November 01, 2018

Communication skills, Yoga and making links…

As we go past the halfway point of the Advanced Cases 1 block, I can hardly believe that this term has gone so quickly.

Recently we have been learning about diabetes and autoimmune diseases, such as lupus. Some of the science behind the immunology and renal/kidney teaching has been very complicated (there are a lot of immune cells to learn!) but it has nicely built on our learning from last year. For example, we were taught about chronic kidney disease, but this year we have gone into more detail about the causes of the diseases and the management of the various types of illnesses. It has been the same with our diabetes teaching. We covered diabetes in detail last year and now our teaching has been more clinical and focused mainly on management of the condition. In that way, the last two weeks have nicely brought our year 1 content back to the fore and forced us to revisit kidney anatomy that perhaps some of us would prefer to leave in the past.

Meanwhile, my clinical placements at George Eliot hospital have been continuing. For the last two weeks I have had bedside teaching every Monday. This is where a qualified doctor takes out a small group of students (typically 2-4) and finds them some interesting patients to meet. We would then take the history and conduct an appropriate system examination (or a few). All of this is followed by constructive feedback from our supervisor on technique and content and a walk through some of our differentials and reasoning. This block, our bedside teaching supervisors have expected more from us in terms of diagnosis and management too, whereas in year 1 it was mostly about just taking a basic history and conducting a basic examination.

I took the history from both patients which was useful as I hadn’t conducted a proper history since my OSCEs in June! I struggled to remember all of the parts and forgot to ask about all the relevant risk factors for falls. This was brought up afterwards by the supervisor and we went over it for revision. Despite feeling quite rusty, it was refreshing to get stuck back into my histories and refresh my memory on specific areas to ask when a patient has had a fall. The feedback I received from my supervisor was good in terms of communication, with just a few pointers for how I can improve in terms of content!

Last week we also had a small group session to help develop our communication skills. We were in small groups of 4, and had to take a history from a patient while assessed by a facilitator. All of this sounds relatively straightforward, but the patients, played by professional actors, had complicated histories and had been briefed to not make our jobs easy. For example, a patient may be reluctant to give us information or act very nervous. This was an interesting challenge for us. So far, a lot of our history taking practice has been done on fellow students. Whilst this has been a great way to build our confidence, peers can often be a little too helpful in prompting questions and examinations. In reality patients will present with a wide range of personalities, beliefs, preconceptions and will more often than not have no idea what the cause of their symptoms may be or what information is relevant. It was exciting to try and use our communication skills to ease information out of the patients using non-verbal techniques such as leaving silences if you feel the patient has more information to give. It also helped us practice our listening skills, including looking for small verbal cues (i.e. inflections in voice and tone). This was some great revision of first year skills, but also a nice step up in complexity in terms of challenge.

For a bit of a change in pace I decided to attend WMS Yoga Society that one of friends helped set up. I enjoy yoga and decided I needed some down-time during the week so it was great to go along. It was nice to see lots of other medics from various year groups get together and do something which wasn’t medicine related, even for just an hour. All in all, it was a nice relax and a well-deserved reset after a busy couple of weeks and prepared me for week 8 of Advanced Cases 1. Bring on a week of Genetics!


Jordan


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Our Med Life blogs are all written by current WMS MB ChB students. Although these students are paid to blog, we don’t tell our bloggers what to say. All these posts are their thoughts, opinions and insights. We hope these posts help you discover a little more about what life as a med student at Warwick is really like.

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