Consultation course in general medicine
How can you as a medical student use all the knowledge you have acquired about diseases, injuries, diagnostics, and treatment during the first five years of your studies to meet the specific patient you now have in front of you during a consultation?
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On Monday, January 30th, the kickoff for a two-day course took place where medical students in their eleventh semester (MED 11) got to engage in consultation training. 80 course participants were divided into groups of four individuals and instructed to simulate a consultation situation where a doctor meets a patient.
Set up as a role-play
"The course is scheduled for the first and second days of the semester. We call it the consultation course. It consists of some theory, but mainly focuses on exercises on how to handle a consultation situation. We want to offer this course at this stage of the study as it's intended as preparatory for the students before they enter practice in general medicine," says Knut Eirik Ringheim Eliassen from the Section for General Practice (FAM). Along with Professor Stefan Hjörleifsson, Eliassen is responsible for the academic aspects of this course.
Eliassen believes that the timing is right for students to take this course now.
"Now they've completed five years of medical studies and have learned a lot about diseases, diagnostics, and treatment. They possess a fair amount of communication skills, and the ability to talk to people. Nevertheless, it can be wise to practice putting this knowledge into a systematic context so they can use the knowledge they've acquired when meeting patients."
Hjörleifssson also believes that the course is valuable learning for students at this phase of their studies and that they thoroughly enjoyed themselves during the course.
"Students were engaged in exercises where they switch roles as a doctor and a patient. The group of four consisted of one doctor, one patient, and two observers. The observers' role is to provide feedback. Once the consultation is finished, the roles are swapped. So, there are four people around a small table, and they receive feedback directly. How did Jonas perform in this interview? Was Lise skilled at asking questions? We get a bit nervous when asked in that manner, because the questions take us out of our comfort zone. At the same time, it's a lot of fun, as there's no room to be passive in such a setting," says Hjørleifsson.
Ten scientific staff members, mostly experienced general practitioners, participate in the course as guides. Their job is to sit with the students during the role-play and provide feedback.
"We invest a lot in this course. Ten guides distributed across twenty tables. This means that each guide only has two groups to work with, and therefore, they can provide students with valuable feedback."
Eliassen mentions that the course is intended for all students in the cohort, not just those who intend to work in general medicine.
"It fits very well within the context of a consultation with a general practitioner or at a medical clinic, but at the same time, the techniques and methods the students are trained in could be used in all patient encounters."
Interest in the whole individual
What the students are being trained in is called the patient-centered method. This means that they shouldn't solely be interested in the diseases of the patients they meet but also in the individuals with the diseases.
"If you go to your doctor with stomach problems, the doctor shouldn't only care about your pancreas but also about you and how you're doing. The consultation should be person-centered," says Hjörleifsson.
Eliassen says that the main goal of the course is for students to arrive at further steps in consultation with the patient within the limited timeframe of a consultation situation.
"They should bring all they've learned over five years and use this knowledge when meeting the individual sitting in front of them. Within a brief half-hour, the doctor must decide whether the patient should be admitted, referred further, or sent home. It's not possible to take this course before reaching this point in the study since enough knowledge is required before making these assessments," says Eliassen.
In the exercise, the consultation only lasts for seven to ten minutes. When students go into practice, the time will naturally be longer.
"We've chosen to make the time shorter in the course because we believe that learning from feedback and discussion is as valuable as completing the tasks. What we want to avoid is spending too much time on task-solving and too little time on reflection and feedback. When they encounter real patients in an actual consultation situation, they'll have more time and be even more prepared."
