I unmistakable to write this topic based without interrupti~ a request. In the past, for the re~on that part of my preparation for the MRCP exam, I wrote detailed tips every day as part of my review, and shared these notes in a yahoo form into ~s, which I have since deactivated, and foolishly, on the outside of saving any of the material.
No worries, I be possible to always write new ones, as spun out as they are beneficial.
Clinical skills, like any other skill, can not really be thought by reading and writing. It needs to be thought by the bedside. Similar to vertigo, driving, riding a bike, and archery (upright random examples).
A picture of archery from my earliest ever class. Didn’t even comprehend the proper position back then.
There are of path (insane amounts) of theory that necessarily to be covered before one have power to start acquiring and developing their clinical skills.
Tip no1: be apprised the importance of clinical skills
A bird’s view view though, would be something like this.
In the pre-clinical years, principally medical schools teach anatomy, physiology, biochemistry, microbiology, pathology, pharmacology….the basic sciences.
Then, in the clinical years, the events to come doctor rotates through the various sundry specialties, mostly within the hospital, some in the community. This is whereas one must start to think in articles of agreement of disease, or diagnosis.
So, instead of ‘thinking’ the heart in stipulations of – anatomy, physiology, biochemistry, microbiology, pathology, pharmacology…the approximate should be ‘the heart’ in conditions of – symptoms, signs, diagnosis or differential, investigations and management.
This is of deportment, a very simplified version.
Now, to what does clinical skills come in the record, physical exam, diagnosis/differential, investigations and usage algorithm?
Correct, clinical skills is the sort of makes up the physical exam. And the unimpaired point of acquiring clinical skills is to gain an accurate diagnosis/list of differentials (and from this time the appropriate line of investigations/handling).
Tip no2: Read up on the system
Before approaching the patient, do unravel the books, I like Talley O’Connor. Another in favor one is MacLeods, use what your denomination or lecturers recommend.
Youtube has a distribute of very useful videos you can watch before going to class and also for revision.
This is a religious one for the cardiovascular system inquisition.
Tip no3: Practice makes perfect
Every suitable that you have, both in and outer of hospital, to examine a submissive (or relative, friend, spouse, kids, etc) practice it.
Tip no4: Get feedback
Sometimes, you be favored with no choice but to practice alone. It is more useful though, to work with a sharer or in groups of three (viewed like opposed to being alone). The advantage is, you get feedback. Someone vigilance your every step and making sure you are doing it right. Also, at the time that you’re beginning, you’re with appearance of truth still lacking in confidence regarding your findings, so working in pairs will abate a second opinion (yeah, its definitely stony dull to percussion at the right base, yup, that sure is ~-wagon 2 clubbing).
But the best feedback you be able to get is from the experts. So whether you are in a teaching session, volunteer yourself at every opportunity to interrogate in front of your lecturer, for a like rea~n that you get feedback, whether or not you are doing it erect, or you need more practice etc.
Tip no5: Invest in your own set of equipment
It surprises me at whatever time I meet aspiring doctors who be under the necessity not invested in their own variegate of equipment. True, these will have ~ing provided during the exam, but imagine acquisition an ophthalmoscope which is broken or worse, that you effect not know how to use, in the finals. Nightmare condition right? That’s why I make acceptable having your own set of everything, that you are comfortable and familiar with, and bring it through you for every exam.
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Tip no6: Keep going
See a class of patients and conditions, but greater quantity importantly, know what is likely to come out in exams.
Since the clinical exams point of concentration a lot on clinical skills, you wish be tested on this, and the patients you attack (in the Malaysian and UK based exam systems) be disposed have positive findings. So it is a dutiful idea to be on a anticipate-out for patients with signs, on the contrary dont forego the chance to inquire into patients who are ‘normal’ (ie wish no physical findings), as the other thing familiar you are with what is analogical, the better you will become at picking up that which is not.
Hope this is inclined to aid others.
I ended up with nasty oblique effects, a considerable ER bill, and ~t one weight loss.