© The Author 2009. Published by Oxford University Press on behalf of the RCGP. All rights reserved. For permissions please e-mail: journals.permissions@oxfordjournals.org
Crammer's Corner
GP, Chapelgreen practice, Sheffield, RCGP Examiner and Blueprint clinical lead, Associate Postgraduate Dean Yorkshire and the Humber Deanery, UK
E-mail: amar.rughani@sheffield.ac.uk
| The first 150 words of the full text of this article appear below. |
 |
‘Diagnostics’ |
|---|
‘Diagnostics’ is the second of the relationship, diagnostics, management, professionalism clusters and is made up of four domains from the competency framework, these being
- Data gathering and interpretation
- Making a diagnosis/making decisions
- Clinical management
- Managing medical complexity
The process is not difficult to understand and briefly we can describe it in terms of a continuum of:
Being able to ask the right questions ... from the right people (which will include colleagues) ... gather information from questions, investigations and examinations in order to:
 |
- decide which information is the most relevant and important ... generate ideas from ourselves and from others ... decide which of these ideas are the most important in order to:
- bring the strands together in a defensible plan
Because of our medical training, the focus of diagnostics is on medical problems and clinical management. However, as GPs, our problem-solving skills are applied much more widely. Therefore, the
|
Data gathering and interpretation |
|---|
Obtains information from the patient that is relevant to their problem
Whose problem is it?
Systematically gathers information, using questions appropriately targeted to the problem
Assessor's corner: systematic questioning
Makes appropriate use of existing information about the problem and the patient's context
How would you make use of information about the patient's context?
Assessor's corner: using available information
Proficiently identifies the nature and scope of enquiry needed to investigate the problem
Employs examinations and investigations that are broadly in line with the patient's problem
Identifies abnormal findings and results
What other sorts of abnormality might we be asked to identify?
Chooses examinations and targets investigations appropriately
What types of test might we be expected to know about?
Identifies the implications of findings and results
In what way could DNA (‘did not attend’) rates be thought of as abnormal findings?
Uses an incremental approach, basing further enquiries, examinations and tests on what is already known and what is later discovered
Tolerating uncertainty
CiteULike 
Connotea 
Del.icio.us What's this?