Thanks for coming to the lectures – or for viewing them online.
These were two in-person lectures for the Warwick Medical School “Clinical Skills Society” delivered in October of 2021. Due to social distancing, we gave two presentations simultaneously to different audiences, and as there were a few differences in what we chose to focus on and discuss we wanted to make them both available to the students who attended, as well as to the wider community.
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- Outline how the medical history fits into the broader theme of the patient journey
- Outline how to structure a general medical history (eg using the Warwick Medical School “Four Frames” approach)
- Outline how to focus the general history, once the history of the presenting complaint has been elucidated
- Outline how to take a pain history of the presenting complaint
- Outline the tenants of a past medical history, drug history and allergies
- Outline how to take a social history
- Outline “ICE” in the OSCE setting
history taking introduction
A 65 year-old male presents with heartburn. He says its worse when he has a warm cup of tea, and describes the sensation as a 4 out of 10 for pain. He drinks 13 units of lager a week, and has smoked 20 cigarettes each day for 10 years. His weight is 92Kg, he is 1.85m tall. On examination, he has no peripheral stigmata of disease, except elevated body habitus and does not appear distressed.
Which system would you most-likely want to “click” into first, during the first frame?
Obese class I
Obese class II
There is no recommendation
Always more than 5 days
Acute coronary syndrome
Positive barium swallow
Abnormal chest X-ray
Family history of reflux
Improvement of pain on lying down
Improvement of pain on taking ibuprofen
The tendency to be influenced by what someone else has said to create preconceived idea.
The tendency to search for or interpret information in a way that confirms one's preconceptions
The unconscious tendency to be favorably biased toward people like ourselves
Using a too-narrow approach and description of the situation or issue.
Once a diagnostic label has been assigned to a patient by another individual, it is very difficult to remove that label and interpret their symptoms with fresh eyes
Upper oesophageal sphincter
Lower oesophageal sphincter