nf0621: welcome [4.7] today [1.1] we're talking about [0.9] communication 
skills [2.3] it's the core part [0.7] of what you learn [0.6] if you want to 
become [0.2] a doctor [2.5] ninety-five per cent [0.2] of doctors [0.5] spend 
most of their days [0.7] talking to people [1.0] one way or another [1.8] 
ninety-eight per cent of doctors [1.0] have to be able to consult [1.6] even if 
you're a pathologist you have to talk to the relatives of the people you cut up 
[2.1] and you have to be able to talk to other doctors as well [1.7] so this is 
absolutely [0.3] crucial [1.0] now one of the first things about communication 
skills that we teach you all [0.2] is that first of all [1.2] you should 
introduce yourselves [0.4] and so [1.6] we're going to introduce ourselves [0.
7] because in the next few years you're going to become [0.2] fairly familiar 
[0.5] with all these names [0.6] that are [0.4] in front of you here [1.5] and 
we thought we'd give you this opportunity to find out [0.4] who we are [0.9] 
and we're all going to introduce ourselves [0.3] to you so that [0.7] all of 
you will be taught by us [0.8] probably most of us [0.4] before you qualify [0.
9] even if not directly in 
the next few months [0.9] so we thought you'd like to know who we are [1.5] so 
[0.9] this is our [0.5] Department of Undergraduate G-P Education at the moment 
[0.2] we have two senior lecturers [0.2] namex and namex [1.3] and [1.1] as of 
[0.9] two weeks' time we have ten [0.5] part-time G-P lecturers [0.9] all of us 
are [1.7] more than half-time more than two-third time G-Ps [0.9] in the week 
[0.6] and [0.6] all of us [1.0] spend most of our time [0.3] actually at the 
coalface [1.7] so if my [0.3] people could come up [0.2] please [1.0] and [0.5] 
we'll let namex [2.1] now [0.8] the most important members of our team as far 
as you're concerned [0.4] are [1.2] namex who's our undergraduate administrator 
[1.5] and namex [0.3] her assistant who's i think officially called the 
secretary [1.6] these two ladies [0.7] are [0.6] the heart of our department [0.
6] and they run everything and you will be going to see them and phoning them 
[0.9] lots and lots [1.6] [laughter] but now [0.3] namex [0.6] all yours [3.1] 
nm0622: i'm the director of G-P Undergraduate Medical Education at namex 
Medical 
School [0.3] and we're all [0.3] members of the Department of [0.5] 
Undergraduate General Practice Education [0.9] namex asked us to give [0.2] er 
an amusing theme about ourselves and [0.2] a message therefore about 
communication [0.8] my wife says that my interest in cricket has become an 
obsession [0.5] and this is myself actually [0.4] on a very rare occasion [0.4] 
going out [0.2] to bat [0.9] and i wanted my communication [0.4] theme to er 
surround [0.7] cricket because [0.3] to be successful in cricket [0.5] requires 
[0.2] teamwork [0.5] it can't be [0.6] a solo [0.3] effort [0.7] and if you 
think of the team it's more than just [0.4] the players [1.1] if you make the 
analogy with [0.2] you as doctors in the future you're going to be the major 
players [0.4] in the N-H-S but there are a lot of other players as well [0.7] 
there's the ground staff [0.6] the umpires [0.2] the scorers the fixture 
secretary publicity [0.6] those who make the teas [0.4] and many others so 
there are many others in the N-H-S team [0.4] as well as doctors [0.9] and 
we'll all have different skills which namex's just alluded to some of us may be 
pathologists some of us may be [0.5] G-Ps so 
similar to the cricket team there are those that are good at batting [0.4] some 
at bowling some at fielding [0.9] but [0.3] success is not through individuals 
[0.2] for us to be successful we've got to communicate [0.9] and [0.6] thinking 
particularly of the university we have teamwork in teaching that's why [0.3] 
we're introducing ourselves as a team [0.3] in order to make it a success we've 
got to communicate [0.7] for you as students during your four years to be 
successful [0.3] you've got to be able to communicate [0.5] both as pairs and 
within groups during seminar work [0.4] particularly in relation to problem 
based learning [0.8] that requires teamwork [0.7] and similarly when you go 
into practice [0.3] people don't work on their own nowadays they work in teams 
both in the community [0.6] and in hospital [0.7] so effective teamwork depends 
on good communication to enable mutual understanding of needs [0.5] whether on 
[0.2] or off the field [0.7] so the amusing bit for me is [0.4] i have the long 
walk out from the pavilion on to the [laughter] 
cricket square [0.4] a relatively short time [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 [0.7] and then unfortunately [0.4] the long walk [0.
