" n="ss" dur="1"/> of supporting # Wolverhampton Wanderers and as <pause dur="0.4"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> you might know # <pause dur="0.6"/> they're appalling <pause dur="0.6"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> so # that's all i've got to say really <pause dur="0.2"/> <vocal desc="laughter" iterated="y" n="sl" dur="2"/> </u><gap reason="break in recording" extent="uncertain"/> <u who="nm0632" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/>

hi my name is <gap reason="name" extent="2 words"/> as you can read <vocal desc="laughter" iterated="y" n="sl" dur="1"/><pause dur="0.5"/> # <pause dur="0.2"/> basically i've been appointed recently as a lecturer here so i've not had all the <pause dur="0.6"/> # experiences all these lecturers who <pause dur="0.2"/> managed to <pause dur="0.3"/> # get these fantastic slides <pause dur="0.6"/> but basically when i was studying for my M-R-C-G-P that's what i looked like <pause dur="0.5"/> # and just to let you know that if you're getting really <pause dur="0.5"/> # pissed off with doing intensive study for medicine <pause dur="0.2"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> then you can produce a child like that which is <vocal desc="laughter" iterated="y" n="ss" dur="1"/> what i did afterwards thank you <vocal desc="laughter" iterated="y" n="ss" dur="1"/> <kinesic desc="applause" iterated="y" n="ss" dur="5"/> </u><gap reason="break in recording" extent="uncertain"/> <u who="nm0633" trans="pause"><kinesic desc="projector is on showing slide" iterated="n"/>

hi <trunc>m</trunc> my name is <gap reason="name" extent="2 words"/> i've <unclear>got B</unclear> but <pause dur="0.4"/> probably in future i'll get a O-B-E or M-B-E <vocal desc="laughter" iterated="y" n="ss" dur="2"/> but that's an <pause dur="1.1"/> that's an example of # <pause dur="0.5"/> communication <pause dur="0.8"/> i <pause dur="0.2"/> haven't put my slides or anything there because Powerpoint is always a distraction and # i'm trying to <pause dur="0.8"/> provide a kind of a visual communication <pause dur="1.0"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> so they can look at me <pause dur="2.4"/> <vocal desc="laughter" iterated="y" n="ss" dur="2"/> and i for a long time i was at the other end of # <pause dur="0.4"/> # <pause dur="0.7"/> the <pause dur="0.5"/> where you were sitting and listening to other people but i'm just <trunc>r</trunc> i've just recently joined as <gap reason="name" extent="1 word"/> as a lecturer here <pause dur="0.6"/> and i'm a G-P in # <gap reason="name" extent="1 word"/> <pause dur="0.8"/> okay <pause dur="0.3"/> thank you <vocal desc="laughter" iterated="y" n="ss" dur="1"/></u><pause dur="3.6"/> <u who="nf0621" trans="pause"> okay so now you know who we all are <pause dur="1.2"/> and a little bit <pause dur="0.8"/> about it <pause dur="2.4"/> so <pause dur="0.5"/> i thought we'd get ourselves back to the basics <pause dur="1.1"/> of this <pause dur="1.5"/> and # <pause dur="2.3"/> the first thing to know <pause dur="0.3"/> is <pause dur="2.0"/><kinesic desc="changes slide" iterated="n"/> that this bit of the course is part of your Clinical Skills module <pause dur="2.1"/> don't worry about writing things down <pause dur="1.2"/> nothing there are no

notes to be taken from this lecture <pause dur="1.4"/> okay <pause dur="1.9"/> it's a practical course it's not theoretical <pause dur="1.2"/> there is no knowledge to be learned <pause dur="2.3"/> it's taught <pause dur="0.2"/> by practising doctors <pause dur="2.2"/> with simulated <pause dur="0.3"/> and real patients <pause dur="1.6"/> communication skills are skills <pause dur="0.2"/> and you can't learn skills by writing about them <pause dur="0.5"/> you can write about Beethoven's piano concerto <pause dur="0.3"/> till the papers are <kinesic desc="demonstrates size with hands" iterated="n"/> this big <pause dur="0.2"/> you can talk about it <pause dur="0.4"/> till people's ears drop off <pause dur="0.2"/> and it will not let you be able to play it <pause dur="0.6"/> to be able to play it <pause dur="0.3"/> you must <pause dur="0.7"/> play <pause dur="1.2"/> again <pause dur="0.9"/> and again <pause dur="1.1"/> and so this is not for you to write and us talking about it <pause dur="0.4"/> that makes you think <pause dur="0.7"/> that the real learning <pause dur="0.3"/> happens with the patients <pause dur="1.6"/><kinesic desc="changes slide" iterated="n"/> so <pause dur="0.5"/> why <pause dur="0.3"/> teach <pause dur="0.8"/> communication </u><pause dur="2:22.8"/> <event desc="starts video" iterated="n" n="nf0621"/><kinesic desc="video plays" iterated="y" dur="2:13"/><event desc="stops video" iterated="n" n="nf0621"/> <u who="nf0621" trans="pause"> <vocal desc="clears throat" iterated="n"/> <pause dur="0.6"/> well <pause dur="1.1"/> i like that because <pause dur="0.2"/> it's got so many <pause dur="0.5"/> examples <pause dur="0.3"/> of communication cock-ups <pause dur="3.1"/> later on when you watch it <pause dur="0.2"/> you'll actually be able to spot them <pause dur="0.2"/> and you'll say ah he's using a word

