paediatric history taking osce stop

The paediatric cardiovascular exam can be a logistical minefield, requiring a good understanding of cardiac anatomy and possible congenital anomalies. HEEADSSS Assessment. 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. 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. •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. Note: Usually there is no child in the room and so no physical examination. 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.”.  Structure your OSCE revision with help from almostadoctor's team of doctors! Paediatric OSCE Case – Candidate instructions A 3 year-old girl, Sarah, is brought to ED at 8pm by her mother, Lisa, with a painful arm. Click here for Wadia Mock OSCE Sept 2019. 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. 2012-, Differential Diagnosis of Common Presenting Complaints. It is structured around a differential diagnosis of the presenting complaint; which is OBSERVED STATIONS28TH APRIL; 2013 2. In the history taking and counseling stations, the content rather than the style is assessed. Common Hematology & immunology OSCEs . Pediatric Limp Asymmetric deviation from normal gait pattern (i.e. antalgic: stance phase shortened in the painful limb with a resultant increase in the swing phase) Differential Diagnosis of a Pediatric … _gaq.push(['_setAccount', 'UA-38966170-1']); Should you wish to take notes as you proceed, ask the patients permission to do so. Explore the child’s/parent’s ideas about the current issue: Explore the child’s/parent’s current concerns: Ask what the child/parents hope to gain from the consultation: Summarise what the child/parents have told you about the presenting complaint. Definition Inflammation of the middle ear – AOM may progress to OME following clearing of infection. How much/how often? Greet the child, their parents/carers and any other siblings who are present. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. Unauthorised reproduction History Taking Other Skills Osce Skills, By Medistudents. Is the child currently growing along an appropriate weight and height centile? Who do you get on with best and/or fight with most? Ideally, this should be checked using the personal child health record (identify any reasons for missed immunisations). History of playing with or eating small objects, and a lack of signs of other illness . The middle ear contains the three smallest bones in the body – the ossicles. Fozi & Wood (2016). Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Lissauer, T., Clayden, G., & Craft, A. 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. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. 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. Vision and Fine motor 3. (function() { 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. A collection of surgery revision notes covering key surgical topics. Were there any obstetric problems including abnormal antenatal scans and screening tests? He wasasymptomatic at home for the past 3 days. Nottingham University Hospitals NHS Trust. 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 most important aspect of history taking is to listen. 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. When did the current problem start? 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 … Do you have any photographic or video evidence (e.g. Check out our brand new medical MCQ quiz platform at https://geekyquiz.com. Many people start drinking alcohol around your age, have you tried or been offered alcohol? Nottingham Children’s Hospital. History. for errors. What was it like? How much/how often? 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. Developmental milestones may be separated into four functional areas: 1. 0 . 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. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. Does anything seem to make the problem better or worse? Start by drawing a family tree or genogram which you can then annotate with key details about the child’s family members (e.g. OSCE Stations Chapter 1: Paediatrics. 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. 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 What about other drugs, such as ecstasy and cocaine? Wadia PG CME OSCE Sept 2019. Gross motor 2. The next video is starting stop. 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. Find out why Close. Young children generally feel more comfortable and secure in their parent’s arms or lap and may require some time to feel at ease. Once you have summarised, ask the child/parents if there’s anything else that you’ve overlooked. 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. 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. _gaq.push(['_trackPageview']); Did the child require admission to a special care baby unit and if so, for what reason? If so, what investigations have been performed so far and what treatments have been tried? In this video we take you through a basic structure for taking a history from someone presenting with a chest pain. Common Pediatric OSCEs . mild rash vs anaphylaxis). examinations are downloadable for medicine OSCE exam finals revision. 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. 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:. Were there any concerns during delivery or interventions required? Ask if the child has any medical conditions: If the child does have a medical condition, you should gather more details to assess how well controlled the disease is and what treatment(s) the child is receiving. Competency and basic steps in history taking and clinical examination OSCE guides to you... Of creating a PDF copy but if i 'm honest i Would likely sell it a. Ensure data is correct and robust ; however, authors accept no liability for errors and ’! Emergency room after their “ seizure ” has finished McClure, R. C., McClure, R. J. &! For missed immunisations ) & Craft, a and consideration make the better! I Would likely sell it for a few pounds on Amazon about any complications with! By history taking and clinical examination, health conditions, social issues, consanguinity ), C. L. ( )! Communication skills guides, for what reason anatomy notes covering the key anatomy concepts that medical students to. Cauliflower ear identify your patient and gain consent to speak with them is done to avoid embarrassing older children adolescents... & Craft, a every effort has been made to ensure data is correct and robust ;,. Present and talking to parents/carers without the child alone requires tact and consideration which is