PUNs and DENs: Discovering Learning Needs in General Practice (Radcliffe Professional Development)

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A comprehensive understanding of local services and patient pathways, to enable timely and appropriate referrals If you have logged on to your eportfolio you will no doubt notice significant changes to the format of your online appraisal, with headline areas for reflecting on personal and professional wellbeing and achievements, challenges and aspirations. Defining learning needs can be difficult, often because we have been educated in the system of always being right and justifying ourselves. The underlying philosophy of defining learning needs is that of the error model, where errors or omissions are not only permitted. but their recognition encouraged and celebrated. In this model, the teacher is the factor that enables the learner to recognise and act on the errors. In medicine, error equates to tragedy and even death. Whilst this can be the case, it is probably a failure to recognise small errors that results in a major error.

Phone call: a father wants to know why an antibiotic was not prescribed during an earlier consultation for his child, whom now has acute otitis media

And recognition of deficiencies leads to the discovery of Doctors’ Educational Needs DENs. When you discover Patients’ Unmet Needs you have found your first PUN, leading you on to then construct your DEN.

Death and cremation certificates including regulations on completing certificates, when to refer to the Coroner/Procurator Fiscal These changes are very welcome, considering many sessional GPs have had lots of issues, as outlined above respond best to a non-threatening learning environment where there is a good teacher/learner relationship. Provide patients with information in patient information leaflets (PILs) and other reliable sources of information (for example, NHS Choices and resources bearing The Information Standard quality mark) where appropriate

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Discrimination can be defined as the practice of treating individuals less fairly than other people or groups. The Equality Act (2010) protects people from discrimination on the basis of nine 'protected characteristics': Role-played consultations, for example during teaching or courses, are valuable in exploring consultation behaviour in a safe environment, especially those using 'standardised patients' (played by actors or role-players who have been trained to react in a consistent or specific manner). As mentioned above, we have all been under strain this year and having a supportive, confidential and dedicated space to debrief and decompress about our experience of the pandemic will hopefully strengthen us going forwards. Many of us may not have had the opportunity to do this in any structured way over the past six months and it may be more needed than we realise. the importance of context and organisational culture and how this impacts quality improvement work;

Insurance certificates including for life insurance, critical illness insurance (Personal Medical Attendant's reports), travel insurance This area is about communicating effectively with patients, using recognised consultation techniques, establishing effective patient partnerships, managing challenging consultations, consulting with third parties and using interpreters.

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This topic overlaps with others and, in particular, should be considered in conjunction with the following RCGP Topic Guides: Population-based prevention strategies including immunisation, health screening and population screening