{"title":"Communication skills training for emergency department senior house officers--a qualitative study.","authors":"G Lloyd, D Skarratts, N Robinson, C Reid","doi":"10.1136/emj.17.4.246","DOIUrl":"https://doi.org/10.1136/emj.17.4.246","url":null,"abstract":"<p><strong>Objective: </strong>To identify common weaknesses in senior house officer-patient consultation skills, and evaluate direct observation with feedback and negotiation of educational contracts, as a teaching tool in an emergency department setting.</p><p><strong>Method: </strong>Common weaknesses were identified through review of feedback charts by three trained observers. Alteration in clinical and learning behaviour, as well as senior house officer and observer perceptions of the teaching were evaluated qualitatively by a combination of semistructured interviews and focus groups.</p><p><strong>Results: </strong>Several common weaknesses were identified, notably the use of closed questions, and poor negotiation and explanation of treatment plan and follow up. The senior house officers perceived improvement in their clinical practice, welcomed feedback, and subsequently set, though did not complete educational contracts. While comfortable with this style of teaching, the observers felt that it did not make efficient use of teaching time.</p><p><strong>Conclusions: </strong>This study identifies common weaknesses in the consultation skills of emergency department senior house officers and confirms the need for training in this area. Direct observation is effective in changing behaviour to this end, though self directed learning is not necessarily stimulated. Video recorded consultations with group feedback may be a more effective teaching tool.</p>","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 4","pages":"246-50"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21761203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Ingested coins and metal detection.","authors":"S Maurice, K Mackway-Jones","doi":"10.1136/emj.17.4.282","DOIUrl":"https://doi.org/10.1136/emj.17.4.282","url":null,"abstract":"Best evidence topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practising clinicians. The search strategies used to find the best evidence are reported in detail in order to allow clinicians to update searches whenever necessary. The BETs published below were first reported at the Critical Appraisal Journal Club at the Manchester Royal Infirmary. Each BET has been constructed in the four stages that have been described elsewhere. Four positive and two negative BETs are reported in this issue of the journal. The six topics covered in this issue of the journal are:","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 4","pages":"282-3"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21761120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Activated charcoal in paracetamol overdose.","authors":"K Richell-Herren, M Harrison","doi":"10.1136/emj.17.4.284","DOIUrl":"https://doi.org/10.1136/emj.17.4.284","url":null,"abstract":"","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 4","pages":"284"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21761122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Management of uncomplicated soft tissue gunshot wounds.","authors":"K Mackway-Jones, M Harrison","doi":"10.1136/emj.17.4.284-a","DOIUrl":"https://doi.org/10.1136/emj.17.4.284-a","url":null,"abstract":"","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 4","pages":"284-5"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.284-a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21761123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"bestbets.org: odds on favourite for evidence in emergency medicine reaches the world wide web.","authors":"K Mackway-Jones, S Carley","doi":"10.1136/emj.17.4.235-a","DOIUrl":"https://doi.org/10.1136/emj.17.4.235-a","url":null,"abstract":"","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 4","pages":"235-6"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.235-a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21761200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can communication skills workshops for emergency department doctors improve patient satisfaction?","authors":"F L Lau","doi":"10.1136/emj.17.4.251","DOIUrl":"https://doi.org/10.1136/emj.17.4.251","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether the attending of the communication skills workshops by the emergency department doctors improves patient satisfaction and reduces the number of complaints on doctors' attitude.</p><p><strong>Method: </strong>Standard performas were sent to all emergency departments (EDs) in Hong Kong soliciting their numbers of written complaints on doctors' attitude or communication problems during the nine months before and after a series of communication skills workshops. Patient satisfaction surveys in four representative EDs, before and after the workshops, were collected and the satisfaction rates of doctors' attitude, explanation and advice were subsequently compared.</p><p><strong>Results: </strong>For the hospitals that responded, written complaints against doctors' attitude reduced from 26 (1 January 1995 to 30 September 1995) to 15 (1 July 1996 to 31 March 1997), amounting to a 42% reduction despite an increase of attendance from 724000 to 898000 (p = 0.05 chi2). From the 663 and 480 questionnaires collected before and after the workshops respectively, the satisfaction rate to doctors' attitude increases from 88.3% before to 98% after the workshops, while the satisfaction rate to explanation and advice provided by doctors increases from 79.8% to 93.8%.</p><p><strong>Conclusion: </strong>Communication skills workshops in Hong Kong can improve ED doctors communication skills with a corresponding increase in patient satisfaction and reduction of complaints against ED doctors.</p>","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 4","pages":"251-3"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21761204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pain in young children attending an accident and emergency department.","authors":"C McCarthy, S Hewitt, I Choonara","doi":"10.1136/emj.17.4.265","DOIUrl":"https://doi.org/10.1136/emj.17.4.265","url":null,"abstract":"<p><strong>Objectives: </strong>To assess pain in young children presenting to an accident and emergency (A&E) department. To evaluate the use of the toddler-preschooler postoperative pain scale (TPPPS) and the use of analgesia in these children.</p><p><strong>Methods: </strong>100 children aged 1-5 years presenting to an A&E department were assessed for pain. Pain assessments were carried out using a modified form of the TPPPS; a visual analogue scale by parents and a numerical scale by nursing staff.</p><p><strong>Results: </strong>The majority of children were assessed as having pain: 60 by the TPPPS, 58 by the nurses and 63 by parents. Only 30 children, however, received analgesia. Children with the highest pain scores as assessed by nursing staff or using the TPPPS all received analgesia.</p><p><strong>Conclusions: </strong>The pain scale appears suitable for use in young children in A&E departments. The subsequent management of pain in young children could be improved.</p>","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 4","pages":"265-7"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21761208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rapid sequence intubation.","authors":"S Bush, A Gray, A McGowan, N Nichol","doi":"10.1136/emj.17.4.309-a","DOIUrl":"https://doi.org/10.1136/emj.17.4.309-a","url":null,"abstract":"Editor,—We recently had a patient attend our department repeatedly feigning acute dystonia in an attempt to obtain procyclidine medication. The case illustrates the fact that many medications are abusable.1 Patients are knowledgeable and may be willing to go to some lengths to obtain them fraudulently. Accident and emergency staff should be alert to this possibility when faced with unusual stories or situations. The psychotropic drug directory is a brief handy reference, which may help in …","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 4","pages":"309"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.309-a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21761673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"British Association for Accident and Emergency Medicine Conference, Cambridge, 4–6 April 2000","authors":"","doi":"10.1136/emj.17.4.300","DOIUrl":"https://doi.org/10.1136/emj.17.4.300","url":null,"abstract":"Eighth International Conference on Emergency Medicine, Boston, Massachusetts, USA, 4–7 May 2000","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 1","pages":"300 - 308"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.4.300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64230675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}