Tuesday, May 22, 2007

"Well, the patient doesn’t appear to be UNDERweight…"

So for the past two days I’ve been a simulated patient for the 3rd year OSCEs. This is my second time doing this, and it’s definitely a different experience being on that side of the bed. Yesterday I was the patient for a neck exam (“This patient has come in today because of a suspicion of an overactive thyroid. Perform an examination of the neck, focusing on the thyroid gland.”), while today I was the patient for cardiovascular system exam (“Please perform an examination of the cardiovascular system, leaving out abdomen, peripheral pulses, BP, etc” [it’s only a 5 minute station – how much can you really expect to get done?). It’s always fun to notice the slight differences from student to student, whether it is because they were taught by a different demonstrator, learned little tricks during practicing, or just practiced differently. You can also almost always tell who has practiced, and who hasn’t (which is funny, because they knew exactly what was going to be on the exam because they were told so weeks in advance). I found that the students with excellent communication skills and confidence in speaking would be very nervous when it came time to the examination; and those that were quiet or shy would know exactly what signs to look for and didn’t miss a thing. Maybe it’s compensation, maybe not. But there were also the handful or so who were amazing at both – and it’s probably those who got full marks, although having peeked at the marking sheet, it didn’t look like their attitude to the patient or whether they hurt me during examination or not (seriously, some of those guys can be rough!) had any effect on their grade.

Best lines from the two days:
• During neck exam, on General Inspection: “Well, the patient doesn’t appear to be underweight…”
• During CVS exam, when finding apex beat: “Apex beat is not palpable due to excess body fat.”

And now I embark on my long night of packing, as I leave for home on Thursday.

Until next time,