3] back to the pavilion [laughter] [1.6] pass on to [0.2] namex 
nf0623: thank you [0.6] er i'm namex's sort of other half in the academic 
department in that er i'm codirector [0.6] er [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 [0.7] er [0.9] i've been here since January [0.2] er [0.4] and i was 
at U-C-L prior to that er [0.4] my major interest is obviously in communication 
and consultation skills [0.5] er which is also a research interest for for many 
years i was head of the international unit which is [0.4] involved in primary 
care development projects abroad [0.5] er [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 [0.2] 
for me to the U-K which i use in my daily 
practice [0.7] er [1.6] these projects are quite expensive and it's led me to 
reflect on [0.5] er looking at what we've actually done whether we've actually 
done anything in fact for the patients er in terms of primary care development 
[0.6] and i've been looking at patient centred instruments er which is a 
research interest i [0.3] intend to pursue [0.5] er along with a little bit of 
international work that that i'm doing here [0.7] er so hopefully er you'll see 
more and more of that as as the course progresses [0.2] thank you 
nf0621: okay here you are namex we'll leave it there [0.4] 
nm0624: okay [2.0] [laughter] well will the miracle happen when i need to press 
it 
nf0621: yeah [laughter] [0.2] 
nm0624: yeah 
nf0621: yes it will 
nm0624: okay thank you [0.2] er my name is namex [0.2] and er i'm one of the 
part-time lecturers here [0.7] 
yes i do believe in miracles er because for one [0.2] i became a doctor [0.6] 
er [laughter] [1.4] if i can do it [0.2] i think anybody can [1.1] [laughter] i 
mean clearly er talking about communication skills i mean that's the theme [0.
6] er you [0.2] obviously have some [0.2] attributes in communication because 
that's what we test in the interview [0.9] but [0.5] the course is [0.4] and 
our aim is [0.6] in particular [0.2] to develop some of those attributes [0.5] 
and fine tune them so that you become very successful doctors [0.9] right [1.9] 
now [0.3] miracles do happen and one of them happened to me very recently [0.2] 
i was on holiday in Toronto [0.8] and after twenty-five years i met a drinking 
partner [0.8] [laughter] now can you believe [0.3] that two people could be 
attending [0.4] two different [0.5] weddings in at the same venue [0.6] and be 
outside the hall at the same time [0.4] across the road [0.8] so a very 
quiet [0.4] sort of [0.2] voice says namex [1.0] and i thought nobody knows me 
here so i ignored it [3.4] [laughter] a slightly louder one came namex [0.8] 
and there was a guy smiling across the way [0.8] and it made my day i have to 
say it made my year i suppose [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 [0.3] and relationships are very important for G-Ps [0.3] thank 
you 
nm0625: i'm namex i'm a G-P in er [0.2] namex [0.9] and as as namex's sort of 
outlined [0.6] er you'll come across me both in the Communication Skills module 
which is what you're doing in this phase one [0.7] and then later [0.7] er we 
get involved in Clinical Methods which again is er departmental [0.8] and 
practice based [1.1] the reason i've sh-, [0.5] selected this slide to show you 
is is partly to illustrate that we do have 
lives [0.6] outside this building [0.5] but also to er [0.6] sort of highlight 
that communication is not always verbal [1.3] and it is important to be able [0.
4] to recognize and appreciate non-verbal communication [0.8] er [0.2] and also 
recognize that different things [0.3] mean different [1.0] er [0.5] different 
things depending on the circumstances that [0.2] that you find yourself in [0.
5] i mean does does anybody here go diving or [0.3] scubaing or [1.5] so the 
people who don't what [0.2] i mean the message there is [0.2] 
sf0626: go up [0.6] 
nm0625: go up yes [0.2] er [laugh] [1.1] not having a great time [0.7] 
[laughter] which is [0.7] more represented by that [0.8] [laughter] okay [0.5] 
thank you 
nf0627: first er bad communication error is i work in namex not in namex so 
[laughter] 
nf0621: i'm sorry 
nf0627: i apologize for that 
nf0621: 
oh that's my fault 
nf0627: [laughter] don't worry [0.4] 
nf0621: er 
nf0627: i was going to say the should we put the [0.2] the photograph up at 
this stage [1.5] now this will give you a laugh [0.2] [laughter] [0.6] the [0.
2] [laughter] 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 so [laughter] [0.4] it 
is actually me er a hundred years ago [0.3] [laughter] on my wedding day [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 [0.4] er so now i [0.
