Person centred practice is the second enhance explore module. It is designed to be completed in FY1, but you are welcome to do it at any time in your training.
Too often in the healthcare system, patients are not listened to. We can sometimes get hung up on guidelines and protocols, instead of doing what our patients actually want. With ever increasing numbers of treatment options available, it is essential that we provide patient centred care. Research shows that this is both safer and more effective. By speaking to people about their wishes we can also reduce unnecessary tests and use resources more sensibly.
We all understand that the care we provide should be patient centred, but in the highly pressurised NHS this can sometimes be difficult. This module is designed to help you build skills in this area that you can apply to your everyday practice.
This module will help you to empower patients and provide care that is personalised to them. It will help you understand the principles around shared decision making and how to put these into practice. It will also look at communication strategies you can employ when interacting with patients to enable them to take a greater role in their care.
Like the other modules in the enhance explore programme, this is designed to be completed in around six hours. Some people may find a particular area interesting and want to take longer, but this is not compulsory.
Resources
This a is a list of resources, divided by the main outcomes of the module. We have tried to keep them as varied as possible, and you will find articles, eLearning, videos and podcasts that are relevant to the domain.
You can pick the resources that interest you most, and you are more than welcome to find your own too! If you find something that you think would be helpful to share, feel free to let us know here.
Module Basics
– The Enhance Guide for Foundation Doctors (15 minute read) gives an excellent overview of the Enhance programme with links to other useful resources
– The Enhance Handbook (13 minute read for section) is an in-depth document that gives an overview of the whole programme, along with describing the six enhance domains in detail. You can access individual sections or a PDF of the whole handbook via this page
– The module workbook (10 minute read)
– The pre- and post- module self assessment matrix (2 minute read)
– The evidencing engagement form (2 minute read)
– The REAL form is now on the Horus ePortfolio, accessed here
Patient autonomy and shared decision making
– Why I’m afraid to grow old (14 minute watch) is an engaging TEDx video from a rehabilitation physiotherapist about making patient centred decisions
– National Voices “I” statements (5 minute read) are resources that were created with patient groups an provide an expression of how patients would like to be treated. There are further sections and a video if you want to learn more
– Shared decision making (30 minute eLearning) is a free course from the personalised care institute that covers the basics of shared decision making in an easy to follow interactive eLearning package
– Core skills in personalised care (60 minutes eLearning) covers the basic tenets of personalised care and how you can employ these in your work
– Personalised care as a junior doctor (30 minute eLearning) aims to educate junior doctors about the principles of personalised care and its relevance to their practice. It will discuss how they can effect changes in their workplace to treat patients more effectively
– Teachback method for shared decision making (17 minute video) is as an evidence based technique for clinicians to use during consultations to ensure that patients understand the information they have been given. It is particularly useful for people with low health literacy. This video will help you use teachback in your everyday practice
– Person centred approach (2 hour eLearning) this eLearning breaks down how to take a person centred approach to care, along with examples and quiz questions
– Making person centred care a reality (8 minute listen) is a recording from Clenton Farquarson, a long term NHS user about approaches needed to provide patient centred care
Communication and consent
– BMA core ethics guidance (26 minute read) covers a variety of ethical dilemmas and how to approach them. Section 3 covers consent specifically and provides a simple overview of the law
– Principles of consent (1 hour eLearning) covers the basics of consent using videos and eLearning slides
– How to calculate treatment risks and help patients make informed decisions (30 minute eLearning, BMJ login required) is a mainly audio module on communicating risk to patients
– Communication skills (1 hour eLearning, BMJ login required) eLearning that covers communication skills to help you reach a diagnosis, explain treatment, break bad news, and communicate with your peers
– Handling and responding to difficult conversations (48 minute video) talks about recognising trauma and how to approach challenging discussions with our patients
– Managing conflict (58 minute video) this video discusses the reasons for conflict, how to reduce it and the idea of ‘courageous conversations’
– All Our Health trauma informed practice (20 minute eLearning) this is the website for the All Our Health programme. It discusses various non-clinical factors that can affect patient care. The trauma informed practice module gives a basic overview of what this is and how it can aid patient care. You can find the link at the bottom of the page
– How far can empathy go (10 minute watch) is a brief TEDx video that discusses empathy in difficult situations
Patient safety
– Patient safety level one (various) is an ELFH resource that outlines the essentials of patient safety for healthcare practitioners
– “Just a routine operation” (14 minute video) is a film made about Martin Bromiley, whose wife died during routine sinus surgery. He is a pilot with a special interest in human factors. He discusses the lessons learned from his wife’s case
– Patient stories (various videos) uses videos and broadcast media approaches to discuss patient experience and safety issues in healthcare
– #AskHowIAm (5 minute read) is a handy infographic from National Voices on ensuring you centre wellbeing in consultations with patients with long term conditions
– #AskHowIAm information for patients (5 minute read) is a leaflet for patients that talks about emotional wellbeing in the context of long term conditions
When things go wrong, what part should we play (18 minute watch) is a TEDx talk about medical error and not individualising blame. It also discusses the role of race in GMC complaints
Healthcare within a community
– Family dynamics affecting discharge (30 minute eLearning) explores the challenges around discharge that stem from social and family circumstances
– Seeing the whole picture (20 minute eLearning) is an eLearning package that looks at non clinical factors in patient discharge
– The population wellbeing portal (various resources) has a huge number of resources that look at community care. They are created in conjunction with the society of public health. Modules found here would be useful for all domains
– What is social prescribing? (12 minute read) is a good explainer from the Kings Fund of what social prescribing is and the evidence for its use
– All Our Health social prescribing (20 minute eLearning) gives another bite sized explanation of social prescribing. You can find the link at the bottom of the page
– Love, care and hard work: life as an unpaid carer (32 minute podcast) is a short listen about the experiences of a couple who care for others. It can also be found on Spotify and Apple podcasts
Other
– The module resource area (various websites, podcasts and apps) has a selection of materials on person centred practice