1 of 14 integrated curriculum evaluation exercise approach to interview and pe skills anita c....
TRANSCRIPT
1 of 14
Integrated Curriculum Evaluation Exercise
Approach to Interview and PE Skills
Anita C. Mercado, MDICEE Director
2 of 14Integrated Medical Curriculum - ICEE
Appropriate
o Move from open to directed questionso“What brings you in today?”
Inappropriate
o Leading: “It’s not a sharp pain, is it?”o Multiple choice: Is your pain sharp, dull or
aching?
History of Present Illness(HPI)
3 of 14Integrated Medical Curriculum - ICEE
Appropriate
o Clarify answers when neededo Ask questions in sufficient detail
Inappropriate
o “I get the pain when I walk” (how far/fast)o “I’m a social drinker.” (quantify amount)o “I eat a balanced diet.” (explore details)
HPI
4 of 14Integrated Medical Curriculum - ICEE
Appropriate
o Relevant positive and pertinent negative itemso ASCVD*: Presence or absence of risk factors
Inappropriate
o ASCVD: Questions not relevant to chief complaint
Interview: PMH, FMH, SH, ROS
*ASCVD- atherosclerotic cardiovascular disease
5 of 14Integrated Medical Curriculum - ICEE
Appropriate
o Introduce sensitive subjects appropriatelyoSocial history: “I need to ask you some
personal questions. Is that ok with you?
Inappropriate
o Sexual or drug use history without introduction
Interview: PMH, SH, ROS
6 of 14Integrated Medical Curriculum - ICEE
Appropriate
o Place patient in correct positionoExamine the patient from the right side- if
possibleInappropriate
o Examine patient over their gownoHeart exam in sitting position onlyo Fail to drape properlyo Fail to raise leg support
Physical Exam: Position
7 of 14Integrated Medical Curriculum - ICEE
Appropriate
o ASCVD: Heart and vascular exams
Inappropriate
o HTN: omit fundoscopic examo Bleeding: omit conjunctiva color/palloro Weight loss: omit thyroid exam
Physical Exam: Relevance
8 of 14Integrated Medical Curriculum - ICEE
Appropriate Inappropriate
Physical Exam: Common Mistakes
Ensure appropriate distance from the patient.
9 of 14Integrated Medical Curriculum - ICEE
Appropriate Inappropriate
Physical Exam: Common Mistakes
Ensure proper technique when using oto- / ophthalmoscope.
10 of 14Integrated Medical Curriculum - ICEE
Appropriate Inappropriate
Physical Exam: Common Mistakes
11 of 14Integrated Medical Curriculum - ICEE
Appropriate
o Warn before painful/surprising maneuvers
Inappropriate
o Abrupt PE maneuverso Palpate thyroid gland from behind without
warning
Physical Exam: Patient Comfort
12 of 14Integrated Medical Curriculum - ICEE
Poor IntroductionPoor eye contact/No fluidityDisorganized data gatheringPremature closurePremature counselingLecture counselingIgnoring patient concernsInterrupting patientPoor closureIncomplete interview
Interview Challenges
13 of 14Integrated Medical Curriculum - ICEE
Questions about the ICEEPlease read ICEE orientation content or
contactAnita C. Mercado, [email protected]