3] then i was a medical student and getting married [0.3] now i'm [0.4] a [0.2] 
daughter still [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 [0.4] it's quite possible [0.5] and i thought when i looked at that if you 
look at the eyes and it my me-, my communication message is eye contact is 
really important [0.4] and if you look at my eyes i'm looking in the right 
direction [2.3] [laughter] and i and i think that is the story of my life 
[laughter] i really do 
ss: aah 
nm0628: hello i'm er i'm namex [0.6] this here [0.3] is my little new daughter 
namex who's now sixteen weeks old [0.4] 
ss: aah 
nm0628: and that was the day she was born there [laughter] [0.5] so er [0.5] i 
was just about i'm [0.9] i just er wanted to illustrate some non-verbal 
communication can anybody what 
what's [0.3] what am i thinking here do you reckon [0.6] [laughter] oh by the 
way that is my wife not [laughter] [0.5] can anybody read what my face is 
thinking there i this is why i use this i think [0.3] 
sm0629: well it's how did we both get into the same shirt [0.2] 
nm0628: yeah [laughter] it's it's it's very sad isn't it [4.2] y-, yeah it it's 
especially with my size as well [laughter] isn't it [1.6] yeah any any other 
offers [laughter] [2.6] it's a mixture of extreme p-, pride and absolute terror 
if you notice [laughter] the sort of [0.5] a grimace on my face as well so er 
[0.4] anyway this is what actually happens to you if you have a kid [0.9] 
[laughter] 
ss: 
aah [0.6] 
nf0621: so there's Homer Simpson i A-K-A me with little namex [0.4] absolutely 
blotto on my lap it's absolutely knackering but er [0.8] [laughter] but anyway 
that's me er i am a human being [0.3] er by the way the way not to get a 
stomach like that is not to put a stone a year on in medical school [laughter] 
that's what i did [1.1] it's it's mainly the curry every night after the beer 
avoid it like the plague [laughter] but er [0.6] but anyway i'm a G-P in namex 
up the road a little village and one of the part-time lecturers here and i 
teach mainly the commu-, er the [0.4] Clinical Method course a little bit later 
on so [0.4] you'll be coming across me so it's nice to meet you all and i'll 
pass on thanks a lot 
nf0621: this is me [1.4] and [0.2] i thought i wasn't going to overload it with 
too many er bytes [0.4] of information so [0.9] i just [laughter] thought we'd 
er [5.6] we'd go 
back to the [0.3] necessity for verbal skills in consultation [0.7] and just to 
remind you [2.3] and now 
nf0630: i'm namex [0.2] i'm the only [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 [laughter] 'cause i am quite short [0.6] er [0.4] as it 
said i'm a G-P in namex as well which probably a lot of people have just moved 
to namex and you don't know where it is [0.4] it's actually the little village 
outside namex which is very famous obviously for a chap who used to write plays 
and things [0.5] er and he's also very famous [0.2] er for acting so i thought 
it was only fair [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 [laughter] when you come and whinge to me about having to do videos 
just bear in mind what i've had to go through to do this [0.2] okay 
nf0621: 
right [0.4] our next lecturer [laughter] [1.7] 
nm0631: hello [0.9] er my name's namex i'm a G-P in south namex at a place 
called namex and which is why i was a bit late so i apologize for that [0.6] 
that's me [1.5] [laughter] er [0.7] i don't really have any teaching points 
about that i just thought that was quite sweet [0.5] [laughter] although i 
guess er [1.0] if there is anything to learn about it it's if you do have any 
bad habits er [0.4] try and lose them as early as possible 'cause i'm still 
suffering from my family affliction [0.6] [laughter] of supporting er 
Wolverhampton Wanderers and as [0.4] [laughter] you might know er [0.6] they're 
appalling [0.6] [laughter] so er that's all i've got to say really [0.2] 
[laughter] 
nm0632: 
hi my name is namex as you can read [laughter] [0.5] er [0.2] basically i've 
been appointed recently as a lecturer here so i've not had all the [0.6] er 
experiences all these lecturers who [0.2] managed to [0.3] er get these 
fantastic slides [0.6] but basically when i was studying for my M-R-C-G-P 
that's what i looked like [0.5] er and just to let you know that if you're 
getting really [0.5] er pissed off with doing intensive study for medicine [0.
2] [laughter] then you can produce a child like that which is [laughter] what i 
did afterwards thank you [laughter] 
nm0633: 
hi m-, my name is namex i've got B but [0.4] probably in future i'll get a O-B-
E or M-B-E [laughter] but that's an [1.1] that's an example of er [0.5] 
communication [0.8] i [0.2] haven't put my slides or anything there because 
Powerpoint is always a distraction and er i'm trying to [0.8] provide a kind of 
a visual communication [1.0] [laughter] so they can look at me [2.4] [laughter] 
and i for a long time i was at the other end of er [0.4] er [0.7] the [0.5] 
where you were sitting and listening to other people but i'm just r-, i've just 
recently joined as namex as a lecturer here [0.6] and i'm a G-P in er namex [0.
