BlueSpikes
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Currently finishing 3rd year Gp placement and keep finding myself to be halfway through a consultation and going blank and running out of questions to ask.
Any help?
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Gaucat
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Have you tried having a checklist for the main areas? Sometimes having it in a physical form helps a little. Over time you will start to get a bit of a mental checklist and won’t need it anymore, but it’s a good way to practice at first if you keep forgetting to ask certain things.
Last edited by Gaucat; 1 month ago
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Anonymous #1
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SOCRATES is your friend.
It's meant to be for pain but I adapted it and applied it for every symptom.
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fishfacesimpson
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First of all don't worry. You're right at the start of learning a really difficult skill and trust me there are doctors who have been practicing for years who will miss out a lot of details for sometimes common things. Even experienced people will have a brain freeze so completely normal for it to happen a lot early on.

It's like every skill, key is practice.

Remember the history of presenting complaint is not just a collection of symptoms. You're building a story. You have to interpret that story to distill it into the different problems the patient is having. A lot of the time the basic problem you're trying to solve is where in the body is the problem arising from. This is the case for many common presentations eg. Shortness of breath, headache, abdominal pain etc. Once you know where; you hone in your questions to find out what the physiological process might be.

Getting slicker and better at it is all about pattern recognition. The problem is clinical written exams in medical school distil those patterns into a few key points. History taking is all about human interaction and how you guide the history will vary from patient to patient, so you have to go digging

I'm not a mind map kind of guy generally but found them very helpful as an aide memoir for basic presenting complaints. You can even write a sort of mind map as you're talking to patients.

Always always make a note (mental or written) about what you've seen that day. Not necessarily the final diagnosis but the history of presenting complaint and how that led to different differentials. It's easy to write down 10 conditions you saw in a day and read the pathophysiology of each that evening but it's more useful to reflect on the questions you did or didn't ask that day for certain symptoms.
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BlueSpikes
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Thank you very useful fishfacesimpson
I think I just need to practice loads from what you have said. I did get lazy with noting conditions I saw in the day. In the future I'll make sure to do this and note differentials etc.

Much appreciated
Last edited by BlueSpikes; 1 month ago
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asif007
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To me this just sounds like you need to practise taking more histories before you do them on patients. Learn the structure of histories for every presenting complaint and learn the signs/presentations of all the potential diseases you're looking for. You can't do one without the other. Go through any good OSCE teaching manual - they have checklists of everything you need to do, plus explanations for why you're asking each question and how a particular disease might present. Practise with your fellow medical students, share knowledge, learn from each other and maybe do some peer-to-peer teaching for people who aren't picking it up. Being able to teach it to someone else reinforces your confidence in the subject.
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BlueSpikes
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(Original post by asif007)
To me this just sounds like you need to practise taking more histories before you do them on patients. Learn the structure of histories for every presenting complaint and learn the signs/presentations of all the potential diseases you're looking for. You can't do one without the other. Go through any good OSCE teaching manual - they have checklists of everything you need to do, plus explanations for why you're asking each question and how a particular disease might present. Practise with your fellow medical students, share knowledge, learn from each other and maybe do some peer-to-peer teaching for people who aren't picking it up. Being able to teach it to someone else reinforces your confidence in the subject.
I agree. I didnt practice history taking much and am always a little anxious when thinking about taking one.
Do you have any recommended OSCE teaching manuals?
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seaholme
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(Original post by BlueSpikes)
I agree. I didnt practice history taking much and am always a little anxious when thinking about taking one.
Do you have any recommended OSCE teaching manuals?
https://www.amazon.co.uk/OSCE-Cases-...dp/1848290632/
I remember using that one and it was pretty good with lots of cases to practice and sample mark schemes.
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