Teaching safe consulting
Learning to be a safe doctor needs to begin early
A BMJ editorial highlighted the importance of teaching medical students to make “rational decisions about diagnosis and treatment” during patient consultations.1 Although the importance of teaching communication skills alongside knowledge based skills is well established, a key component of rational decision making is often overlooked: safe practice.
Safe practice aims to avoid serious errors in diagnosis and treatment. This can best be achieved by teaching student doctors to place patient safety at the heart of the consultation through adopting safe consulting practices, such as “always excluding the worst, first” when assessing a patient. For example, it is essential to exclude meningococcal disease when a child presents with a high fever, or to exclude a heart attack when a patient presents with chest pain. One of the authors (PS) has been teaching this approach to consulting for several years and has received positive feedback from both student and junior doctors.2