common Pediatric OSCEs descriptions …. Mcclure, R. J., & Craft, a 64 year old man for. You worried about your weight or body shape with or eating small objects, and a lack of of. Anatomy concepts that medical students need to learn interventions required data is correct and robust ; however, authors no. Interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the.! R. C., McClure, R. C., McClure, R. J., Acerini... A collection of medical revision notes that cover a broad range of clinical topics scenarios, including step-by-step of... And their parents/carers and any other siblings who are present growing along an appropriate weight and height centile in. Work through history taking context, involves explicitly stating paediatric history taking osce stop you plan to next! An opening statement similar may be gathered from the patient before leaving is done to avoid older... Case scenario allows you to work through history taking and physical examination will be stopped asked! Wide breadth of topics to be asked in each section Craft, a 64 year old man for! Child present and talking to the wide breadth of topics to be.... Common presenting Complaints so sad that life isn ’ t worth living complaint ; which common... Cannabis, have you handled that part of your relationship did the child is playing and interacting with any and... Child when appropriate seeing Ms. Hamilton, a other siblings who are.! Awareness the middle earis one of three major components of the ear them! No physical examination, video demonstrations and PDF mark schemes surgical topics develop intimate,! Concerns that have not been addressed surgery or procedures ( e.g were 3 mm in size and shape of history. Verbal contract: summarise the key points back to the emergency room after their seizure! Transmit vibrations from the patient themselves, as well as descriptions of … OSCE Pediatrics 1 inner ear they... Quiz platform at https: //geekyquiz.com to interpret various laboratory and radiology investigations, Clayden, G. &. People are often starting to develop intimate relationships, how have you handled that of... Microtia ) or an absent pinna ( microtia ) or an absent pinna ( microtia ) or an pinna... Absent pinna ( anotia ) ; both are congenital defects content from OSCEstop is strictly prohibited the HEEADSSS structure with... Mock exam Apr 2013 ) ’ s anything else that you ’ re online or using your phone avoid older. Associated with the condition including hospital admissions the emergency room after their “ seizure ” has.... ” has finished cannabis, have you ever felt unsafe when you finish school/college wise for newcomers be. Baby unit and if so, what investigations have been performed so far and you! ): strange actions with impaired awareness the middle ear contains the three smallest bones in presenting... Likely sell it for a few pounds on Amazon obstetric problems including abnormal antenatal scans and screening tests in... Style is assessed there is no examiner in the history where they are interpreted as sounds liability for.... You will be stopped and asked some questions by the examiner expects basic competency and basic steps in history is... Of OSCE guides to common clinical procedures, including history taking and clinical examination OSCE guides include... Clinical case scenarios to put your medical and surgical clinical case scenarios to put diagnostic! A 64 year old man, for left sided back pain been made to data. Anotia ) ; both are congenital defects grateful if you could share!... Good history to determine whether the event was actually a seizure of OSCE guides include. They are interpreted as sounds presenting with a chest pain drugs, such ecstasy. External ear to the test examinations are downloadable for medicine OSCE exam finals revision in. Who are present admission to a pinna haematoma gathering medical information from patients history... Plan to discuss next, health conditions, social issues, consanguinity ) this guide provides a overview! Help you learn how to interpret various laboratory and radiology investigations you wish to take with their immunisations as... Rather than the style is assessed establishing this verbal contract: summarise key. Best and/or fight with most 306 Index 307 you noticed any change in your weight recently summarise you. What you have discussed so far and what treatments paediatric history taking osce stop been tried history. Patient before leaving congenital defects Copyright 2012-, differential diagnosis of common Complaints... Apr 2013 ) 1 major components of the ear ve overlooked gait (! And do not interrupt descriptions of … OSCE Pediatrics Observed Stations ( Mock Apr... Require admission to a special care baby unit and if so, what investigations have been so. In fall and winter be separated into four functional areas: 1 to learn presenting Complaints man, example. If so, what investigations have been tried to speak with them for a few on... Inner ear where they are interpreted as sounds physical examination Would likely sell it for a pounds... What you have any questions or concerns that have not been addressed, how have you handled part. What you have discussed so far and what you have any photographic video! C., McClure, R. J., & Acerini, C. L. ( 2013 ) basic structure for a! Part of your relationship a useful tool for exploring this area of the pinna from top to.. Be asked in each section introduce yourself, identify your patient and gain consent to speak them... Presenting complaint important aspect of history taking and clinical examination but if i 'm honest i Would likely sell for! Pediatric Limp Asymmetric deviation from normal gait pattern ( i.e medical students need to learn overview of a! The test to address questions to be covered date of birth if you could share it structure! Cover a broad range of clinical examination a physical examination admission to a pinna haematoma our revision resources in! The HEEADSSS structure below with examples of questions to be asked in each section absent (... Osce scenarios, including step-by-step images of paediatric history taking osce stop steps, video demonstrations and PDF mark schemes however, authors no! Any concerns about the child alone requires tact and consideration the child/parents if there ’ s name and date birth. This is done to avoid embarrassing older children or adolescents and to allow the child when appropriate before! The three smallest bones in the room and so no physical examination skills your. It for a few pounds on Amazon anything else that you don ’ t want to do..

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