that <pause dur="0.2"/> he thinks he means something different from this one does and <pause dur="1.0"/> he's <trunc>d</trunc> you know <pause dur="0.6"/> but <pause dur="2.1"/> the whole of that Carry On film <pause dur="1.2"/> is <pause dur="0.2"/> about the misunderstanding <pause dur="0.2"/> that happens in that consultation <pause dur="0.7"/> and although <pause dur="0.4"/> that is a film and you've probably seen it before <pause dur="0.6"/> i will say that i have seen worse consultations happen in real life <pause dur="2.4"/> so <pause dur="0.2"/> perhaps there is some <pause dur="0.3"/> point in teaching <pause dur="0.3"/> communication <pause dur="2.0"/> good communication <pause dur="0.3"/> has rewards and bad communication has punishments <pause dur="2.6"/><kinesic desc="changes slide" iterated="n"/> if you communicate well you know why the patient has come <pause dur="2.9"/> you can make a diagnosis <pause dur="2.0"/> the patient can understand <pause dur="0.4"/> your explanation <pause dur="2.0"/> the patient might take your treatment <pause dur="1.9"/> and the patient will like you <pause dur="2.2"/> on the other hand <pause dur="0.3"/> if you can't communicate <pause dur="2.1"/> you miss <pause dur="0.3"/> the real reasons <pause dur="0.3"/> that they've come to see you <pause dur="1.3"/> you miss important diagnoses <pause dur="2.2"/> and the patient <pause dur="0.3"/> does not <pause dur="0.8"/> understand you <pause dur="0.5"/> or what is going on <pause dur="2.5"/> patients don't then do what you want them to do <pause dur="1.7"/> and you get complaints <pause dur="0.9"/> so on a very real and practical <pause dur="0.4"/> level <pause dur="1.1"/> being able to communicate well <pause dur="0.9"/> is absolutely <pause dur="0.3"/>

crucial <pause dur="1.6"/> for what we do <pause dur="0.2"/> as doctors <pause dur="2.7"/><kinesic desc="changes slide" iterated="n"/> so <pause dur="0.9"/> what <pause dur="0.5"/> is <pause dur="0.3"/> good <pause dur="0.2"/> communication <pause dur="2.4"/> well <pause dur="0.2"/> we've seen it can be non-<pause dur="0.2"/>verbal <pause dur="2.2"/> i can by the way i use my body <pause dur="1.3"/> or not <pause dur="1.3"/><kinesic desc="crosses arms across body" iterated="n"/> give completely different impressions <pause dur="0.6"/> to people <pause dur="2.1"/> your body language <pause dur="0.2"/> your expression <pause dur="0.7"/> your posture <pause dur="3.2"/> wasn't the patient's expression marvellous <pause dur="0.2"/> when the doctor was talking <pause dur="0.6"/> looking at the X-ray <pause dur="3.3"/> non-verbal <pause dur="0.9"/> communication can also be paralinguistic <pause dur="0.6"/> things like the tone of your voice and your voice quality <pause dur="0.3"/> can communicate <pause dur="0.3"/> important things <pause dur="1.5"/> recently got a new curate in my church <pause dur="0.9"/> and she goes on about <shift feature="voice" new="mimicking an other's voice"/>the love of Christ <shift feature="voice" new="normal"/><vocal desc="laughter" iterated="y" n="ss" dur="1"/> and i think <vocal desc="shudder noise" iterated="n"/> <vocal desc="laugh" iterated="n"/> <pause dur="0.2"/> every time she does it <pause dur="0.7"/> i'm <pause dur="0.2"/> i know it's wrong but <pause dur="0.2"/> <vocal desc="sigh" iterated="n"/> i just wish somebody had taken her <trunc>an</trunc> aside and said <pause dur="0.6"/> you can learn how to make your voice <pause dur="0.2"/> more <pause dur="0.9"/> relaxing <pause dur="1.1"/><vocal desc="laughter" iterated="y" n="sl" dur="1"/><pause dur="1.0"/> good communication can also be verbal <pause dur="2.2"/> what you say <pause dur="0.3"/> matters enormously <pause dur="0.4"/> the precise

