* Never hurts to ask the patient – are you comfortable? Before you start the physical exam
* Look at the patients face for expressions/discomfort/pain
* Prepare your introduction in advance – be ready to make subtle changes to it
* Read the questions carefully and do only what is required, extra tasks carry NO points.
* At the end of a counseling station, if appropriate, you can refer the patient to a support group, provide pamphlets or refer them to websites with more information on their conditions. They can always come back to you or call you if they have any questions!
* Do not hurry into the task; find the right pace while you practice with your study partner. Nervousness can make you go faster (or slower) than usual!
* For the counseling stations, let the patient ask you questions rather than you blurting out all your info at once. “Do you have any questions or concerns?”, “I hope I was clear so far”.
* Don’t forget to wash your hands before you start the physical examination
* For a depressed patient, who isn’t talking, break the ice by asking very basic questions
* History taking: most of it is readily provided by the patient; however, sometimes there is an important piece of info that the pt gives you only when you specifically ask for it!
* Know how to put together pieces of an ophthalmoscope/otoscope and know how to use them
* Know how to break bad news, expect the patient to cry. Give them a moment to digest the bad news. They are actors but they know you have only 10 mins ;)
* Don’t forget BP/Vitals especially for Cardiac/Resp cases– the examiner would usually ask you to skip it
* Greet the examiner as well when you enter the room.
* Make good eye contact.
* Show empathy – My father died last year of cancer “Oh, I am sorry about that, .. ..”,
* Do not blame/judge the patient.
* Say “I would like to ask you a few personal questions” before you ask personal questions like sexual history, etc
* It’s a good idea to summarize during history taking. I summarized once after HOPI and the rest at the end of the history. Only include positive findings in your summary and only if you have time. (eg. “So Mrs. Smith, from what I have gathered so far, you have some chest pain in the center of your chest, especially after heavy meals and when you lie down. Is that correct?”)
* Study partner – very important. Point out your partner's mistakes, ask them to do the same!
* Time your practice sessions right from the start, get used to the 10-minute time limit.
* Use clear and easy to understand language, do not use medical terminology with patients (if you do, explain it)
* Know how to manage patient emotions – crying, anger, depressed, anxious, pain, worried.
* You do not have to know the dosage of medications, you must know what treatment options are for the condition or at least a broad idea of it (eg, IV fluids and antibiotics).
* Listen to the patient – almost everything they say is important
* Mnemonics definitely help during history taking. Follow a sequence and get used to it. PAMHUGSFOSS is a commonly used one for History taking.
* If you get a chance go to North shore hospital and check out the OPD rooms
* The actors grade you out of 5. Be nice to them! Make them feel comfortable, be kind, be empathic, speak clearly, use layman's terms, etc.
* Leave the room as soon as the bell rings (say thank you while you leave, to both the patient and the examiner). Your time for the next station starts when the bell rings.
Great Tips!
ReplyDeleteHi...hm id like to know if you have cex files?or where i can acquire one?
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