MRCPsych UK: Paper A, B, and CASC Prep

Important Points about the History of Drug Use Regular or intermittent Amount (know the units) Pattern dependence/withdrawal  Impact on work, relationships, money, police  Screening questionnaires e.g. CAGE

Common Crisis Situations in Clinical Practice Point out the crises seen in day to day clinical practice. Developmental crises common to all occur in  Stressful states of human maturation and transition. e.g. hospitalization Situational crises person faces stressful and traumatic event e.g. flood, earthquake, rape, etc. WHO Guidelines for the Treatment of Alcohol Withdrawal

Informational Care to Calm Down an Agitated Patient with Delirium A 46-year-old man is admitted to the medical emergency, and he is very agitated and restless, the diagnosis is delirium. The family wants urgent management. What informational care we provide to the family by you to calm them down? Sitting and introduction Rapport building and inquiries Symptoms are of medical illness and  As soon we confirm the diagnosis, we will treat him for the medical cause, and  Symptoms will settle down. Frequently reorient him He may see scorpions etc, reassure him Keep close to him Keep lighting suitable for sleep and enough visibility. Prevent harm to the patient and the family. Closes the interview

The Basics of Communication Skills Communication skills are central to clinical assessment. The following are the basic techniques that improve communications Skills.  Attending and listening Active listening Verbal techniques Funneling Paraphrasing Selective reflection Empathy building Checking for understanding.

The biopsychosocial model of healthcare emphasizes the following paradigms of doctor-patient relationship Psychosocial assessment, Use of communication skills, Informational care, Counseling, Crises intervention, and Extension of care to the family.     "The biopsychosocial model is an interdisciplinary model that looks at the interconnection between biology, psychology, and socio-environmental factors. The model specifically examines how these aspects play a role in topics ranging from health and disease models to human development. George L. Engel developed this model in 1977 and is the first of its kind to employ this type of multifaceted thinking. The biopsychosocial model has received criticism about its limitations but continues to carry influence in the fields of psychology, health, medicine, and human development." Source: Biopsychosocial model - https://en.wikipedia.org

Factors that Obstruct Effective Communication The following factors can interfere with effective communication during clinical assessment.  Lack of exclusivity, for example, assessment on the bedside inside a unit of 20 patients.  Anxiety by a doctor, because of which divides their attention and concentrating, not the assessment is difficult.  Awkward seating that makes it difficult to relax while assessing a patient.  Lack of attention to the nonverbal cues Offensive remarks. Frequent interruptions.  Selective listening. Daydreaming. 

Belief in potential of healing act Capacity to listen and empathies Respect and dignity of humans Tolerance to difference of opinion Gentle spirit Ability to mix creative thinking Never give up.