words that you use <pause dur="1.0"/> how you say it <pause dur="2.1"/> and the way you respond <pause dur="0.6"/> to the people <pause dur="0.8"/> # <pause dur="0.5"/> <unclear>has said</unclear> <pause dur="3.1"/><kinesic desc="changes slide" iterated="n"/> so <pause dur="3.2"/> let's have a think about <pause dur="0.4"/> these skills <pause dur="5.0"/> these are the skills that you're going to be <pause dur="0.2"/> practising but before we get on to that i think we ought to have <pause dur="0.8"/> another video </u><pause dur="1:36.7"/> <event desc="starts video" iterated="n" n="nf0621"/><kinesic desc="video plays" iterated="y" dur="1:28"/><event desc="stops video" iterated="n" n="nf0621"/><kinesic desc="changes slide" iterated="n" n="nf0621"/> <u who="nf0621" trans="pause"> so the first and most important skill <pause dur="1.5"/> is listening <pause dur="7.0"/> questioning <pause dur="2.1"/> how to ask questions <pause dur="0.4"/> it's quite frightening at first <pause dur="1.6"/> going up to a complete stranger <pause dur="1.0"/> and asking them questions about when they had their bowels open and <pause dur="2.0"/> what their mother did and oh <pause dur="0.5"/> all sorts of personal things about pain <pause dur="0.6"/> and bodies <pause dur="3.0"/> responding <pause dur="0.3"/> knowing what to say and how to say it when somebody <pause dur="0.7"/> gives you a bit of themselves <pause dur="2.7"/> and how to explain <pause dur="1.1"/> how to explain things so that people understand <pause dur="1.6"/> not the way you understand it but the way <pause dur="0.5"/> they will understand it <pause dur="2.4"/> so let's have a little look at these skills <pause dur="0.2"/> <trunc>w</trunc> one at a time <pause dur="1.3"/> just briefly <pause dur="0.2"/> because we don't want to waste too much time on this <pause dur="3.3"/><kinesic desc="changes slide" iterated="n"/> so listening <pause dur="5.6"/>

you have to give patients space <pause dur="0.4"/> and time <pause dur="0.4"/> to express themselves <pause dur="6.4"/> it's actually quite <pause dur="0.3"/> difficult <pause dur="0.6"/> to hear <pause dur="0.4"/> what patients are actually saying <pause dur="2.6"/> we take it for granted but very often <pause dur="0.7"/> you know there's family arguments where <pause dur="0.3"/> <shift feature="voice" new="mimicking an other's voice"/> i told you about so and so <shift feature="voice" new="mimicking an other's voice"/>no no you didn't <pause dur="0.2"/> you didn't say that you said something <trunc>el</trunc> <shift feature="voice" new="normal"/><pause dur="0.7"/> it's very difficult <pause dur="0.3"/> to hear what people say <pause dur="0.3"/> because very often <pause dur="0.4"/> you're expecting <pause dur="0.7"/> an answer <pause dur="1.3"/> and you get <pause dur="0.8"/> dragged <trunc>b</trunc> off by your expectation <pause dur="1.1"/> and practising listening to the story that patients <pause dur="0.2"/> really tell you <pause dur="1.4"/> is very important <pause dur="3.1"/> you have to overcome <pause dur="0.6"/> the barriers to disclosure <pause dur="2.0"/> they're always there <pause dur="0.8"/> they'll be worse for you <pause dur="0.2"/> when you're feeling insecure <pause dur="0.9"/> when you're only a first year medical student <pause dur="1.0"/> and you feel <pause dur="0.4"/> like this <pause dur="0.5"/> but even the most experienced doctor has to overcome <pause dur="0.3"/> barriers <pause dur="0.7"/> in order to be able to help <pause dur="0.6"/> as well as they can <pause dur="5.1"/> if i've got one message that i'm going to give you above all others <pause dur="0.5"/> it's <pause dur="0.8"/> to value the patient's contribution <pause dur="0.5"/> as equal <pause dur="0.6"/> to your

own <pause dur="1.4"/> in fact <pause dur="0.5"/> it's not just equal to your own it's probably <pause dur="1.7"/> everything <pause dur="4.6"/> and by the time <pause dur="0.3"/> you qualify <pause dur="0.6"/> we hope you will have the knowledge and the skills <pause dur="0.7"/> to process what the patient says <pause dur="1.6"/> to be able to make <pause dur="0.6"/> this magic thing called <pause dur="0.2"/> a diagnosis <pause dur="0.4"/> but more than that not just a label <pause dur="0.8"/> a real insight <pause dur="0.5"/> into that patient's world <pause dur="1.0"/> something that will make sense to them <pause dur="0.4"/> as well as you <pause dur="7.5"/><kinesic desc="changes slide" iterated="n"/> so you're going to be doing this <pause dur="0.4"/> by listening <pause dur="0.3"/> but also by questioning <pause dur="1.5"/> anybody know anything about questions <pause dur="1.5"/> anyone <pause dur="0.9"/> <kinesic desc="indicates member of audience" iterated="n"/> yeah </u><pause dur="1.1"/> <u who="sm0634" trans="pause"> # <pause dur="0.5"/> basically not to ask leading questions to keep them open </u><pause dur="1.1"/> <u who="nf0621" trans="pause"> brilliant <pause dur="0.6"/> yeah <pause dur="2.1"/> sounds very easy <pause dur="0.2"/> doesn't it not to ask leading questions <pause dur="0.5"/> but there are basically two sorts of questions <pause dur="0.2"/> there are closed questions <pause dur="1.1"/> these are ones that can be answered by yes and no <pause dur="1.4"/> things like <pause dur="0.2"/> do you have you are you <pause dur="3.6"/> and there are open questions <pause dur="0.7"/> which actually allow <pause dur="0.3"/> a

