Sunday, August 9, 2009

Teaching Students How To Consult Specialists

I subscribe to several medical Twitter feeds, ones that are 1) useful 2) have a readable frequency of posting 3) and are relevant.

Thanks to the feed by "Dr. Ves", I found a cute survival guide written for first-year general practitioners in the United Kingdom. Now their medical education system differs from ours significantly, as well as their whole funding, but I was excited to find this new mnemonic: SBAR.

Situation: I am [med student, resident, doc] on [the general inpatient service, the urgent care clinic, the pediatric clinic], and I need your help with [x].

Background: give patient's age, reason for presentation to your service, current status, problem, relevant history and exam, relevant labs, etc.

Assessment: I think the problem is x

Recommendation: I want to do this, what would you recommend. OR I need you to see them.
(Record: record your conversation, the plan, and if they are consulting, the time frame)

I like that it gives a nice framework for students to think about speaking to a consultant. Oftentimes we tell them "call nephrology", and they are awkward and incomplete on the phone, despite coaching. However, this acronym, SBAR, is entirely new to me, and I find it hard to remember. Another acronym and mnemonic SOAP, is a framework we teach for writing notes, and it also appears in the guide for new physicians. Notes, it appears, are universal. It will be easy and convenient to remind students of what they know and frame their call to the consultant in a SOAP format.

Subjective: how is the patient doing, what brought them in, what are their concerns
Objective: background/history, age, labs, exam
Assessment: as above
Plan: as "recommendation" above

Abbreviation: sbar, UK, soap

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