Title Page
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Document No.
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Conducted on
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Prepared by
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Location
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Personnel
Client & Patient Details
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Client Surname
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Patient Name
Doctor Details
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Doctor Surname
- Tabrett
- Fisher
- Logan
- Kitamura
- Carey
- Ng
- Durose
- Romeo
- Meredith
- Mutton
- Stenberg
- Lord
- Cooper
- Frindik
- Howe
- Morris
- Price
Medical Content
Problem Type Selection
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What is the Problem Type?
- Poisoning
- Medical Illness
- Trauma
- Surgery
- Overnight Monitoring
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Which body system is predominately affected?
- Cardiovascular
- Respiratory
- Gastrointestinal /Hepatic
- Urogenital
- Musculoskeletal
- Neurological
- Skin
- Haemo-Lymphatic
Consultation Structure
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Did the doctor initiate the welcome!
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Did the doctor introduce themselves?
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Did the doctor shake hands during the welcome?
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Did the doctor seek an appropriate medical history?
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Did the doctor conduct a physical examination, describing what they were doing?
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Did the doctor describe their findings, in a narrative, relevant to the presenting complaint?
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Did the doctor describe a medically appropriate diagnostic and therapeutic plan?
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Did the doctor seek understanding of the findings and the plan by the use of reflective listening, and good questions?
Consultation Room Delivery
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Was the doctor's pace of speech ...
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How did you hear the doctor's tone?
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Was the doctor's body language...
Blocking words
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Did the doctor use any blocking words?<br>e.g. "See how it goes". "Wait and see". "Probably be okay.." " it could wait".
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Which phrases were used?
- wait and see
- see how it goes
- probably be okay
- it could wait
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Did the doctor use the word " NEEDS" rather than "recommend" in discussing the plan?
Plans and Estimates
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Did the doctor provide a plan in detail BEFORE providing an estimate?
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Did the doctor seek agreement to a medical plan BEFORE providing an estimate?
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Did the client raise any objections to the plan BEFORE an estimate was provided?
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How well did the doctor respond to any objections?
- open and inviting
- shut down
- uncomfortable
- closed behind table
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Did the doctor deliver the estimate and healthcare plan?
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Did the client raise any objections to the plan AFTER an estimate was provided?
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How well did the doctor respond to any objections?
- open and inviting
- shut down
- uncomfortable
- closed behind table
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How well did the nurse respond to any objections?
- open and inviting
- shut down
- uncomfortable
- closed behind table