8] okay [0.3] thank you [laughter] [3.6] 
nf0621: okay so now you know who we all are [1.2] and a little bit [0.8] about 
it [2.4] so [0.5] i thought we'd get ourselves back to the basics [1.1] of this 
[1.5] and er [2.3] the first thing to know [0.3] is [2.0] that this bit of the 
course is part of your Clinical Skills module [2.1] don't worry about writing 
things down [1.2] nothing there are no 
notes to be taken from this lecture [1.4] okay [1.9] it's a practical course 
it's not theoretical [1.2] there is no knowledge to be learned [2.3] it's 
taught [0.2] by practising doctors [2.2] with simulated [0.3] and real patients 
[1.6] communication skills are skills [0.2] and you can't learn skills by 
writing about them [0.5] you can write about Beethoven's piano concerto [0.3] 
till the papers are this big [0.2] you can talk about it [0.4] till people's 
ears drop off [0.2] and it will not let you be able to play it [0.6] to be able 
to play it [0.3] you must [0.7] play [1.2] again [0.9] and again [1.1] and so 
this is not for you to write and us talking about it [0.4] that makes you think 
[0.7] that the real learning [0.3] happens with the patients [1.6] so [0.5] why 
[0.3] teach [0.8] communication 
nf0621: [0.6] well [1.1] i like that because [0.2] it's got so many [0.5] 
examples [0.3] of communication cock-ups [3.1] later on when you watch it [0.2] 
you'll actually be able to spot them [0.2] and you'll say ah he's using a word 
that [0.2] he thinks he means something different from this one does and [1.0] 
he's d-, you know [0.6] but [2.1] the whole of that Carry On film [1.2] is [0.
2] about the misunderstanding [0.2] that happens in that consultation [0.7] and 
although [0.4] that is a film and you've probably seen it before [0.6] i will 
say that i have seen worse consultations happen in real life [2.4] so [0.2] 
perhaps there is some [0.3] point in teaching [0.3] communication [2.0] good 
communication [0.3] has rewards and bad communication has punishments [2.6] if 
you communicate well you know why the patient has come [2.9] you can make a 
diagnosis [2.0] the patient can understand [0.4] your explanation [2.0] the 
patient might take your treatment [1.9] and the patient will like you [2.2] on 
the other hand [0.3] if you can't communicate [2.1] you miss [0.3] the real 
reasons [0.3] that they've come to see you [1.3] you miss important diagnoses 
[2.2] and the patient [0.3] does not [0.8] understand you [0.5] or what is 
going on [2.5] patients don't then do what you want them to do [1.7] and you 
get complaints [0.9] so on a very real and practical [0.4] level [1.1] being 
able to communicate well [0.9] is absolutely [0.3] 
crucial [1.6] for what we do [0.2] as doctors [2.7] so [0.9] what [0.5] is [0.
3] good [0.2] communication [2.4] well [0.2] we've seen it can be non- [0.2] 
verbal [2.2] i can by the way i use my body [1.3] or not [1.3] give completely 
different impressions [0.6] to people [2.1] your body language [0.2] your 
expression [0.7] your posture [3.2] wasn't the patient's expression marvellous 
[0.2] when the doctor was talking [0.6] looking at the X-ray [3.3] non-verbal 
[0.9] communication can also be paralinguistic [0.6] things like the tone of 
your voice and your voice quality [0.3] can communicate [0.3] important things 
[1.5] recently got a new curate in my church [0.9] and she goes on about the 
love of Christ [laughter] and i think [laugh] [0.2] every time she does it [0.
7] i'm [0.2] i know it's wrong but [0.2] [sigh] i just wish somebody had taken 
her an-, aside and said [0.6] you can learn how to make your voice [0.2] more 
[0.9] relaxing [1.1] [laughter] [1.0] good communication can also be verbal [2.
2] what you say [0.3] matters enormously [0.4] the precise 
words that you use [1.0] how you say it [2.1] and the way you respond [0.6] to 
the people [0.8] er [0.5] has said [3.1] so [3.2] let's have a think about [0.
4] these skills [5.0] these are the skills that you're going to be [0.2] 
practising but before we get on to that i think we ought to have [0.8] another 
video 
nf0621: so the first and most important skill [1.5] is listening [7.0] 
questioning [2.1] how to ask questions [0.4] it's quite frightening at first [1.
