ABSTRACT
Both clinical experience and seniority in the organisation are likely to lead to requests for consultation in the hospital setting. Consultation skills can be developed by attending one of the growing number of consultation courses now offered. One can also gain familiarity with some of the associated skills through clinical work and in the course of accepting new referrals. A few examples of consultation exercises have been listed below. These exercises are based on situations which we have dealt with or set up in the course of our ‘progression’ towards becoming internal consultants. They are mostly exercises which can be initiated in the course of one’s work and do not require special training sessions or too much extra time with patients or colleagues. The exercises are best tackled with a colleague, with whom one can develop and share ideas. In addition, colleagues can act as consultants to one another in the course of managing some of the problems that may arise in the course of tackling some of the exercises.
The next time a clinical case is referred to you, arrange to spend five or ten minutes with the referrer in order to discuss;
what he/she expects of you in relation to the case
what feedback he/she would find helpful.
Arrange a joint meeting between yourself and one of your main referrers in which you see a patient/client/family together. Define it an opportunity for you to learn from him or her. Use some of the post-session review to discuss a few advantages and limitations of working together over some cases.
In the absence of having a team to help you in your consultation work, describe at least two other views of the problems you identified and consider how you might present these to your consultee.
How would you describe the difference between consultation and liaison to a trainee?
In reviewing a case; what one thing in each case would you have had to do differently in order to be seen to be more
* prescriptive ?
* judgmental ?
Assume that you have been asked by your line manager to offer a consultation to a group of junior members of staff. How might you go about this in relation to
* the line manager?
* the group to whom you are expected to consult?
Discuss with a colleague some of the advantages and disadvantages of only undertaking consultation work or only practising as a clinician.
Practice consultation interviewing skills with a colleague with whom you have arranged to discuss a clinical case. After ten minutes ask your colleague to tell you what he or she found helpful and unhelpful in your interview and to comment on your interviewing style. Swap over roles so that you can experience being consulted to and after feedback to your colleague. Then consider how you might conduct a consultation interview as a team with another member of your department or unit as a consultee.
