1
Sunday, 16th January 2022
Week 1
Medicine
Introduction to clinical reasoning and year 2 communication skills general examination
Clinical reasoning
Ability to sort through features presented by patients and assign a diagnostic label
with development of appropriate treatment as an end goal
Experts recognise a characteristic sign or feature due to years of experience
o Why histories are important to help develop this knowledge
What skills do you need?
o Communication skills
Year one communication skills
Gathering information
o Open question
Short summaries
Reflections
Long summaries
Explore patient perspectives
Year one biomedical information
Symptoms
o Cardiovascular
o Respiratory system
o Gastrointestinal
Clinical reasoning sessions
Students struggling with these skills
Clinical reasoning in medical education
Increasingly recognised that you need to be taught to reason clinically
block 9
o Symptom analysis
o Single sentence formulation
Block 12
o Analysis of clinical reasoning process
o Deliberate practice of the clinical reasoning process
o Joining up the biomedical perspective
More sessions for clinical reasoning in event of covid and online learning
Symptom’s analysis
Want students to think of ways to discriminate between different causes
How do you differentiate between causes?
o Heart attack
Typically gives pain going into left arm
Worse with exercise
o Acid reflux
Worse when lying down
Development of the abnormal
Different conditions present at different ages
Single sentencer formulation – preparation for year 2 placements
Many components
o Demographics
, 2
Sunday, 16th January 2022
Week 1
Medicine
o Pathophysiology
o Communication skills
o Hypothetico-deductive reasoning
o Surgical sieve
Different disease processes
Metabolic cause
Infective cause
Inflammatory cause
o Metacognitive awareness
Novices who won’t necessarily notice patterns due to not having large amounts of
practice
Can’t suddenly be an expert at driving and it is the same with clinical reasoning
o Need to break it down into different steps
o Why we have these sessions
Breaks it down into different steps and skills
o Dangerous to look at someone and say this is what is wrong
Learn more about gathering information with purpose
Difficult news and patient distress also covered
Jargon
Easy to use the jargon and technical terms but this is not easy for patients to
understand
Important that this is remembered when communicating with patients
Use appropriate information for the patient
Health literacy
Cognitive and social skills to gain access to information to maintain good health
Extends beyond the consultation
Be careful not to make assumptions
Communicate in a way patients can understand
Misconceptions and misunderstandings
Familiar words in unfamiliar ways
Unintentionally use unfamiliar words
o Sedentary
o Positive diagnosis
Thinking they don’t when they do
Supplement with leaflets and booklets and links to online resources
o Can be confusing for some patients
o Jargon
o Technical terms
o Level of language
Top tips
Think about questions asking and why
Think about terms being used and whether they will be understood
General physical examination
Clinical grade PPE will still be worn
Make sure you understand donning and doffing PPE.
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