The anatomy of a consultation: a teaching method.

Overview

The Anatomy of a Consultation is a teaching method useful in introducing residents to Consultation-Liaison psychiatry. It is designed to stimulate them to think actively about the process of consultation in its broadest implications, including interaction with staff. The residents are encouraged to observe, make inferences, establish hypotheses about the evolution of the consultation, and to test these hypotheses by obtaining new information. The analogy of an unfolding detective story is used. A resident is asked to present the evolution of a consultation chronologically for ongoing group discussion. A vertical and a horizontal approach to the examination of the material are used. The vertical proceeds with clarification of the consultation as it evolves toward closure. The horizontal takes as its point of departure various topics that emerge to illustrate general principles and applications in different situations. These topics are approached more systematically and in greater detail in later teaching. Emphasis is placed upon coping and adaptation and the principles of active interventions useful for people in crisis. Patient data is organized within two broad categories: 1) the diagnostic, phenomenologic, and psychopathologic; and 2) the psychodynamic, conflictual, and life historical. An illustrative example is presented.