patient to answer in their own words <pause dur="1.4"/> they can't be answered by yes and no <pause dur="0.5"/> and they usually start with <pause dur="0.2"/> words like who <pause dur="0.6"/> what <pause dur="0.7"/> where <pause dur="0.7"/> why <pause dur="0.9"/> and when <pause dur="3.1"/> learning how to ask open questions <pause dur="0.7"/> to ask questions in a way <pause dur="0.3"/> that allow patients to answer <pause dur="1.2"/> the way they want to <pause dur="0.5"/> is actually quite difficult <pause dur="0.6"/> and <pause dur="0.4"/> in your groups <pause dur="0.6"/> you'll all say ooh i'm going to ask these open questions and then you find you open your mouth and you say <pause dur="1.6"/> do you think it's so and so and you've asked a closed question again <pause dur="0.6"/> and <pause dur="0.3"/> it's so easy <pause dur="0.9"/> to get into habits of asking <pause dur="0.3"/> these closed questions and you have to practise to <pause dur="0.4"/> to become better at it <pause dur="4.5"/><kinesic desc="changes slide" iterated="n"/> i've got these slides in the wrong order but we'll deal with it <pause dur="0.5"/> explaining <pause dur="6.4"/> giving a good explanation <pause dur="0.3"/> i haven't put any detail on the slide <pause dur="0.7"/> because at this point <pause dur="0.8"/> we're not going to be concentrating on <trunc>h</trunc> <pause dur="0.3"/> the precise nuts and bolts of how you do it <pause dur="0.9"/> but the essential <pause dur="0.2"/> is to be able to use the right language <pause dur="0.6"/> and that is a skill that you can practise <pause dur="0.9"/> being able to use the words that

patients <pause dur="0.2"/> understand <pause dur="0.5"/> and in the way that that patient understands it <pause dur="3.3"/> so you then can get a shared understanding <pause dur="3.3"/> and <pause dur="0.5"/> we teach you <pause dur="0.3"/> in order to get that shared <trunc>un</trunc> understanding <pause dur="0.2"/> you're going to use <pause dur="0.3"/> the patient's ideas <pause dur="2.1"/> the patient's concerns what's bugging them <pause dur="2.6"/> and their expectations <pause dur="4.2"/> and you'll be practising this <pause dur="0.4"/> by the time <pause dur="0.4"/> you get to the Clinical Methods course <pause dur="0.8"/> you'll actually know <pause dur="0.2"/> ideas concerns and expectations as ICE <pause dur="0.6"/> it will be something i hope <pause dur="0.5"/> that you'll be so familiar <pause dur="0.4"/> with thinking <pause dur="0.3"/> do i know their ideas do <trunc>n</trunc> i know what <pause dur="0.5"/> what they are worried about <pause dur="0.3"/> do i know what they want from us <pause dur="6.4"/><kinesic desc="changes slide" iterated="n"/> and responding <pause dur="0.6"/> what do you do when somebody bursts into tears <pause dur="0.7"/> what do you do when <pause dur="0.9"/> are there some useful things that you'll get used to <trunc>d</trunc> using <pause dur="0.3"/> things like <pause dur="0.2"/> tell me about <pause dur="2.5"/> tell me about encourages <pause dur="0.5"/> the narrative <pause dur="0.8"/> of a consultation <pause dur="0.2"/> it gets people talking <pause dur="0.4"/> it's a wonderful tool that experienced doctors use <pause dur="0.9"/> you don't usually tell your friends <trunc>t</trunc> <pause dur="0.2"/> tell me about this do you <pause dur="0.7"/> but it's

something that as a professional <pause dur="0.2"/> you'll learn <pause dur="2.5"/> reflection <pause dur="1.1"/> to be able to just <pause dur="1.0"/> repeat back <pause dur="0.2"/> something that a patient has said <pause dur="0.5"/> and not to feel ridiculous about it <pause dur="2.1"/> summarizing <pause dur="0.4"/> to take a long complicated story <pause dur="0.3"/> that a patient has told you <pause dur="0.5"/> and to create it into a nice neat whole <pause dur="0.4"/> so that they can check that you've got <pause dur="0.6"/> all the important data <pause dur="2.1"/> and empathizing <pause dur="1.6"/> how to say <pause dur="1.8"/> naturally <pause dur="0.2"/> easily <pause dur="1.0"/> i'm so sorry <pause dur="0.2"/> if somebody tells them <pause dur="1.1"/> you that <trunc>y</trunc> their father's died or <pause dur="0.3"/> something like that <pause dur="0.6"/> and to be able <pause dur="0.5"/> to feel comfortable about giving that empathy <pause dur="5.9"/><kinesic desc="changes slide" iterated="n"/> so these are all very practical things and me talking to you about them isn't going to help them happen is it <pause dur="2.4"/> so how does our DISC course here <pause dur="0.8"/> help you <pause dur="0.6"/> to develop these skills <pause dur="9.6"/><kinesic desc="changes slide" iterated="n"/> we start out <pause dur="0.6"/> with three seminars <pause dur="4.6"/> each of the seminars <pause dur="0.4"/> takes place here <pause dur="2.2"/> it's about an hour and a half long <pause dur="1.2"/> you'll be in small groups <pause dur="3.5"/> there'll be about ten of you <pause dur="2.0"/> and you'll have <pause dur="0.3"/> a G-P tutor <pause dur="0.3"/> with you in that group <pause dur="1.8"/> you'll also have <pause dur="0.5"/> a thing called a simulated patient <pause dur="4.1"/> we use

