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PDS Exam

PDS UWSMPH

QuestionAnswer
Describe the sequence of the medical encounter. Ask the patient about the problem, examine the aptient, perform testing, determine the diagnosis, develop a plan with the patient
Describe the typical order of medical documentation. Subjective, Objective, Assessment, Plan
Summarize three reasons why the history is an important component of the medical encounter. Establish Trust, acquire information,
Analyze three purposes for the interview. Gather data, develop rapport, respond to emotions, educate and motivate patient, develop differential diagnosis
State the steps to beginning the interview. Introduce yourself, ask how he/she wishes to be called, educate and motivate patients, explain role as medical student, explain purpose of session, explain that MD will see the patient following your interview, obtain permission to perform interview
Integrate non-verbal communication skills into the interview. posture eye contact, open ended questions, don't interrupt, use patient's language, don't scare patient
Construct the 7 main components of the medical history. Intro, CC, HPI, PMH, FH, SH, ROS
Develop a framework to facilitate the analysis of complex clinical ethical problems. autonomy, beneficence, non-maleficence, fairness
Apply the “four box” model to systematically contextualize clinical ethical problems, utilizing guiding ethical principles of autonomy, beneficence, non-maleficence, and fairness (justice). Medical indications, patient preferences, quality of life, contextual factors
·         Define confidentiality. With faith or trust that information will not be disclosed
·         Explain why confidentiality is central to effective health care. essential for patient care; important for societal welfare
·         Determine criteria for exceptions to confidentiality. High probability, serious harm, disclosure likely to prevent harm, no alternatives
·         Defend examples when breaching confidentiality might be appropriate. suicide attempt/threat, contageous diseases, child abuse reporting
Determine why and when providers take a social history. screening physical exam, diagnosis, hidden agenda
Implement strategies that make sensitive questioning easier. consciously acknowledge discomfort, be non-judgemental, get to know patient first, explain reasoning for asking questions
Recognize barriers to taking a sexual history. consciously acknowledge discomfort, be non-judgemental, get to know patient first, explain reasoning for asking questions
·         Describe the two main goals of nutrition assessment evaluate dietary intake and nutritional status; define need for nutritional intervention or therapy
·         Describe three significant negative consequences of undernutrition. reduced immune response, slow wound repair, reduces survival
·         Compare and contrast marasmus and kwashiorkor. marasmus- protein and energy deficiency; kwashiorkor - protein deficiency
·         List the 5 components of a nutrition history. MH, FH, SH, physical activity history, weight history, diet history, medication history
·         Identify general guidelines for collecting a diet history dietary reference intakes, dietary guidelines for americans, 2008 physical activity guidelines,choose my plate recommendations
·         Describe 4 methods to obtain a diet history and discuss use of these methods in clinical practice.
·         Describe the Dietary Guidelines for Americans, including general recommendations for health maintenance and disease prevention.
·         List the food groups and recommended number of servings from each group per day (for someone eating 2000 calories per day) based on ChooseMyPlate.gov.
Given a case or scenario, differentiate the categories of substance abuse continuum. Physical dependence, preoccupation, compulsive use, loss of control
Screening Criteria Screening, brief, intervention, referral to Tx
Determine if alcohol/drug treatment has been effective. improvement in Sx, function, QoL, duration of life
Spirituality
Religion
·         Define and explain five clinical goals of spiritual assessment and care.
·         List and define spiritual assessment tools and key mnemonics.
·         Summarize three practical outcomes of integration of spiritual assessment and patient care.
Describe the patient-physician interaction as an interface between three cultures: physician’s culture, patient’s culture and the health care culture.
