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The group was then divided into small groups of about 10 and the “Patients” moved from one group to another where there was a simulated surgery observed with “volunteer trainers” doing the consultations. A discussion about the “feelings” of the doctor and patient took place. Then group observers gave comments for the trainer and patient to reflect upon – “CONSULTATION SKILLS” – The role or script was available to the actor and observers. The actor gives consistent clues. Questions like: Did I do that well? Did I get to your concerns? How satisfied were you with my management? This lends itself to OSCE – Objective Structured Clinical Examination The process can be more formative than summative. The basis is problem-based casework. e.g. In our cases learning points were as follows: Diagnosis of depression, handling non-compliance addict’s request etc. Assessment of suicide risk. Persuasion of importance of treatment. Safe management and follow up. Listening skills of doctor. Non-verbal cues and their recognition. Advantages Learning takes place in a contextual manner. It is safe environment and time controlled. It is repeatable and can be videotaped for use and is designed to be case specific Patients can feedback and it allows risk taking There are limitations, which are as follows: The process can take time and be costly Recruitment and training needs are high. Physical signs may be absent in actors Children are not used Intimate examinations are out Patients can be known to examinees Case writing and documentation can be an issue. Discussions after the consultations surrounded the challenges to the doctor and patient e.g. 3 Column technique What does patient do? What does doctor do? What no one can do? *1PW‚ŒЕО[bšвл7 8  * ѓ §§§§§§§§§§>*)*P‚Евг[вгою6ўџ$@klГх ќњњњњњњјњњњњњњњњњњњњњњњњњњњњ$)*P‚Евг[вгою6ўџ$@klГх > ? † Ђ Щ ш  + , 7 8 e ‘ Р ф   C D l • М в №  C ќљіѓ№эъчфсолиевЯЬЩЦУРНКДЌЄœ”Œ‰Яњџџ  ыњџџ   ћџџ  1ћџџ  Mћџџ   ”ћџџ •ћџџШћџџЩћџџюћџџ ќџџgќџџhќџџ“ќџџЏќџџУќџџФќџџдќџџеќџџ§џџх§џџѕўџџџџџџџџCџџџxџџџвџџџгџџџ6 > ? † Ђ Щ ш  + , 7 8 e ‘ Р ф   C D l • М в №  C D œ §§јјјјјјєђєєєєєєєєєєєєєєєєєє„h & FC D œ Д Ъ п ѓ œ Д Ъ п ѓ ћііі$„h„h,1hА‚. 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