One to One

The main difficulties are that there are only two opinions rather than a whole group, and it is easy for the session to become a teach-in by the trainer. The success of the session is more dependant on the relationship between teacher and learner. The trainer has a more complex and multi-faceted role with the individual learner, (confidant, support, giver of reference, assessor, advocate etc.) which may be advantageous and give the learner a less threatening exposure to direct observation of practice, but not necessarily so. The use of roleplay may be difficult as there are only two people rather than the whole group who would contribute more suggestions and thereby extend the repertoire of skills and strategies. In one-to-one training there is no observer to contribute objectivity.

What  helps is the trainer being prepared to put herself in the shoes of the learner by contributing directly by offering own suggestions of skills/strategies,  and showing her own video first.

We would suggest that watching a video every other week during the registrar year is mandatory.

Main methods

·      video/audio of real consultations

agenda-led, problem based analysis using roleplay and reverse roleplay and discussion

            Linda Gask’s method/ problem based analysis

            RCA

labelling structure and skills

            using the tape for exploring clinical problems

focusing on specific issues, eg BBN, interviewing depressed patients/telephone consultations

focusing on specific skills eg body language, open/closed cone

            looking at a whole tape to see the patterns emerging (useful for SA/MRCGP)

·      problem case discussion

            roleplay/reverse roleplay

·      trigger tapes

            labelling structure and skills

·      direct observation of surgeries/visits/coop