Basic 7 Steps of Short Case
1. Approach “Approach”
2. Hand off Exam
3. Hand on Exam
4. Finalization “Structure”
5. Interpretation
6. Presentation
7. Discussion “Formulation”
Remember it is only 9 minutes to show yourself in competition.
Time management is of extreme importance.
Basic 7 Steps of Short Case
1. Approach: Few seconds
§ Greeting, warm smile
§ Introduce yourself
§ Permission
§ Put child at
ease
§ Explain what you are going to do
§ Positioning
§ Undress
§ Play and chat with the child.
2. Hand off Exam: 30-60 seconds
§ Observe from end of
the bed
§ Show observing skills
§ Count respiratory
rate if appropriate
§ Compare both sides.
§ Observe closely; face & head or skin stigma.
§ Don’t miss the mouth, all backs & nappy area.
3. Hand on Exam: Maximum 5 minutes
§ Do all or some of Anthropometric measures in growth & nutrition stations “or offer to measure in other cases”
§ Prepare to touch; ask if anything hearting, warm your hands, go to child level,
chat with the child, look to the child’s face.
§ Start away from target area and close gradually
§ Use your hands first, then any tool “Stethoscope, Otoscope, “Warm it”
§ Distract the child or simulate on toy, caregiver or yourself before touch. Mother may help you.
4. Finalization: Few seconds
Say; to complete my examination, I would
like to do ….. (Package of offers). This
makes your image more colorful during very limited time of examination.
5. Interpretation: Few seconds
Before you
turn to the Examiner, you should reconstruct “in your mind” your findings;
positive and negative and formulate a complete bright picture by joining and connecting the
important pieces of information together.
6. Presentation: 30-60 seconds
The best way is to divide your presentation in to
THREE phases:
A.
Start talking after the first circuit by the child’s name
and basic 4 Ds.
B.
Talk through the second circuits “Findings of
general examination”. This is best done by running commentary. Mention the
positive and important negative findings. “Commonly you may miss important
signs you already observed, if you left it to the end”. The Examiner
considers that you didn’t notice it even if it was so clear.
C.
Mention your findings of the third circuit after you complete
it. Turn to the Examiner
and talk confidently.
D.
Summarize
the overall examination and raise your conclusion. “You may
say: "all of these finding are consistent with...and I would like
to..."
The only exceptions are
general and developmental stations. Use running commentary all through stations
and use statement of “child demonstrates” rather than “child can do” in
developmental stations.
7. Discussion: 1-2 minutes
§ Listen carefully to the examiner’s
question and statement.
§ Respond appropriately to the question.
§ Show confident
look and clear voice with appropriate body
language
§ Don’t dig a black hole to express your extended knowledge
§ Don’t go very deeply in details but, hit an
important points as list of headlines.
§ Give a clear diagnosis if you are confident about it.
§ Alternatively, stick to findings and appropriate top priority 2-3
differential diagnosis only related to the patient.
§ Start broadly and focus gradually to
specific investigations or treatment
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