Im in Christmas clinic this week and as fourth years are together with third year students I had the change to observe a case history process a third year was taking. On this patient I observed a neuro-assessment was required. I had learned all the interpretations and meanings before but it was good to go over this again with the tutor after we saw the patient. Joint position sense travels through the dorsal column and Pin prick tests for the spinothalamic tract. With pin prick tests it is necessary that the patient feels it as a pin rather then just tough. Light touch assessment would not be clinical relevant as it travels through both pathways and therefore does not allow to make a specific statement. This was a great change to recap my knowledge on the relevance of neuro assessment tests!
Today I got both my feedback for my CCA and for this term's general clinic. I had prepared myself for this feedback session when I noted on a self-assessment sheet my strength and weaknesses for this term. My tutors were very pleased with my work this term and I got very good comments: ''A good solid term's work - we have no worries and are sure you will continue to improve as your confidence grows with increased experience.'' ''Karolin is an extremely thorough and diligent student. She has an excellent knowledge base and works hard to maintain her standard. Her tutorials have been excellent...'' Using both my self assessment sheet and the tutors' feedback we agreed that I need to improve my clinical performance, justification of findings, confidence in diagnosis making, presentation skills but also my English language skills regards communication and conversational skills. To work on this areas we agreed to an action plan that I would like to practice the CCA process on a regular basis,.. therefore it would be great if tutors replicate the exam situation when I take new patients. I will also try to get some time before I present my hypotheses to write likely differentials on a sheet of spare paper with justifications.. this will help me to have a flow in presenting a patient. As I struggle to present in a clear, precise and fluent manner. Considering my CCA feedback I am suggested to change my order when taking a case history e.g. to allow the patient to share their current symptoms first before questioning on lifestyle, profession etc. By now we were taught the other way round however I will give this a go as it makes sense to me to listen to the patients complaint first before bothering with probable unrelevant details which could possibly bias my thought process. I also was recommended to work on my empathy and communication skills. I have noticed this a couple of time especially in Manna during the last weeks and started already to work on this. I am very pleased with my feedback and look forward to next term!!! 
| AuthorKarolin Krell, final year student at the British School of Osteopathy. ArchivesApril 2013 Categories | ||||
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