Exploring communication and consent – Regional Communications Network

A CPD exercise by a group using a fictitious case scenario helps participants share experience and ideas for managing a difficult patient encounter.

Summary

The GOsC holds regular meetings with representatives of the various regional osteopathic groups. As part of an update on the new CPD scheme, a presentation was given on planning a CPD session with the aim of enabling those attending to consider how they might, in turn, set up a CPD event for their members. As an example of the type of session that could be run, the participants were split into groups, and asked to consider a case scenario.

Planning

The session involved some preparation. A presentation was prepared which looked at elements of trust in the therapeutic relationship, and patient expectations. A case scenario was devised which showed how a communication issue could arise, which led to a complaint being made to the practice by a patient. A report had also been prepared, highlighting resources available on the o zone in the area of consent and communication, as well as external resources which osteopaths are able to use (similar to that contained within this document). In addition, and overview was prepared of the Montgomery judgment made by The Supreme Court in 2015, as this effectively changed the law relating to informed consent.

What did they do?

The session started with an overview of issues affecting trust, and expectations of patients. These were based on research, available on the o zone. The session was interactive with participants able to offer answers to questions posed. Next, the group looked at patients’ values, and how these might influence decisions regarding clinical practice. Participants were invited to consider a thought experiment to illustrate how patient’s choices might be affected and influenced by their individual circumstances. This discussion led into a presentation regarding the Montgomery judgement, and how this had changed the law regarding informed consent. Participants were split into groups of four, and asked to consider a case scenario. They were asked to analyse the case, and offer their perspective on what had happened, how it could have been avoided, and what advice they would give to the osteopath concerned. This was then discussed further as a whole group.

What did the participants learn?

Participants had the opportunity to learn about the Montgomery judgment and its effect on the law relating to informed consent. The main aim was to illustrate how they could plan similar events themselves for their regional group members, although there were plenty of active and useful discussions taking place regarding the case scenario and how this could have been managed. The resources report provided an overview of resources available regarding consent and communication to help with planning future events.

What were the concerns/barriers, and how were these overcome?

For anyone using a case scenario to prompt discussion, there is concern as to how to pitch the level appropriately for what can be a group with varied levels of experience. The case used here seemed to provoke plenty of discussion amongst the groups, with engagement from all participants, whatever their experience. We asked participants to consider how they would advise the osteopath in the scenario, which gave them the opportunity to step back and think how they would advise a colleague in these circumstances, rather than just thinking about what had ‘gone wrong’. This made it more of a positive exercise about enhancing practice, rather than a purely critical one.

How long did it take?

The session took about an hour, though this was in the context of lots of other presentations occurring on the day, and therefore time was limited. The idea was to use the session to illustrate to the regional groups the type of sessions that they could run themselves for their own members or colleagues. With more time for discussion and broader feedback from each of the groups, 1.5 to 2 hours would be ideal.

Would you do it again?

We would do a similar activity again, though the aim, as mentioned above, was more to illustrate to participants how they might consider designing and running a session themselves on consent and communication. Using case scenarios as a means of exploring issues around consent and communication can be a useful exercise in any size group.