6] going up to a complete stranger [1.0] and asking them questions about when 
they had their bowels open and [2.0] what their mother did and oh [0.5] all 
sorts of personal things about pain [0.6] and bodies [3.0] responding [0.3] 
knowing what to say and how to say it when somebody [0.7] gives you a bit of 
themselves [2.7] and how to explain [1.1] how to explain things so that people 
understand [1.6] not the way you understand it but the way [0.5] they will 
understand it [2.4] so let's have a little look at these skills [0.2] w-, one 
at a time [1.3] just briefly [0.2] because we don't want to waste too much time 
on this [3.3] so listening [5.6] 
you have to give patients space [0.4] and time [0.4] to express themselves [6.
4] it's actually quite [0.3] difficult [0.6] to hear [0.4] what patients are 
actually saying [2.6] we take it for granted but very often [0.7] you know 
there's family arguments where [0.3] i told you about so and so no no you 
didn't [0.2] you didn't say that you said something el-, [0.7] it's very 
difficult [0.3] to hear what people say [0.3] because very often [0.4] you're 
expecting [0.7] an answer [1.3] and you get [0.8] dragged b-, off by your 
expectation [1.1] and practising listening to the story that patients [0.2] 
really tell you [1.4] is very important [3.1] you have to overcome [0.6] the 
barriers to disclosure [2.0] they're always there [0.8] they'll be worse for 
you [0.2] when you're feeling insecure [0.9] when you're only a first year 
medical student [1.0] and you feel [0.4] like this [0.5] but even the most 
experienced doctor has to overcome [0.3] barriers [0.7] in order to be able to 
help [0.6] as well as they can [5.1] if i've got one message that i'm going to 
give you above all others [0.5] it's [0.8] to value the patient's contribution 
[0.5] as equal [0.6] to your 
own [1.4] in fact [0.5] it's not just equal to your own it's probably [1.7] 
everything [4.6] and by the time [0.3] you qualify [0.6] we hope you will have 
the knowledge and the skills [0.7] to process what the patient says [1.6] to be 
able to make [0.6] this magic thing called [0.2] a diagnosis [0.4] but more 
than that not just a label [0.8] a real insight [0.5] into that patient's world 
[1.0] something that will make sense to them [0.4] as well as you [7.5] so 
you're going to be doing this [0.4] by listening [0.3] but also by questioning 
[1.5] anybody know anything about questions [1.5] anyone [0.9] yeah [1.1] 
sm0634: er [0.5] basically not to ask leading questions to keep them open [1.1] 
nf0621: brilliant [0.6] yeah [2.1] sounds very easy [0.2] doesn't it not to ask 
leading questions [0.5] but there are basically two sorts of questions [0.2] 
there are closed questions [1.1] these are ones that can be answered by yes and 
no [1.4] things like [0.2] do you have you are you [3.6] and there are open 
questions [0.7] which actually allow [0.3] a 
patient to answer in their own words [1.4] they can't be answered by yes and no 
[0.5] and they usually start with [0.2] words like who [0.6] what [0.7] where 
[0.7] why [0.9] and when [3.1] learning how to ask open questions [0.7] to ask 
questions in a way [0.3] that allow patients to answer [1.2] the way they want 
to [0.5] is actually quite difficult [0.6] and [0.4] in your groups [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 [1.6] do you think it's so and so and you've asked 
a closed question again [0.6] and [0.3] it's so easy [0.9] to get into habits 
of asking [0.3] these closed questions and you have to practise to [0.4] to 
become better at it [4.5] i've got these slides in the wrong order but we'll 
deal with it [0.5] explaining [6.4] giving a good explanation [0.3] i haven't 
put any detail on the slide [0.7] because at this point [0.8] we're not going 
to be concentrating on h-, [0.3] the precise nuts and bolts of how you do it [0.
9] but the essential [0.2] is to be able to use the right language [0.6] and 
that is a skill that you can practise [0.9] being able to use the words that 
patients [0.2] understand [0.5] and in the way that that patient understands it 
[3.3] so you then can get a shared understanding [3.3] and [0.5] we teach you 
[0.3] in order to get that shared un-, understanding [0.2] you're going to use 
[0.3] the patient's ideas [2.1] the patient's concerns what's bugging them [2.