simulated patients quite a bit <pause dur="0.4"/> both in exams <pause dur="0.5"/> and in <pause dur="0.4"/> training <pause dur="2.2"/> and i know that there's a <pause dur="0.2"/> tendency for students to think oh it's only an actor <pause dur="1.0"/> well <pause dur="0.7"/> if you call a simulated patient an actor a lot of them get very offended <pause dur="1.0"/> but these are people <pause dur="0.4"/> who <pause dur="0.8"/> have an alter ego <pause dur="0.8"/> as a person who comes to see a doctor <pause dur="2.0"/> and they know how to be that person <pause dur="0.9"/> and they give you a chance to practise <pause dur="1.7"/> to dry run <pause dur="0.5"/> like going on a dry ski slope <pause dur="0.8"/> you know it's <pause dur="0.6"/> it's easier <pause dur="1.7"/> although it isn't easier <pause dur="0.2"/> when you actually try it you find it feels just like talking <pause dur="0.2"/> to any other patient and of course these are real patients <pause dur="1.0"/> often they have real illnesses <pause dur="1.5"/> but the advantage is <pause dur="0.7"/> that if you say the wrong thing if you laugh when they say my father died <pause dur="1.3"/> you won't have really hurt somebody <pause dur="1.1"/> in a way that can't be undone <pause dur="1.7"/> and if you find <pause dur="0.2"/> that the patient doesn't understand what you're going on about you can say <pause dur="0.2"/> ah i'm sorry shall we try that again <pause dur="0.8"/> and reel back like a videotape <pause dur="0.7"/> and have a <trunc>g</trunc> go using different words <pause dur="1.4"/> for us

experienced doctors we love having a chance to use simulated patients <pause dur="1.0"/> and <pause dur="0.6"/> we <trunc>f</trunc> we find that the work that we can do with them is immensely valuable to us <pause dur="4.3"/> but these seminars that you have are a chance to actually practise <pause dur="0.8"/> your first attempts at talking to patients <pause dur="0.5"/> in a safe <pause dur="0.2"/> environment <pause dur="2.0"/> it's also an environment where <pause dur="0.5"/> you can experiment <pause dur="2.2"/> it's often quite difficult to find out why the patient has come <pause dur="1.4"/> if you're in a group <pause dur="0.2"/> the group can give you ideas <pause dur="0.7"/> how you can ask <pause dur="0.3"/> the right questions <pause dur="0.6"/> to actually find out why <pause dur="0.3"/> these particular patients <pause dur="0.3"/> have come <pause dur="2.3"/> and they also enable you to be able to find out the background <pause dur="0.2"/> to the problems that the patients have <pause dur="0.7"/> at this stage we don't expect you to make medical diagnoses <pause dur="1.3"/> but it's never too <trunc>se</trunc> soon <pause dur="0.4"/> to start practising <pause dur="0.3"/> the actual nuts and bolts of talking to patients <pause dur="0.5"/> finding out <pause dur="0.2"/> what their story is <pause dur="0.5"/> why have they come to the doctor's today <pause dur="0.6"/> what is it they want <pause dur="0.3"/> what is the real problem <pause dur="2.1"/> those skills you need <pause dur="0.5"/> right from day one <pause dur="2.6"/><kinesic desc="changes slide" iterated="n"/> we then follow it

up with real patients because <pause dur="0.8"/> that's what life is <trunc>a</trunc> <pause dur="0.2"/> going to be about for all of you <pause dur="2.7"/> and you then have three sessions <pause dur="0.3"/> in the G-P practice of your group tutor <pause dur="0.4"/> so you will be with <pause dur="0.2"/> the tutor who's been with you in the seminars <pause dur="1.8"/> and you go out in pairs <pause dur="1.4"/> and you'll spend an afternoon or a morning <pause dur="0.5"/> in their surgery <pause dur="2.1"/> and you'll see real patients with real problems <pause dur="0.6"/> and even your tutor won't know anything about them because they'll come in and they'll have something new he <pause dur="0.3"/> and he won't know what it is <pause dur="3.1"/> and you'll be able to talk to them before any other doctor <pause dur="0.6"/> or nurse or anyone has actually spoken to them about this problem <pause dur="0.6"/> and have a go <pause dur="0.3"/> at finding out <pause dur="0.3"/> why the patient has come <pause dur="0.8"/> finding out the background to the problem <pause dur="2.0"/> and then <pause dur="1.0"/> as a pair <pause dur="0.3"/> you can think about the difficulties you find <pause dur="2.2"/> and you can learn to recognize <pause dur="0.6"/> what you do naturally easily <pause dur="0.5"/> and what you're going to have to work at <pause dur="1.3"/> and the most important thing here is that <pause dur="0.2"/> your G-P tutor <pause dur="0.7"/> is going to be giving you <pause dur="0.2"/>

