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KUMEC Friday Teaching Mornings: Lesson Plan for Year 2 Session 2 2015-16 Aims for students Session plan To consider the issues that some patients face in accessing primary care, and how general practice addresses the needs of vulnerable patient groups such as Patients with personality disorders, low literacy, language difficulties, sensory impairments, learning disabilities etc. Stigmatised conditions and socially excluded patient groups and communities Carers, victims of domestic abuse, vulnerable children/young adults, frail elderly, healthcare workers etc. Preparation: ask your receptionist to welcome students (four at 9am and four at 11 am) and to consent four suitable patients (preferable with an acute complaint) from the morning’s list at 9:30, 10:00 and then at 11:30 and 12:00 (if you have time you may see more patients). To critically appraise the impact of different strategies on vulnerable patient groups such as Opening hours, appointment systems, registration systems, incentives and targets, physical environment etc. Access to double appointments, interpreters, home visits, health promotion/screening/vaccination/regular check-ups etc. Case finding and enhanced services To have a further opportunity to practise eliciting a basic focused history from patients Eliciting the patient’s ideas, concerns and expectations Eliciting symptoms and reviewing relevant system(s) Establishing relevant context (past medical history, medications, health behaviours, family & social factors) Ask practice colleagues to allow a pair of students to interview them for 30 minutes at 9:30 and 11:30 (colleague A e.g. practice manager) and 10:00 and 12:00 (colleague B e.g. receptionist). Prepare a case example (a patient, or patient group) that needed support accessing primary care, and how your practice addressed it. Session outline: 1. Welcome and session orientation; explore any issues arising since you last saw these students; discussion around what students understand about access to healthcare and prepared case example (see above). 2. One student pair leaves to interview colleague A (e.g. practice manager) while you observe one student from the other pair elicit a history (you complete each consultation). If you have time / less complex cases you may be able to observe more than 1 patient/pair Students have a list of suggested interview questions in their KUMEC handbooks. 3. Student pairs swap after 30 minutes but interviewing colleague B (e.g. receptionist) 4. Student debrief and log book sign-up; encourage students to spend time reflecting on what they have observed and learnt, developing a plan for how the intend to progress 5. Repeat with a second set of students at 11am. KUMEC Friday Teaching Mornings: Lesson Plan for Year 2 Session 2 2015-16 Timings 09:00 09:30 Patient 1 10:00 Interview colleague B Interview colleague A Patient 2 Student 1 Student 2 Student 3 Tutorial Student 4 10:30 11:00 11:30 12:00 Patient 3 Interview colleague B Interview colleague A Patient 4 Tutorial Student 5 Student 6 Student 7 Student 8 12:30 Tutorial Tutorial Teaching tips Abstract concepts, such as access to healthcare, can come alive through real life case examples Before students have a go at eliciting a history, ask them if there are any specific aspects that they would like feedback on After giving feedback, give students a chance to rehearse suggestions Note Students had an access to healthcare symposium in January, with invited speakers on issues such as domestic abuse, LBTG health, learning disabilities, refugees, homelessness etc. Students have a list of questions on access to healthcare issues that they can ask your practice staff. Some of these questions are derived from a CQC consultation on questions for practices on access to healthcare issues, and may help your practice to prepare for these visits.