To help us improve how we interact with clients, we had to do several "observed consults." Two of them were on consult week (and if you got the chance, you did more while on referral medicine). For comparison, the rest of the consults were us just grabbing the client, taking them into a room, taking a complete history and physical exam, and then locating an attending vet to talk about the case (including diagnoses and plan). They don't come in until you've finished with the client.
In the observed consult, on the other hand, they stay in the room with you. They explain to the client how it's going to work, and that they're going to be a bystander for the consult. They have a clipboard with a grading sheet--and the client gets one, too.
As you might expect, this throws things off. First of all, you're bound to be at least a little more self-conscious, talking in front of an actual vet. Secondly, both good and bad, sometimes the vet can't help themself and starts asking their own questions or redirecting the conversation. This becomes a nuisance if you're with a chatty vet, who strikes up conversation with their friend the client, all while you're still trying to get through the consult. And by far the most annoying thing that I noticed--and the vet agreed when she asked me what I thought about the experience--is that the clients behave very differently. They direct comments and questions at the clinician, even though the clinician is sitting in the corning not saying anything, and I am standing right smack in front of them with my hands on their dog. They're far less chatty with me the student, so it's hard to get into a flow. All in all it's not a very accurate representation of what it's like when the clinician isn't present.
There's a range of niceness when it comes to the grading. Some of the vets are real softies. One of the ones I got gave me tons of helpful advice, and said I did really well in a lot of regards, but still gave me low grades because he has high standards.
Some of the points that stood out were...
- Explain what's going to happen, so the client doesn't sit there wondering "why are they asking me all these unrelated questions?"
- Direct the conversation more; don't let the client run free and tell you everything on their mind. Easier said than done, especially when the client does not stop talking.
- Establish some rapport at the start--it's helpful to know the client's relationship to the animal and what they want out of the consult.
I got called out a lot on point #2. I was all "But... she was saying the answers to all the questions I was about to ask, so I didn't need to stop her," but I was still told I needed to give the consult some more direction. Thus came the question, "How on earth do you do that without being rude?" The best suggestion was to wait for them to take a breath.
Well, actually, what he said was to ask for clarification using a closed yes/no sort of question, so they can't keep going. Then you can redirect with an open question on a different angle. Or you could always outright stop them and politely say you want to focus on something else for the moment.
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