6] and their expectations [4.2] and you'll be practising this [0.4] by the time 
[0.4] you get to the Clinical Methods course [0.8] you'll actually know [0.2] 
ideas concerns and expectations as ICE [0.6] it will be something i hope [0.5] 
that you'll be so familiar [0.4] with thinking [0.3] do i know their ideas do n-
, i know what [0.5] what they are worried about [0.3] do i know what they want 
from us [6.4] and responding [0.6] what do you do when somebody bursts into 
tears [0.7] what do you do when [0.9] are there some useful things that you'll 
get used to d-, using [0.3] things like [0.2] tell me about [2.5] tell me about 
encourages [0.5] the narrative [0.8] of a consultation [0.2] it gets people 
talking [0.4] it's a wonderful tool that experienced doctors use [0.9] you 
don't usually tell your friends t-, [0.2] tell me about this do you [0.7] but 
it's 
something that as a professional [0.2] you'll learn [2.5] reflection [1.1] to 
be able to just [1.0] repeat back [0.2] something that a patient has said [0.5] 
and not to feel ridiculous about it [2.1] summarizing [0.4] to take a long 
complicated story [0.3] that a patient has told you [0.5] and to create it into 
a nice neat whole [0.4] so that they can check that you've got [0.6] all the 
important data [2.1] and empathizing [1.6] how to say [1.8] naturally [0.2] 
easily [1.0] i'm so sorry [0.2] if somebody tells them [1.1] you that y-, their 
father's died or [0.3] something like that [0.6] and to be able [0.5] to feel 
comfortable about giving that empathy [5.9] so these are all very practical 
things and me talking to you about them isn't going to help them happen is it 
[2.4] so how does our DISC course here [0.8] help you [0.6] to develop these 
skills [9.6] we start out [0.6] with three seminars [4.6] each of the seminars 
[0.4] takes place here [2.2] it's about an hour and a half long [1.2] you'll be 
in small groups [3.5] there'll be about ten of you [2.0] and you'll have [0.3] 
a G-P tutor [0.3] with you in that group [1.8] you'll also have [0.5] a thing 
called a simulated patient [4.1] we use 
simulated patients quite a bit [0.4] both in exams [0.5] and in [0.4] training 
[2.2] and i know that there's a [0.2] tendency for students to think oh it's 
only an actor [1.0] well [0.7] if you call a simulated patient an actor a lot 
of them get very offended [1.0] but these are people [0.4] who [0.8] have an 
alter ego [0.8] as a person who comes to see a doctor [2.0] and they know how 
to be that person [0.9] and they give you a chance to practise [1.7] to dry run 
[0.5] like going on a dry ski slope [0.8] you know it's [0.6] it's easier [1.7] 
although it isn't easier [0.2] when you actually try it you find it feels just 
like talking [0.2] to any other patient and of course these are real patients 
[1.0] often they have real illnesses [1.5] but the advantage is [0.7] that if 
you say the wrong thing if you laugh when they say my father died [1.3] you 
won't have really hurt somebody [1.1] in a way that can't be undone [1.7] and 
if you find [0.2] that the patient doesn't understand what you're going on 
about you can say [0.2] ah i'm sorry shall we try that again [0.8] and reel 
back like a videotape [0.7] and have a g-, go using different words [1.4] for 
us 
experienced doctors we love having a chance to use simulated patients [1.0] and 
[0.6] we f-, we find that the work that we can do with them is immensely 
valuable to us [4.3] but these seminars that you have are a chance to actually 
practise [0.8] your first attempts at talking to patients [0.5] in a safe [0.2] 
environment [2.0] it's also an environment where [0.5] you can experiment [2.2] 
it's often quite difficult to find out why the patient has come [1.4] if you're 
in a group [0.2] the group can give you ideas [0.7] how you can ask [0.3] the 
right questions [0.6] to actually find out why [0.3] these particular patients 
[0.3] have come [2.3] and they also enable you to be able to find out the 
background [0.2] to the problems that the patients have [0.7] at this stage we 
don't expect you to make medical diagnoses [1.3] but it's never too se-, soon 
[0.4] to start practising [0.3] the actual nuts and bolts of talking to 
patients [0.5] finding out [0.2] what their story is [0.5] why have they come 
to the doctor's today [0.6] what is it they want [0.3] what is the real problem 
[2.1] those skills you need [0.5] right from day one [2.6] we then follow it 
up with real patients because [0.8] that's what life is a-, [0.2] going to be 
about for all of you [2.7] and you then have three sessions [0.3] in the G-P 
practice of your group tutor [0.4] so you will be with [0.2] the tutor who's 