feedback <pause dur="1.5"/> every time you talk to a patient <pause dur="0.9"/> your G-P tutor <pause dur="0.4"/> will be watching and listening <pause dur="0.2"/> to what you do <pause dur="0.7"/> and they will give you feedback <pause dur="0.6"/> on <pause dur="0.3"/> how you did it well <pause dur="1.2"/> what worked <pause dur="0.4"/> why it worked <pause dur="1.9"/> and they'll give you suggestions for things to try <pause dur="0.7"/> so it's not <pause dur="0.5"/> knock you feedback it's <pause dur="0.2"/> useful feedback <pause dur="0.9"/> and even more importantly at the end <pause dur="0.5"/> of the course <pause dur="0.2"/> they should give you some structured written feedback as well <pause dur="0.6"/> so that you can take that and put it in your portfolio <pause dur="0.9"/> and you've got a record of that work you've done <pause dur="5.5"/><kinesic desc="changes slide" iterated="n"/> so <pause dur="1.0"/> that structured written feedback how do we do it <pause dur="2.0"/> i'm going to rush through this bit <pause dur="0.6"/> because it's <pause dur="1.3"/> it's important but <pause dur="0.5"/> it's also something that probably not <pause dur="0.3"/> # <pause dur="1.1"/> you'll want to know all the details very at some stage but not here <pause dur="1.6"/><kinesic desc="changes slide" iterated="n"/> here we use a thing called <pause dur="0.5"/> we call it the LAP <pause dur="0.5"/> it's called the <gap reason="name" extent="1 word"/> Assessment Package <pause dur="2.4"/> this is the <pause dur="0.3"/> the assessment tool that's used in all the exams in the <gap reason="name" extent="2 words"/> Medical School <pause dur="0.9"/> and <pause dur="0.8"/> it's a way of measuring <pause dur="0.5"/> how you perform when you're talking to

a patient <pause dur="1.7"/> now </u><gap reason="break in recording" extent="1 sec"/> <u who="nf0621" trans="pause"> of you has got i hope <pause dur="0.5"/> a blue <pause dur="0.7"/> book <pause dur="0.4"/> a coursebook <pause dur="2.7"/> if you haven't got one don't fret now <pause dur="0.5"/> don't read it now <pause dur="0.4"/> just make sure you've got one <pause dur="1.1"/> in that book <pause dur="0.2"/> all the details <pause dur="0.5"/> of <pause dur="0.4"/> the assessment that's used <pause dur="0.6"/> for this <pause dur="1.8"/> is recorded <pause dur="6.2"/> and this tool <pause dur="0.3"/> with minor changes is used in all the OSCEs that you get <pause dur="1.6"/> it's used in your intermediate clinical exams that's halfway through your phase two <pause dur="1.7"/> it's used in the Clinical Methods course that we teach later on <pause dur="0.4"/> where you do <pause dur="0.5"/> two months <pause dur="0.9"/> hospital and general practice and <trunc>s</trunc> concentrated work on how you make diagnoses <pause dur="0.3"/> and how you make management plans <pause dur="1.3"/> and <pause dur="0.5"/> for you the important thing </u><gap reason="break in recording" extent="1 sec"/> <u who="nf0621" trans="pause"> assessment tool <pause dur="0.2"/> is how you will be measured in your final clinical exams <pause dur="1.2"/> so <pause dur="0.4"/> becoming familiar <pause dur="0.6"/> with this assessment package <pause dur="0.3"/> is useful to you <pause dur="0.4"/> and i'm going to briefly flick through <pause dur="0.3"/> the criteria <pause dur="0.3"/> that are used <pause dur="0.5"/> in the <pause dur="0.7"/> communication skills part <pause dur="0.4"/> of that

assessment package <pause dur="2.5"/><kinesic desc="changes slide" iterated="n"/> now <pause dur="0.4"/> we only <pause dur="0.3"/> look at what you do <pause dur="0.5"/> in two parts of talking to patients <pause dur="0.6"/> we're not going to be judging you on how you make a diagnosis <pause dur="0.5"/> at this stage <pause dur="0.5"/> but we do look at your behaviour and relationship <pause dur="0.6"/> with patients <pause dur="3.8"/> and your tutor will tell you whether you are <pause dur="0.3"/> maintaining a friendly but professional relationship with patients <pause dur="0.9"/> whether you are conveying sensitivity to the needs of patients <pause dur="2.7"/> and whether you are communicating <pause dur="0.5"/> an awareness that their attitude <pause dur="0.5"/> actually matters <pause dur="0.3"/> towards creating <pause dur="0.2"/> a shared <pause dur="0.5"/> approach <pause dur="2.4"/> you'll also <pause dur="1.1"/> be being judged <pause dur="0.3"/> or being given feedback on your interviewing and history taking <pause dur="0.6"/> skills <pause dur="0.6"/> and there are a lot of criteria here so i'll it's on to the next slide and it's a rather crowded slide and i apologize for that <pause dur="4.7"/><kinesic desc="changes slide" iterated="n"/> you're expected to become fluent at introducing yourself <pause dur="1.0"/> putting patients at ease <pause dur="1.7"/> allowing a patient to tell their story <pause dur="3.0"/> checking out words that the patient uses that you're not sure quite what that patient means <pause dur="0.7"/> so that

