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Videos for SDM MAGIC North Training - Full-length clips

These videos are a training tool. They are designed to help clinicians recognise the differences between every day consulting and enhanced consulting.

We have developed three different video resources - this set are full consultations. The first of each pair is standard - what one might expect of a reasonable day to day consultation. The second of each pair is enhanced - demonstrating a better SDM consultation

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Renal failure - discussing the next steps Standard (Time: 5.20)

9/4/2019 1:47:33 PM

A man with polycystic kidney disease and progressive renal failure is unable to consider a transplant due to a recent melanoma. He has come to a new consultant clinic to discuss options for the ongoing management of renal failure. Man ‘appears’ anxious and lacking in understanding, although it turns out he has clear ideas about his preferences. These are not discovered. The consultant makes assumptions and is aiming to persuade him into the treatment that he thinks is best.

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Renal failure - discussing the next steps. Enhanced (Time: 6.46)

9/4/2019 1:47:33 PM

Choice talk - Expectations are clarified by the consultant. The do nothing option is discussed. Existing knowledge is discussed. The use of ‘we’ enhances the chance of a collaborative decision-making process.Options talk - Lay out of options with explanation. Summarises and checks preferences. Uses decision aid, checks assumptions, and picks up on patient’s cues. Checks prior knowledge. Decision talk - Summarises and checks understanding. Confirms the decision.

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Patient requests to make changes to a drug regime: Standard (Time: 4.48)

9/4/2019 1:47:33 PM

A woman is discussing her current psychotropic drugs with her GP. She finds the current medication very disruptive to her lifestyle. Consultation does not focus on the problem as the woman views it. The GP assumes that the woman is able to cope on her current management plan. He is concerned about relapse and future consequences of a change in treatment. The woman feels frustrated that the GP is not listening to her; she feels compromised and the consultation is unsatisfactory.

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Patient requests to make changes to a drug regime Enhanced: (Time: 5.57)

9/4/2019 1:47:33 PM

Choice talk - Develops an understanding of what’s important to the woman. Options talk - Explores options and checks understanding. Explores benefits and harms. Decision talk - Summarises options and enables decision. They arrive at a decision that more closely fits with what matters to the patient AND which leaves the clinician still happy with the outcome.

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Making a request to leave the ward. Standard (Time: 3.30)

9/5/2019 10:32:34 AM

A woman in a psychiatric ward who is currently on a section of the mental health act requests permission to go shopping. Ward sister is preoccupied by the potential risks. The woman feels she is improving and that the sister is making unnecessary assumptions that things will go wrong. The sister aggravates the situation by using negative language and not noticing the woman’s body language. The woman feels that she is not being listened to and becomes frustrated, angry and abusive.

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Making a request to leave the ward. Enhanced (Time: 5.49)

9/5/2019 10:34:40 AM

Choice talk - The sister checks the patient’s agenda and explains concerns. Options talk - Introduces choice, explores options and benefits and harms. Decision talk - A decision is made reflecting the woman’s preferences, but also taking on board the clinician’s ongoing concerns, and the steps are summarised.

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Discussing treatment for stress incontinence. Standard (Time: 2.58)

9/5/2019 10:36:19 AM

A woman is diagnosed with urinary stress incontinence by her GP and they discuss the options for management. GP is not prompting dialogue and frequently uses jargon to explain the problem and its management. He fails to discuss the issues, or take into consideration her preferences, and leaves the woman with a negative view of her management plan.

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Discussing treatment for stress incontinence. Enhanced (Time: 8.25)

9/5/2019 10:39:41 AM

Choice talk - The woman is supported to understand her problem and her knowledge of options for management are checked. Introduces choice. Options talk -Lays out options before adding the detail, although missed opportunity to elicit patients understanding and beliefs. Explores preference and explores options. Decision talk - Summarises and identifies conflict between choice and guidelines.