been with you in the seminars [1.8] and you go out in pairs [1.4] and you'll 
spend an afternoon or a morning [0.5] in their surgery [2.1] and you'll see 
real patients with real problems [0.6] and even your tutor won't know anything 
about them because they'll come in and they'll have something new he [0.3] and 
he won't know what it is [3.1] and you'll be able to talk to them before any 
other doctor [0.6] or nurse or anyone has actually spoken to them about this 
problem [0.6] and have a go [0.3] at finding out [0.3] why the patient has come 
[0.8] finding out the background to the problem [2.0] and then [1.0] as a pair 
[0.3] you can think about the difficulties you find [2.2] and you can learn to 
recognize [0.6] what you do naturally easily [0.5] and what you're going to 
have to work at [1.3] and the most important thing here is that [0.2] your G-P 
tutor [0.7] is going to be giving you [0.2] 
feedback [1.5] every time you talk to a patient [0.9] your G-P tutor [0.4] will 
be watching and listening [0.2] to what you do [0.7] and they will give you 
feedback [0.6] on [0.3] how you did it well [1.2] what worked [0.4] why it 
worked [1.9] and they'll give you suggestions for things to try [0.7] so it's 
not [0.5] knock you feedback it's [0.2] useful feedback [0.9] and even more 
importantly at the end [0.5] of the course [0.2] they should give you some 
structured written feedback as well [0.6] so that you can take that and put it 
in your portfolio [0.9] and you've got a record of that work you've done [5.5] 
so [1.0] that structured written feedback how do we do it [2.0] i'm going to 
rush through this bit [0.6] because it's [1.3] it's important but [0.5] it's 
also something that probably not [0.3] er [1.1] you'll want to know all the 
details very at some stage but not here [1.6] here we use a thing called [0.5] 
we call it the LAP [0.5] it's called the namex Assessment Package [2.4] this is 
the [0.3] the assessment tool that's used in all the exams in the namex Medical 
School [0.9] and [0.8] it's a way of measuring [0.5] how you perform when 
you're talking to 
a patient [1.7] now 
nf0621: of you has got i hope [0.5] a blue [0.7] book [0.4] a coursebook [2.7] 
if you haven't got one don't fret now [0.5] don't read it now [0.4] just make 
sure you've got one [1.1] in that book [0.2] all the details [0.5] of [0.4] the 
assessment that's used [0.6] for this [1.8] is recorded [6.2] and this tool [0.
3] with minor changes is used in all the OSCEs that you get [1.6] it's used in 
your intermediate clinical exams that's halfway through your phase two [1.7] 
it's used in the Clinical Methods course that we teach later on [0.4] where you 
do [0.5] two months [0.9] hospital and general practice and s-, concentrated 
work on how you make diagnoses [0.3] and how you make management plans [1.3] 
and [0.5] for you the important thing 
nf0621: assessment tool [0.2] is how you will be measured in your final 
clinical exams [1.2] so [0.4] becoming familiar [0.6] with this assessment 
package [0.3] is useful to you [0.4] and i'm going to briefly flick through [0.
3] the criteria [0.3] that are used [0.5] in the [0.7] communication skills 
part [0.4] of that 
assessment package [2.5] now [0.4] we only [0.3] look at what you do [0.5] in 
two parts of talking to patients [0.6] we're not going to be judging you on how 
you make a diagnosis [0.5] at this stage [0.5] but we do look at your behaviour 
and relationship [0.6] with patients [3.8] and your tutor will tell you whether 
you are [0.3] maintaining a friendly but professional relationship with 
patients [0.9] whether you are conveying sensitivity to the needs of patients 
[2.7] and whether you are communicating [0.5] an awareness that their attitude 
[0.5] actually matters [0.3] towards creating [0.2] a shared [0.5] approach [2.
4] you'll also [1.1] be being judged [0.3] or being given feedback on your 
interviewing and history taking [0.6] skills [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 [4.7] you're expected to become fluent at introducing 
yourself [1.0] putting patients at ease [1.7] allowing a patient to tell their 
story [3.0] checking out words that the patient uses that you're not sure quite 
what that patient means [0.7] so that 
you don't get the sort of mismatches [0.5] that happened in the Carry On film 
[2.2] phrasing your questions simply and clearly [2.1] being able to sit on 
your hands and shut up when needed [2.4] finding out [0.7] why the patient has 
come [0.2] their ideas [0.2] concerns [0.4] and expectations [3.8] and looking 
at the whole [0.3] problem [0.2] as it affects the patients [0.4] not just [0.
