Try practice Sarcoidosis in term of Seven core clinical skills assessed in the PACES examination.
Here is a sample from 2010/2 diet:
station 2- jt pain , dry cough and bilateral gld + in CXR,
two candidates sat apart 2 weeks in a UK centre got the same scenario.
(PS. in station 4,don’t bother skill D, ie.Differential Dx;but it is assessed in all other stations!)
Clinical Skill/Skill Descriptor
A
Physical Examination
Demonstrate correct, thorough, systematic (or focused in Station 5 encounters), appropriate, fluent and professional technique of physical examination.
B
Identifying Physical Signs
Identify physical signs correctly, and not find physical signs that are not present.
C
Clinical Communication
Elicit a clinical history relevant to the patient’s complaints, in a systematic, thorough (or focused in Station 5 encounters), fluent and professional manner.
Explain relevant clinical information in an accurate, clear, structured, comprehensive, fluent and professional manner.
D
Differential Diagnosis
Create a sensible differential diagnosis for a patient that the candidate has personally clinically assessed.
E
Clinical Judgement
Select or negotiate a sensible and appropriate management plan for a patient, relative or clinical situation.
Select appropriate investigations or treatments for a patient that the candidate has personally clinically assessed.
Apply clinical knowledge, including knowledge of law and ethics, to the case.
F
Managing Patients’ Concerns
Seek, detect, acknowledge and address patients’ or relatives’ concerns.
Listen to a patient or relative, confirm their understanding of the matter under discussion and demonstrate empathy.
G
Maintaining Patient Welfare
Treat a patient or relative respectfully and sensitively and in a manner that ensures their comfort, safety and dignity.
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Comments
station 5
from RCP site says:
“You should assess the problem by means of a relevant clinical history and a relevant physical examination. You do not need to complete the history before carrying out appropriate examination.
• You should respond to any questions the patient may have, advise the patient of your probable diagnosis (or differential diagnoses) and your plan for investigation and treatment where appropriate.
• You have 8 minutes to complete the task.”
THAT MEANS MINUTE 6-8 SHOULD BE SPENT with the patient ON
1.ASKING CONCERN OR FEAR
2.TELL THE DIAGNOSIS
3.EXPLAIN MANAGEMENT PLAN
LAST 8-10 MINUTE ENCOUNTER WITH LEAD EXAMINER WILL MAINLY RELATE TO
1.FINDINGS
2.DDx
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