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Introduction to Exam Skills: Patient Introduction, Hand Hygiene, and Vital Signs (Large then Small groups) - |
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September 09, 2009 3:00 PM - 5:00 PM |
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Scott Sallay M.D. |
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Send 1 member from each group to TSO to check out a PE box at the beginning of this small group session. When necessary, PE boxes are available for all PE sessions. PE boxes contain limited supplies. There are not enough supplies in each box (e.g. stethoscopes) for all students in each small group. Students should bring their required medical equipment, as specified by the SOM Dean’s Office, to each pertinent PE session. |
| Assignment Due Today: |
Students should preview the "Intro and Vitals" portion of the physical exam DVD on PCM Online prior to today's session.
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| Student Readings: |
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| Faculty Only: |
| Syllabus |
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Faculty copy of Mosby readings |
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| Internet Sites: |
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| Session Goal: |
To introduce general physical exam procedures which will be reviewed and expanded upon with each physical exam session.
To get to know group members, to establish comfortable learning environment in which group resources can be utilized, and to set agenda for future sessions.
To introduce the vital signs.
To introduce standard precautions and hand hygiene.
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| Student Objectives: |
Describe the appropriate methods of hand hygiene.
Describe OHSU policies for standard precautions and hand hygiene.
Demonstrate effective hand hygiene- hand washing and using hand sanitizer.
Define vital signs.
List normal values for respiratory rate, heart rate, BP, temperature.
Describe normal and normal pulse rhythms.
Describe pulse amplitude and contour.
Describe the respiratory rate, rhythm, and effort.
Demonstrate the proper technique of blood pressure measurement.
Describe the Korotkoff sounds.
Describe common technical problems in obtaining an accurate blood pressure.
Describe normal values of blood pressure and define and those of hypertension.
List what is assessed for "general appearance," identifying normal aspects.
Demonstrate ability to identify radial and carotid pulses, and the jugular vein.
Define hypertension, hypotension, tachypnea, arrhythmia, dysrhythmia, tachycardia, bradycardia, apnea for an adult patient.
Define and explain purpose of basic examination techniques: inspection, palpation, percussion, auscultation.
Demonstrate proficiency in Vital Signs DVD checklist.
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| Small Group Activities: |
- Discuss overall set of sessions and how students can get the most out of them.
- Discuss effective hand hygiene and why providers are so poor at it.
- Discuss characteristics which are described for "general appearance."
- Discuss importance of vital signs in clinical setting.
- Using the checklist, demonstrate standard methods used to evaluate vital signs. Students will practice in pairs obtaining respiratory rate, heart rate, and BP while instructor gives feedback.
- Each student should demonstrate taking one set of vital signs to their faculty group leader.
- In the last 15 minutes, students will break into 2 groups for a GOSCE-type exercise on Vital Signs. This exercise will be similar to the GOSCE, but are not a test and are intended to be educational and an opportunity to formally practice the skills covered in the session.
In each group, one student will be the “patient” and one student will be the “doctor.” The students designated as the patients will receive the case that they are to role-play one week before the session. The student group will receive instructions for the exercise during class. During the exercise, the student “doctor” will follow the instructions for the exercise. The group will then have an opportunity to make additions or corrections to the “doctor’s” performance. Once they are done, the “patient” will provide feedback on the groups performance.
Instructors will observe the exercise and provide feedback to the two groups. It is probably not possible to observe each group simultaneously, and the instructor may need to alternate groups weekly.
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Assignment
Due
Sep 16:
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Students should watch the online video of a physician performing a history and physical and then write up the encounter using the format provided in the syllabus (video will be announced when ready). Students should bring 11 copies of their write up to class.
Students should review the written presentation examples and come to critique them in the small group setting.
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