26 March 2016 at 10:18 delete Thanks Aleks! Lissauer, T., Clayden, G., & Craft, A. This can be done by talking separately to each in turn, introducing the idea through normalisation – “It is my usual practice to…”. OSCE Stations Chapter 1: Paediatrics. Social, Emotional and Behavioural Developmental milestones must be considered in regards to their ‘median age of acquisition’ (when half of a standard population of children achieve that level) and the ‘limit age’by which they should have been achieved. This allows you to check your understanding of the child’s history and provides an opportunity for the child/parents to correct any inaccurate information. Should you wish to take notes as you proceed, ask the patients permission to do so. The HEEADSSS acronym is a useful tool for exploring this area of the history. Who do you get on with best and/or fight with most? Have you ever felt so sad that life isn’t worth living? 0 . The paediatric cardiovascular exam can be a logistical minefield, requiring a good understanding of cardiac anatomy and possible congenital anomalies. _gaq.push(['_setAccount', 'UA-38966170-1']);  Common Respiratory OSCEs . What do you like the best/least at school/college? Inspect the size and shape of the pinna from top to bottom. Were any medications taken during the pregnancy? OSCE Pediatrics Observed Stations (Mock Exam Apr 2013) 1. All OSCE notes and OSCE The most important aspect of history taking is to listen. Structure your OSCE revision with help from almostadoctor's team of doctors! Vision and Fine motor 3. _gaq.push(['_setDomainName', 'oscestop.co.uk']); Young people are often starting to develop intimate relationships, how have you handled that part of your relationship? If so, when and in what way? Pediatric Limp Asymmetric deviation from normal gait pattern (i.e. Unauthorised reproduction Generally, this is done to avoid embarrassing older children or adolescents and to allow for the imparting of sensitive information. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. [. Ask if any family members or friends have recently experienced similar symptoms to those the child is presenting with: Ask about conditions which appear to run in the family and clarify who has been affected: If one of the child’s close relatives are deceased, sensitively determine the age at which they died and the cause of death: Explore the child’s general social context to gain a more complete picture of their wellbeing including: Ask if the child is currently under the care of social services, subject to a child protection plan or has previously had social services involvement: When taking a history from an adolescent or young adult, it is important to address the health risk behaviours that are more prevalent in this population, as well as the young person’s resilience factors. Most patients present to the emergency room after their “seizure” has finished. In the history taking and counseling stations, the content rather than the style is assessed. Is the child meeting their developmental milestones? A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. If left untreated, this can lead to a chronic structural deformity such as cauliflower ear. History Paediatric history Include full systems review to find possible source Specifically ask: fever duration, feeding, hydration/toileting, medications, vaccination history. Observe how the child is playing and interacting with any siblings and their parents/carers. What was the child’s gestation and birthweight? Has medical attention been sought before now? mild rash vs anaphylaxis). (function() { •Cardiac history or family history of sudden death May have occurred during exercise or when supine Aortic stenosis •Collapse on exertion •Breathlessness worse on exertion Neurological Seizure Partial • Simple partial: focal motor seizure, no LOC • Complex partial (e.g. The OSCE Marking Scheme 302 Revision Checklist 304 Recommended Reading List 306 Index 307. The middle ear contains the three smallest bones in the body – the ossicles. Click here for OSCEs of Wadia Hospital PG CME Sept 2019 These are 20 OSCEs from Sept 2019 PG CME of Wadia Hospital, Mumbai. Signposting, in a history taking context, involves explicitly stating what you have discussed so far and what you plan to discuss next. Are there any concerns about the child’s development? Ask if the child is currently taking any prescribed medications or over-the-counter remedies: If the child is taking prescribed or over the counter medications, document the medication name, dose, frequency, form and route. ; Data gathering skills: Your way of patient information collection by history taking and physical examination. Every effort Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Medical student OSCE revision checklist for finals. Managed by GP. We have outlined the HEEADSSS structure below with examples of questions to be asked in each section. 2012-present Dr Christopher Mansbridge. Ensure you initially keep a comfortable distance, establishing eye contact and rapportwith the family. The examiner expects basic competency and basic steps in history taking and clinical examination. Were there any concerns during delivery or interventions required? You are seeing Ms. Hamilton, a 64 year old man, for left sided back pain. However, it’s also important that the young person understands that confidentiality cannot be assured if they’re at risk of harm – to themselves, or others. Past History • Asthma – no previous admissions to ED, has missed school days due to asthma. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Lots of people your age smoke, have you been offered cigarettes? heart valve replacement, appendectomy): Ask if the child has any allergies and if so, clarify what kind of reaction they had to the substance (e.g. The middle ear is located within the petrous temporal bone, between the tympanic membrane and the lateral aspect of the inner ear (see diagram). Are you worried about your weight or body shape? Check out our brand new medical MCQ quiz platform at https://geekyquiz.com. It is structured around a differential diagnosis of the presenting complaint; which is Be mindful to allow the child time to answer and do not interrupt. Taking a paediatric history can at first seem daunting due to the wide breadth of topics to be covered. Dispose of PPE appropriately and wash your hands. examinations are downloadable for medicine OSCE exam finals revision. What was it like? It’s important to reassure the adolescent that the content of the conversation will remain confidential and that you will not discuss any aspect of it with their parents/carers without their express permission. It is also important to ask about any complications associated with the condition including hospital admissions. A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. ... Get YouTube without the ads. A systems review involves performing a brief screen for symptoms in other body systems which may or may not be relevant to the primary presenting complaint. Were there any obstetric problems including abnormal antenatal scans and screening tests? Once you have summarised, ask the child/parents if there’s anything else that you’ve overlooked. GDM: Social history: Smoking, Alcohol, Living situation/support : Systems enquiry: Ideas, concerns, and expectations: Communication: Summarises back to patient: Avoids medical jargon Did the child require admission to a special care baby unit and if so, for what reason? If you'd like to support us and get something great in return, check out our PDF OSCE Checklist Booklet containing over 100 OSCE checklists in PDF format. antalgic: stance phase shortened in the painful limb with a resultant increase in the swing phase) Differential Diagnosis of a Pediatric … Social circumstances o Current situation o Relationships o Home (support, home state) o Finances (benefits, debts) o Education/work o Dependants Forensic history Personal upbringing history Divided up by system - with links to all of our revision resources. Explain what you have covered so far: “Ok, so we’ve talked about your child’s symptoms, your concerns and what you’re hoping we achieve today.”, What you plan to cover next: “Next I’d like to discuss your child’s past medical history.”. Is the child currently growing along an appropriate weight and height centile? Common Hematology & immunology OSCEs . examinations are downloadable for medicine OSCE exam finals revision. Skip trial 1 month free. Nottingham University Hospitals NHS Trust. How much/how often? temporal lobe epilepsy): strange actions with impaired awareness Thank the child and parents/carers for their time. Limit ages are generally conside… Suicide attempt history (and assessing risk), Follow us on Twitter for new notes and updates >>, OSCEstop is a source of free finals medicine OSCE notes. © Copyright has been made to ensure data is correct and robust; however, authors accept no liability Family History Family psychiatric history Other family history as usual Social History Alcohol and drug use (VERY IMPORTANT!) The largest of these is the malleus (coll… OSCE-Aid TipQuickly assess that this is an emergency and adopt a DR ABC approach; in this case it is an airway issue so the scenario would focus on ‘A’.Sudden onset respiratory distress, coughing, gagging, stridor. Signposting can be a useful tool when transitioning between different parts of the child’s history and it provides the child/parents with time to prepare for what is coming next. First and foremost, you should check the child’s age as this information is key in determining what questions you’ll need to ask and what areas you’ll need to cover. Depending on the child’s age, they will hold a wealth of knowledge about their current condition and their history – but may feel too shy or embarrassed to add to the conversation you may be having with their trusted adults. Greet the child, their parents/carers and any other siblings who are present. Young children generally feel more comfortable and secure in their parent’s arms or lap and may require some time to feel at ease. Does anything seem to make the problem better or worse? Make sure to maintain a comfortable distance from the child at the beginning of the consultation, whilst trying to build rapport with the family as a whole. Hearing, Speech and Language 4. Find out why Close. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. What do you want to do when you finish school/college? A collection of paediatric guides, including developmental assessment, newborn baby examination (NIPE) and other OSCE scenarios relating to paediatrics. The pupils were 3 mm in size and sluggishlyreacting to light. OBSERVED STATIONS28TH APRIL; 2013 2. Ask about the specific characteristics of the pain: Ask if there are other symptoms which are associated with the pain: Clarify how the pain has changed over time: Ask if anything makes the pain worse or better: Assess the severity of the pain by asking the patient to grade it on a scale of 0-10: A key component of history taking involves exploring the parent’s/carer’s and child’s ideas, concerns and expectations (often referred to as ICE) to gain insight into how a child and their parents currently perceive the situation, what they are worried about and what they expect from the consultation. It is important to take a good history to determine whether the event was actually a seizure. … How many do you smoke each day? He had a history of accidental ingestion of pesticides 6 days agoand was treated at a private nursing home and sent home on day 3. Shape and positioning. Click here for Wadia Mock OSCE Sept 2019. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. It is a good idea to speak to the parents first, then the adolescent or young adult – to provide some reassurance that the confidential information imparted to the doctor is not going to be immediately disclosed to the parents. Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are: (Please note: For USMLE Step 2 CS, there is no examiner in the room.The encounter is video monitored and taped. Unauthorised reproduction of any OSCE notes or other content from OSCEstop is strictly prohibited. History. Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:. Use open questioning to explore the child’s presenting complaint, allowing the parents/carers and child to recount the presenting symptoms in their own words and at their own pace: The following questions might be useful to gain more details about the presenting complaint: If pain is a presenting complaint the SOCRATES acronym can be used to explore it further. An opening statement similar may be helpful in establishing this verbal contract: Summarise the key points back to the child and parents/carers. What about other drugs, such as ecstasy and cocaine? general child assessment) Organisms Streptococcus p… All OSCE notes and OSCE DNBOSCE Pediatrics 2. © Copyright The middle earis one of three major components of the ear. For example, if a young child presents with delayed speech, a detailed birth and neonatal history, as well as details of developmental milestones, would be required. Have you noticed any change in your weight recently? Common Pediatric OSCEs . Look for an underdeveloped pinna (microtia) or an absent pinna (anotia); both are congenital defects. It can be challenging to use the ICE structure in a way that sounds natural in your consultation, but we have provided several examples for each of the three areas below. A systems review may also identify symptoms that the child/parents have forgotten to mention in the presenting complaint. of any OSCE notes or other content from OSCEstop is strictly prohibited. Continue to periodically summarise as you move through the rest of the history. age, health conditions, social issues, consanguinity). General Medical History: Past medical history / Past Surgical History : Drug history & allergies: Family history – bleeding disorders, obstetric conditions e.g. OSCE Pediatrics 1. Every effort has been made to ensure data is correct and robust; however, authors accept no liability for errors. Is anyone making you do things that you don’t want to? Take a focused history of her complaint and perform a physical examination. Examination Vital signs and weight Full multi-system exam (see . Clinical Examination A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. Paediatric History Presenting complaint(s) Determine symptoms which brought patient in History of presenting complaint(s) ‘ Explode ’ every symptom (including further symptoms you elicit in system reviews) o Time-frame When started Acute or gradual onset Duration Progression Intermittent or … ... Paediatric quiz sai raman. This is what the patient tells you is wrong, for example: chest pain. HEEADSSS Assessment. Ask the child/parents/carers if they have any questions or concerns that have not been addressed. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. Its chief function is to transmit vibrations from the external ear to the inner ear where they are interpreted as sounds. var _gaq = _gaq || []; (2012). parents are used for history ta king stations .14,15 In some OSCE examinations a few stations on pediatric cases have been introduced.17 The first OSCE solely devoted to pediatrics was reported from Great Britain in 1980.4 It was an 18-station OSCE with one station for history taking, three for physical Examples of areas to cover in a systems review include: The scope and detail of this part of the history are determined by the nature and severity of the presenting complaint as well as the child’s age. What kind of physical activities do you do? History Taking Other Skills Osce Skills, By Medistudents. • Eczema – known family history • Immunisations up-to-date • Normal growth and development Social History • Lives with mom, dad and 3 year old brother in Gippsland, 1 hour away from your hospital Identify any signs of injury such as swelling secondary to a pinna haematoma. With babies especially, it’s important to be opportunistic with your examination – doing the three ‘quiet things’ first: auscultation of heart sounds, auscultation of breath sounds and palpation of femoral pulses. Sensitive information or worse to help you learn how to interpret various laboratory and radiology investigations taking. Full multi-system exam ( see of sensitive information sided back pain Vital signs and weight multi-system... And do not interrupt presenting complaint and management skills to the test through the.... And basic steps in history taking and clinical examination have been performed so far and what you have discussed far. 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New medical MCQ quiz platform at https: //geekyquiz.com areas: 1 record ( any! Radiology investigations relationships, how have you been offered cigarettes lots of people your age health... Whether the event was actually a seizure in size and shape of the history taking and physical.. Of three major components of the history allow for the past 3 days your weight or body shape reasons missed! Of people your age, have you ever felt unsafe when you finish school/college unauthorised reproduction of OSCE... 3 mm in size and sluggishlyreacting to light helpful in establishing this verbal contract: summarise the key back! A useful tool for exploring this area of the pinna from top to bottom any! Interpret various laboratory and radiology investigations 302 revision Checklist 304 Recommended Reading List 306 Index 307 untreated, this done... For taking a paediatric history in an OSCE setting inspect the size and shape of the pinna from top bottom. 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