3] their bodies [0.7] that the whole of them [0.3] as a [0.3] a functioning 
individual [0.4] in society [0.4] in a family [3.8] and although [0.3] we do 
test [0.2] on [0.5] we tell you if you're getting the right sort of information 
[0.4] in your questioning [1.8] and we'll give you [0.6] praise if you're well 
organized [0.5] at this stage we don't expect [0.3] people [0.3] to be [0.4] 
starting to get a really controlled [0.2] history [0.5] because [0.9] it's is-, 
it's difficult [1.1] it is a skill [1.5] it's every bit as complicated learning 
to consult with patients as it is learning to drive [1.9] and [1.2] if it seems 
a bit daunting [0.4] most of you have learned to drive by now [0.6] in fact i 
hope all of you have [0.8] but [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 [0.3] you 
actually let the clutch out and it went [0.2] down the road [laughter] [3.6] so 
where do we go from here [1.3] the seminars are on Thursday afternoons [3.1] 
the group dates and times [1.7] will be on the noticeboards [0.8] namex are 
they [0.2] actually on the noticeboards at the moment [0.4] 
nm0625: have to be up by Friday [0.2] 
nf0621: they'll be up by Friday [1.6] so you will know [0.2] who your G-P tutor 
is [0.5] where they're based [0.3] who else is in your group and what time your 
sessions are [3.0] your tutor is going to be the G-P whose practice you will be 
visiting [7.6] you can start visiting your G-Ps after the second [0.2] seminar 
[1.7] now [0.5] the first first seminar is on the twenty-fifth of September so 
in about a week's time [1.0] and the last [0.2] third seminar is on the sixth 
of November [0.3] so all of you should have been out [0.3] to your general 
practices [0.3] sometime [0.2] during the month of October or November [0.8] 
and you then have until the following June [0.5] to complete your three [0.2] 
visits [5.0] and [0.5] please [0.6] read your clinical skills workbook [1.7] 
read it [0.6] and read it [0.7] and read it and don't lose it [0.4] because 
you'll need it later on [0.7] in your Clinical Skills [0.3] module that starts 
[0.4] in November [0.6] as well [2.7] have we got [0.7] any questions or 
queries [1.7] anywhere 
sf0635: are there any leftover workbooks 
nf0621: yeah we've got a wave over there [0.2] one over there [0.4] 
sf0636: are there any leftover workbooks down at the front 'cause there aren't 
any at the back [0.2] 
nf0621: there are two-hundred workbooks and there are slightly fewer than two-
hundred students so there should be enough to go round yes [1.3] some are going 
your way [0.2] 
sf0636: thank you 
nf0621: any others [0.4] short [0.5] right [0.6] if we all make sure that 
anyone who hasn't got one [1.5] gets one before 
they go [6.6] yes [2.2] now [0.2] before you go [1.4] before you go [0.8] l-, 
namex who's your administrative [1.7] your ad-, [0.3] the G-P [0.2] 
undergraduate G-P administrator [0.4] is going to introduce herself 
nf0637: i'm in room one-one-three [3.1] and extension number seven-three-eight-
o-eight [6.4] okay our secretary is namex [1.1] she's in the same room [0.3] 
and she's on extension seven-four-o-four-four [3.4] er [0.5] namex put up here 
that attendance is compulsory i will know within an hour if you've not turned 
up at your practices [1.2] okay [0.5] er [0.4] it's not [0.9] acceptable to not 
be there if you know that you can't make it phone me in advance and let me know 
[0.6] let your doctors know and it has to be [0.6] y-, er er [0.2] a good 
reason why you're not going to be there [0.7] okay [0.5] er other than that if 
you've got any issues any problems you can come and see me [0.3] any time at 
the moment i have got hours posted on 
my door [0.5] but for the moment [0.4] while you're sort of getting used to 
things come and see me any time you like [0.2] thank you 
nf0621: right [0.2] now [1.6] namex wants to have a brief word after me [0.6] i 
just want to basically say [0.6] namex is in her office [0.9] most of the time 
[1.1] nearly always [0.2] if you've got a problem with any of this part of the 
course [0.3] she's there [0.3] and namex [0.8] if y-, [0.3] if namex isn't 
there namex is [0.3] and they are [0.2] fantastic they [0.6] you know they 
really do help and they help us as well [0.8] so [0.3] you'll you'll all get to 
know her really well by the end [0.8] from my point of view that's the end of 
the lecture namex wants to have a quick word but [0.4] 
thank you very much for being so [0.4] quiet and listening [0.2] thanks [7.1] 
nm0622: i i ju-, just wanted to say enjoy very much being at namex University 
and the medical school for the next four years [0.6] if you do have any 
problems or concerns now you've met us all i'm sure we'd be [0.2] all very 
happy [0.4] to an-, [0.2] to answer any queries that [0.3] you may have [0.4] 
er [0.4] the next lecturer Dr namex [0.2] has suggested i think quite rightly 
[0.3] you have a break for the next three or four minutes just to stretch your 
legs [0.6] outside and then please come back in the lecture theatre in the next 
[0.2] five minutes thank you very much