you don't get the sort of mismatches <pause dur="0.5"/> that happened in the Carry On film <pause dur="2.2"/> phrasing your questions simply and clearly <pause dur="2.1"/> being able to sit on your hands and shut up when needed <pause dur="2.4"/> finding out <pause dur="0.7"/> why the patient has come <pause dur="0.2"/> their ideas <pause dur="0.2"/> concerns <pause dur="0.4"/> and expectations <pause dur="3.8"/> and looking at the whole <pause dur="0.3"/> problem <pause dur="0.2"/> as it affects the patients <pause dur="0.4"/> not just <pause dur="0.3"/> their bodies <pause dur="0.7"/> that the whole of them <pause dur="0.3"/> as a <pause dur="0.3"/> a functioning individual <pause dur="0.4"/> in society <pause dur="0.4"/> in a family <pause dur="3.8"/> and although <pause dur="0.3"/> we do test <pause dur="0.2"/> on <pause dur="0.5"/> we tell you if you're getting the right sort of information <pause dur="0.4"/> in your questioning <pause dur="1.8"/> and we'll give you <pause dur="0.6"/> praise if you're well organized <pause dur="0.5"/> at this stage we don't expect <pause dur="0.3"/> people <pause dur="0.3"/> to be <pause dur="0.4"/> starting to get a really controlled <pause dur="0.2"/> history <pause dur="0.5"/> because <pause dur="0.9"/> it's <trunc>is</trunc> it's difficult <pause dur="1.1"/> it is a skill <pause dur="1.5"/> it's every bit as complicated learning to consult with patients as it is learning to drive <pause dur="1.9"/> and <pause dur="1.2"/> if it seems a bit daunting <pause dur="0.4"/> most of you have learned to drive by now <pause dur="0.6"/> in fact i hope all of you have <pause dur="0.8"/> but <pause dur="0.9"/> if you're feeling a bit daunted when you're talking to patients and

thinking it's difficult just remember how awful it was the first time <pause dur="0.3"/> you actually let the clutch out and it went <vocal desc="car stalling noise" iterated="y" dur="1"/> <pause dur="0.2"/> down the <shift feature="voice" new="laugh"/>road <shift feature="voice" new="normal"/><vocal desc="laughter" iterated="y" n="sl" dur="1"/> <pause dur="3.6"/><kinesic desc="changes slide" iterated="n"/> so where do we go from here <pause dur="1.3"/> the seminars are on Thursday afternoons <pause dur="3.1"/> the group dates and times <pause dur="1.7"/> will be on the noticeboards <pause dur="0.8"/> <gap reason="name" extent="1 word"/> are they <pause dur="0.2"/> actually on the noticeboards at the moment </u><pause dur="0.4"/> <u who="nm0625" trans="pause"> have to be up by Friday </u><pause dur="0.2"/> <u who="nf0621" trans="pause"> they'll be up by Friday <pause dur="1.6"/> so you will know <pause dur="0.2"/> who your G-P tutor is <pause dur="0.5"/> where they're based <pause dur="0.3"/> who else is in your group and what time your sessions are <pause dur="3.0"/> your tutor is going to be the G-P whose practice you will be visiting <pause dur="7.6"/> you can start visiting your G-Ps after the second <pause dur="0.2"/> seminar <pause dur="1.7"/> now <pause dur="0.5"/> the first first seminar is on the twenty-fifth of September so in about a week's time <pause dur="1.0"/> and the last <pause dur="0.2"/> third seminar is on the sixth of November <pause dur="0.3"/> so all of you should have been out <pause dur="0.3"/> to your general

