Narrativity and the teaching of consultation skills: Godwin’s story

I am teaching communication skills to GP registrars in South East England using actors role-playing as patients.a Our 'patient', Rob, is consulting with Godwin, a registrar, while Godwin's colleagues observe and take notes.Rob is talking about his headaches; he's been suffering for months, nothing helps, he's totally fed up.The features don't sound suspicious, so Godwin isn't too worried, but he commiserates and offers to refer Rob to the hospital.But Rob is irritated, that will take ages he says, he needs something NOW.Godwin hesitates and suggests some routine painkillers.Rob snaps back how he already told him they don't work, he can't sleep, he's even started drinking two whiskeys before bedtime.The observers can see Rob is throwing Godwin a bone.But Godwin is stuck.Why isn't Rob pleased with the offer of a referral?In his confusion he says again he will refer Rob and then suggests he could try an anti-migraine medication.Rob explodes, this isn't migraine he says, why won't Godwin help him!? Godwin retreats and says he's sorry to hear that and once again says he will refer Rob and that he can carry on taking the painkillers.Rob sighs.I call time.Godwin is glum.'That was awful', he says.'The problem is I thought it was a headache story, but really it was an anxiety story.'Someone in the group helpfully chips in -'perhaps it was both?'