Teachers:

MD PhD  Alicja Małgorzata Ołtarzewska on duty at Department on Monday (12-14 p.m.)

email:  alicja.oltarzewska@umb.edu.pl

MD PhD Anna Gryko on duty at Department  on Tuesday ( 12-14 p.m.)

email: anna.gryko@umb.edu.pl

CHECK LIST

Gathering informations from the patient about the main complaint

ESTABLISHING INITIAL RAPPOR, STUDENT:

1. greets the patient, invites the patient to the doctors’ office YES/NO

2. introduces self (by saying own name, and explaining own role) YES/NO

3. obtains the patient's consent to conduct an interview YES/NO

4. indicates the place to seat YES/NO

5. obtains patient’s personal data - patient's name and age, YES/NO

IDENTIFICATION OF THE REASON FOR CONSULTATION, MAIN COMPLAINT

1. Asks an open-ended question to identify the reason of the patient’s attendance.

2. Asks another problem-oriented open question (Please tell me about this pain)

3. Uses the open-to-closed cone method YES/NO

4. Explores all characteristics of pain (acronym SOCRATES): site, onset, character of the pain, radiation, associated symptoms, timing (moment of occurrence and duration) exacerbating/relieving factors, severity (on a scale of 1 to 10) YES/NO

5. Clarifies (explains incomprehensible phrases) YES/NO

6. Uses screening (Is there anything else?) YES/NO

7. Uses paraphrase (repeating the patient's words in your own words) YES/NO

8. Summarizes the patient's statements, confirms the problem or list of problems with which the patient reported to the doctor YES/NO

ACTIVE LISTENING TECHNIQUE, NON-VERBAL COMMUNICATION

1. makes eye contact YES/NO

2. does not interrupt the patient after asking an open question, YES/NO

3. confirms that he hears: nods (mhmm), nods, says "I understand" YES/NO

3. is turned towards the patient, sits leaning towards him YES/NO

4. gesticulates carefully (controls "para-movements") YES/NO

6. warns the patient when he wants to note down YES/NO

7. uses silence, pauses (without breaking eye contact) YES/NO

9. avoids medical jargon YES/NO

EXPLANATIONS OF THE TECHNIQUES

OPEN-TO CLOSE CONE METHOD

OPEN QUESTION RELATED TO THE PROBLEM

(Tell me more about this pain)

SPECYFIC/CLARIFYING QUESTIONS (When the pain started?)

CLOSED QUESTIONS (Did you vomit?)

CLARIFICATION

Inquiring about the meaning of incomprehensible words and phrases said by the patient

"Can you explain what it means for the pain to be so 'weird'?"

SCREENING

Screening questions: ASKING THE PATIENT IF THERE IS ANYTHING ELSE THEY WANT TO ADD

"Anything else?"

It is used until the patient has nothing to add

Screening can be used at various points during the consultation, e.g.

• when identifying the reason for visiting a doctor

• when asking about associated symptoms related to the main complaint

• when identifying symptoms not related to the main complaint (symptoms affecting other organs and systems)

REPEATING, SUMMARY, SUMMARY PATIENT'S STATEMENTS

• ECHO: literal REPEATING a word or phrase SPOKEN BY THE PATIENT

• role: emphasizing an important fact ("So very severe pain"), clarifying ("does he feel the right side?", "uncomfortable?")

• PARAPHRASE – rephrasing the statement and repeating it.” I understand that…"

• SUMMARY of the patient's main complaint at the end,

• role: time for reflection for both the patient and the doctor, whether we want to ask something, supplement or correct information.

List of skills acquired by the medical students during the practical clinical training

Confirmation of the acquired skills is signed by the doctor conducting classes at the GP practice

1. Use of an oximeter.
2. Differential diagnosis of the most common adult diseasees.
3. Diagnostic, therapeutic and prophylactic planning in the most common adult diseases.
4. Interpretation of laboratory results.
5. Prevention, diagnosis and treatment of the most common diseases in primary care.
6. Delivering unfavorable information according to protocols (e.g.: SPIKES, EMPATIA, ABCDE).
7. Death confirmation.
8. Ambulatory care and rehabilitation of chronically ill patients.
9. Familiarisation with rules of nursing and feeding of a newborn and neonate.
10. Analyzing the summary of product characteristics (SPC) and critical appraisal of medical advertising materials.
11. Planning referral of patients to specialists.
12. Individual approach to current treatment guidelines or other therapeutic methods when standard therapy is ineffective or contraindicated.
13. Practical knowledge of the contracting process of both public and commercial health care services.

Solving clinical problems with the use of internet based medical databases

Please solve the following 3 clinical problems using internet based databases