practices <pause dur="0.3"/> sometime <pause dur="0.2"/> during the month of October or November <pause dur="0.8"/> and you then have until the following June <pause dur="0.5"/> to complete your three <pause dur="0.2"/> visits <pause dur="5.0"/> and <pause dur="0.5"/> please <pause dur="0.6"/> read your clinical skills workbook <pause dur="1.7"/> read it <pause dur="0.6"/> and read it <pause dur="0.7"/> and read it and don't lose it <pause dur="0.4"/> because you'll need it later on <pause dur="0.7"/> in your Clinical Skills <pause dur="0.3"/> module that starts <pause dur="0.4"/> in November <pause dur="0.6"/> as well <pause dur="2.7"/> have we got <pause dur="0.7"/> any questions or queries <pause dur="1.7"/> anywhere </u><u who="sf0635" trans="overlap"> are there any leftover workbooks </u><u who="nf0621" trans="overlap"> yeah we've got a wave over there <kinesic desc="indicates member of audience" iterated="n"/> <pause dur="0.2"/> one over there <kinesic desc="indicates member of audience" iterated="n"/></u><pause dur="0.4"/> <u who="sf0636" trans="pause"> are there any leftover workbooks down at the front 'cause there aren't any at the back </u><pause dur="0.2"/> <u who="nf0621" trans="pause"> there are two-hundred workbooks and there are slightly fewer than two-hundred students so there should be enough to go round yes <pause dur="1.3"/> some are going your way </u><pause dur="0.2"/> <u who="sf0636" trans="pause"> thank you </u><u who="nf0621" trans="latching"> any others <pause dur="0.4"/> short <pause dur="0.5"/> right <pause dur="0.6"/> if we all make sure that anyone who hasn't got one <pause dur="1.5"/> gets one before

they go <pause dur="6.6"/> yes <pause dur="2.2"/> now <pause dur="0.2"/> before you go <pause dur="1.4"/> before you go <pause dur="0.8"/> <trunc>l</trunc> <gap reason="name" extent="2 words"/> who's your administrative <pause dur="1.7"/> your <trunc>ad</trunc> <pause dur="0.3"/> the G-P <pause dur="0.2"/> undergraduate G-P administrator <pause dur="0.4"/> is going to introduce herself </u><gap reason="break in recording" extent="uncertain"/> <u who="nf0637" trans="pause"> i'm in room one-one-three <pause dur="3.1"/> and extension number seven-three-eight-o-eight <pause dur="6.4"/> okay our secretary is <gap reason="name" extent="2 words"/> <pause dur="1.1"/> she's in the same room <pause dur="0.3"/> and she's on extension seven-four-o-four-four <pause dur="3.4"/> # <pause dur="0.5"/> <gap reason="name" extent="1 word"/> put up here that attendance is compulsory i will know within an hour if you've not turned up at your practices <pause dur="1.2"/> okay <pause dur="0.5"/> # <pause dur="0.4"/> it's not <pause dur="0.9"/> acceptable to not be there if you know that you can't make it phone me in advance and let me know <pause dur="0.6"/> <vocal desc="clears throat" iterated="n"/> let your doctors know and it has to be <pause dur="0.6"/> <trunc>y</trunc> # # <pause dur="0.2"/> a good reason why you're not going to be there <pause dur="0.7"/> okay <pause dur="0.5"/> # other than that if you've got any issues any problems you can come and see me <pause dur="0.3"/> any time at the moment i have got hours posted on

my door <pause dur="0.5"/> but for the moment <pause dur="0.4"/> while you're sort of getting used to things come and see me any time you like <pause dur="0.2"/> thank you </u><u who="nf0621" trans="overlap"> right <pause dur="0.2"/> now <pause dur="1.6"/> <gap reason="name" extent="1 word"/> wants to have a brief word after me <pause dur="0.6"/> i just want to basically say <pause dur="0.6"/> <gap reason="name" extent="1 word"/> is in her office <pause dur="0.9"/> most of the time <pause dur="1.1"/> nearly always <pause dur="0.2"/> if you've got a problem with any of this part of the course <pause dur="0.3"/> she's there <pause dur="0.3"/> and <gap reason="name" extent="1 word"/> <pause dur="0.8"/> if <trunc>y</trunc> <pause dur="0.3"/> if <gap reason="name" extent="1 word"/> isn't there <gap reason="name" extent="1 word"/> is <pause dur="0.3"/> and they are <pause dur="0.2"/> fantastic they <pause dur="0.6"/> you know they really do help and they help us as well <pause dur="0.8"/> so <pause dur="0.3"/> you'll you'll all get to know her really well by the end <pause dur="0.8"/> from my point of view that's the end of the lecture <gap reason="name" extent="1 word"/> wants to have a quick word but <pause dur="0.4"/>

thank you very much for being so <pause dur="0.4"/> quiet and listening <pause dur="0.2"/> thanks <kinesic desc="applause" iterated="y" n="ss" dur="6"/> </u><pause dur="7.1"/> <u who="nm0622" trans="pause"> i i <trunc>ju</trunc> just wanted to say enjoy very much being at <gap reason="name" extent="1 word"/> University and the medical school for the next four years <pause dur="0.6"/> if you do have any problems or concerns now you've met us all i'm sure we'd be <pause dur="0.2"/> all very happy <pause dur="0.4"/> to <trunc>an</trunc> <pause dur="0.2"/> to answer any queries that <pause dur="0.3"/> you may have <pause dur="0.4"/> # <pause dur="0.4"/> the next lecturer Dr <gap reason="name" extent="1 word"/> <pause dur="0.2"/> has suggested i think quite rightly <pause dur="0.3"/> you have a break for the next three or four minutes just to stretch your legs <pause dur="0.6"/> outside and then please come back in the lecture theatre in the next <pause dur="0.2"/> five minutes thank you very much

</u></body>

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