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#8 The Communication and Ethics Short Case - Format, Common Situations, Consent, The Pillars of Medical Ethics ⚖️
In this episode we talk through the structure and how to prepare for short case station 1 , the Communication and Ethics station, one of the most failed stations outside of candidates who sit their exam outside of Ireland.
Sign up to Pastest MRCP Clinical revision resource via our affiliate link below:
https://www.awin1.com/cread.php?awinmid=46017&awinaffid=1651835&campaign=MRCPi+Bedisde&ued=https%3A%2F%2Fwww.pastest.com%2Fmrcp-part-1%2F
The cases will include communication scenarios relating to:
Information giving–example: discussing of treatment options with a patient with sexually transmitted infection, MRSA. SLE communication
Breaking bad news – example: telling a person her husband died, or telling a patient they have cancer, their father was given too much methotrexate (daily instead of weekly) and now has neutropenic sepsis, intracranial bleed post thrombolysis now GCS 7 post same - explain to daughter, drug error
Consent – example: obtaining consent for treatment from a patient with a mild cognitive impairment
Confidentiality–example:maintaining confidentiality under pressure from family members
Managing challenging situations – example: discussing organ donation with next of kin of a ventilated patient who has an organ donor card in her pocket but the next of kin objects because it is against his/her religion, paracetamol overdose wanting to DAMA, counselling poorly controlled T1DM, verbally de-escalating an angry patient who wants to leave the ward who may not have capacity
Ethics – example: telling a colleague that you need to report their drug abuse as they are unsafe to continue to practice
As mentioned the SPIKES mnemonic as a potential tool for working through communication stations:
S - Setting - how can you optimise the setting? e.g. A family member being present for support, ideally a quiet private place etc.
P - Perception - clarifying what is the patient or family member's current perception of events to date?
I - Invitation - inviting the patient or family the opportunity to say how much or what exactly they want to know
K - Knowledge - giving the knowledge or information you need to deliver
E - Empathy - Displaying empathy throughout the consultation
S - Summarise for the patient or the family what you have discussed and offer the opportunity for the to ask questions
The 4 pillars of Medical Ethics:
1. Autonomy - respecting a patient's right to make their own decisions
2. Beneficence - Making decisions to benefit the patient
3. Non-maleficence - Do no harm to the patient
4. Justice - fair allocation of time and resources for all patients' benefit
Click here for the RCPI MRCPI Clinical Info and Resource page
The Irish Medical Council's Guide to Professional Conduct and Ethics for Registered Medical Practitioners PDF
https://www.medicalcouncil.ie/news-and-publications/reports/guide-to-professional-conduct-and-ethics-for-registered-medical-practitioners-amended-.pdf
Get in touch with us at [email protected] or via our socials Twitter and Instagram @mrcpibedside
Show music: Stepping on Lego. Instagram @steppingonlego_
Forward any enquiries to [email protected]
Consultant Lead: Professor Declan Byrne, Consultant physician in general internal and geriatric medicine at St. James Hospital, Dublin
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By Dr Christine Condon and Dr Harry EconomosIn this episode we talk through the structure and how to prepare for short case station 1 , the Communication and Ethics station, one of the most failed stations outside of candidates who sit their exam outside of Ireland.
Sign up to Pastest MRCP Clinical revision resource via our affiliate link below:
https://www.awin1.com/cread.php?awinmid=46017&awinaffid=1651835&campaign=MRCPi+Bedisde&ued=https%3A%2F%2Fwww.pastest.com%2Fmrcp-part-1%2F
The cases will include communication scenarios relating to:
Information giving–example: discussing of treatment options with a patient with sexually transmitted infection, MRSA. SLE communication
Breaking bad news – example: telling a person her husband died, or telling a patient they have cancer, their father was given too much methotrexate (daily instead of weekly) and now has neutropenic sepsis, intracranial bleed post thrombolysis now GCS 7 post same - explain to daughter, drug error
Consent – example: obtaining consent for treatment from a patient with a mild cognitive impairment
Confidentiality–example:maintaining confidentiality under pressure from family members
Managing challenging situations – example: discussing organ donation with next of kin of a ventilated patient who has an organ donor card in her pocket but the next of kin objects because it is against his/her religion, paracetamol overdose wanting to DAMA, counselling poorly controlled T1DM, verbally de-escalating an angry patient who wants to leave the ward who may not have capacity
Ethics – example: telling a colleague that you need to report their drug abuse as they are unsafe to continue to practice
As mentioned the SPIKES mnemonic as a potential tool for working through communication stations:
S - Setting - how can you optimise the setting? e.g. A family member being present for support, ideally a quiet private place etc.
P - Perception - clarifying what is the patient or family member's current perception of events to date?
I - Invitation - inviting the patient or family the opportunity to say how much or what exactly they want to know
K - Knowledge - giving the knowledge or information you need to deliver
E - Empathy - Displaying empathy throughout the consultation
S - Summarise for the patient or the family what you have discussed and offer the opportunity for the to ask questions
The 4 pillars of Medical Ethics:
1. Autonomy - respecting a patient's right to make their own decisions
2. Beneficence - Making decisions to benefit the patient
3. Non-maleficence - Do no harm to the patient
4. Justice - fair allocation of time and resources for all patients' benefit
Click here for the RCPI MRCPI Clinical Info and Resource page
The Irish Medical Council's Guide to Professional Conduct and Ethics for Registered Medical Practitioners PDF
https://www.medicalcouncil.ie/news-and-publications/reports/guide-to-professional-conduct-and-ethics-for-registered-medical-practitioners-amended-.pdf
Get in touch with us at [email protected] or via our socials Twitter and Instagram @mrcpibedside
Show music: Stepping on Lego. Instagram @steppingonlego_
Forward any enquiries to [email protected]
Consultant Lead: Professor Declan Byrne, Consultant physician in general internal and geriatric medicine at St. James Hospital, Dublin