Accessing Electronic Clinical Log

17.30.06

Thanks to Rachel for these notes.

Only 1 case needed for formative exams.
Specimen questions available after Christmas on VITAL.

• SPIDER.
• Student records/Medicine/Clinical logbooks.
• Enter core cases.

Other cases
• Select "non-core" from drop-down list.
• Select code.

Case presentation - on clinical placements, in clinical skills OSCEs, post-grad
• History taking.
• Examination.
• Accurate documentation.
• Verbal presentation.

Second Year
• History and examination.
• Basic understanding of management.
• By Fourth Year, you will be expected to discuss/understand all aspects of a case.

OSCE
• Bring 10 core cases - label 1-10.
• 5 minute preparation station:
-Told which presentation.
-Paper provided.
• Use notes as prompt.
• Not necessary to memorise case, but try not to read off sheet.
• Presentation skills assessed.
• 10 minutes to present case.
• Quicker presentation = more time for questions from examiner.
• Bring cases you are familiar with.
• Try to cover a range of conditions.
• Try to find a range of patients.

• PC.
• HPC.
• PMH.
• MxH and allergies.
• FH.
• SH.
• ROS.

Structure
• Examination finding.
• Summary/impression.
• Differential diagnosis.
• Investigations/management.
• Outcome.

Tips
• Comprehensive history.
• Know examination findings.
• Think the case through.
• Present in structured order.
• Be prepared to discuss pathophysiology.

Start
• Relevant information.
• Set the scene.

Passage of time
• Order of presentation and duration of symptoms important.

HPC
• Most questions pertaining to a certain system, but consider others too.

PMH
• List of all medical/surgical events.
• Ask about specific important diseases.

MxH
• Prescribed drugs (current).
• Name.
• Form.
• Dose.
• Frequency.
• Reason.
• Duration.
• OTC.

FH
• All patient's family's medical complaints.
• Don't say "nothing relevant."

ROS
• Expect symptoms relevant to history.
• Don’t ignore others.
• Don't reel off list of things patient doesn't have.

Specialty subjects
• Paediatrics:
-Antenatal/neonatal hx.
-Developmental.
-Immunisation.
• Gynaecology:
-Menstrual etc.

Examination
• Systematic order:
-General inspection.
-Relevant system.
-Other systems.
• Record ALL positive findings, and any relevant negative findings.

Summarising
• Brief - ~3 sentences.

Differential diagnosis
• Start with most likely, then less likely.
• Investigations tailored to help you decide which diagnosis.

Investigation and management
• List simplest initial tests first.
• Should be able to discuss results and their significance.

Common mistakes
• Fibbing.
• Not making sense.
• Using abbreviations (avoid this).
• Missing out important negatives.
• Not finding out about disease process and drugs (classes).
• Not investigating particulars of the case.

Discussion
• Clarifying points in hx.
• Discuss pathophysiology.

Have a good Christmas.