Culture A shared system of beliefs, values, and/or learned patterns of behavior
·         Determine characteristics of a qualified interpreter. Fluent in two languages, Trained as interpreter, not a family member, never a minor
·         Demonstrate strategies to effectively communicate through an interpreter. pre-interview meeing with interpreter, positioned in room adequately, speak directly to pt, speak at an even pace and in short segments
·         Determine when a patient needs an interpreter. effective communication may be hindered by language barrier
·         Illustrate appropriate steps to take when an interpreter is needed but not available. language line or on-call interpreter
·       Demonstrate the Introduction. o   Greet the patient and introduce yourself., o   Ask the patient what he/she wishes to be called., o   Explain your role as a medical student / purpose of your interview., o   Explain that the physician will see the patient following the student intervi
·       Demonstrate the Chief Concern/History of Present Illness. o   CC question: “What brings you to clinic?”, o   Agenda-setting question: “What else would you like to discuss today?”, o   Open-ended HPI statement: “Tell me more about your… (concern).”, o   Ask about location, quality, severity, timing, context, asso
·       Interview skills to demonstrate. o   Use a patient’s name upon introduction and throughout the interview., o   Use open-ended questions throughout the interview., o   Does not interrupt patient.
·         Demonstrate the PMH elements of the medical interview, including: o   Adult medical conditions, o   Major childhood illnesses, o   Current medications, o   Surgeries, o   Major injuries, o   Hospitalizations, o   Immunizations, o   Allergies / reactions
·         Demonstrate FH elements of medical interview, including: o   Hereditary diseases, o   Familial illnesses, o   Family traits, o   Illnesses that have a profound effect on the patient’s psychological environment such as psychiatric disorders and substance abuse.
·         Interviewing techniques to practice (build on previously learned techniques): o   Ask for clarification, focusing on specific episodes of illness, injury and hospitalization, o   Does not rush patient’s answers, o   Uses plain, non-medical language
·         Demonstrate the Introduction element of the medical interview. o   Greet the patient and introduce yourself., o   Ask the patient what he/she wishes to be called., o   Explain your role as a medical student / purpose of your interview., o   Explain that the physician will see the patient following the student intervi
·         Demonstrate asking the Chief Concern element of the medical interview. o   CC question: “Why were you brought you to the hospital?”
·         Demonstrate asking the Agenda-setting questions of the medical interview. o   “What else would you like to discuss today?”
·         Demonstrate the History of Present Illness element of the medical interview. o   HPI statement: “Tell me more about your… (concern).”, o   Practice asking about location, quality, severity, timing, context, associated symptoms, modifying factors, treatment, impact, patient perception., o   Practice summarizing before moving on to
·         Demonstrate the Past Medical History element of the medical interview. o   Practice asking about adult medical conditions, major childhood illnesses, current medications, surgeries, major injuries, hospitalizations, immunizations, allergies / reactions.
·         Demonstrate the Family History element of the medical interview. o   Practice asking about hereditary diseases, familial illnesses, family traits, and illnesses that have a profound effect on the patient’s psychological environment.
·         Interviewing techniques to practice (build on previously learned techniques): o   Focus on specific episodes of illness, injury and hospitalization., o   Use appropriate eye contact/body language, o   Attend to patient’s body language/non-verbal communication.
·         Demonstrate the SH elements of the medical interview (Born/raised, living situation, relationship/support system, daily activities, leisure, alternative/complimentary treatment, cultural/spiritual beliefs, advanced directives, nutrition, caffeine, exercise, sleep, safety, environmental exposure, tattoos/pie
·         Recognize and identify patient/physician barriers in obtaining an adequate social history. consciously acknowledge discomfort, be non-judgemental, get to know patient first, explain reasoning for asking questions
·         Interviewing techniques to demonstrate (build on previously-learned techniques): o   Obtain permission to discuss sensitive topics, o   Ask patient to clarify unclear information, o   Do not interrupt or rush patient’s answers, o   Verbally acknowledge emotional content of interview, o   Avoid multiple questions, o   Use plain, non-me
·         Utilize the HEADSS model of adolescent questioning when interviewing adolescents. Home, Eductation/Employment, Activities, Drugs, Sexuality, Suicide/Depression
Intro Greet & introduce, ask how to address, explain role as student, explain the MD will see pt, obtain permission
CC Open ended question (CC), set agenda, open ended statement re:CC, location, quality, severity, timing, context, associated signs, better, worse, Tx thus far, impact, patient's perception, summarization
PMH Adult medical conditions, major childhood illnesses, medications, surgeries, major injuries, hospitalizations, immunizations, allergies/reactions
FH info from 3 generations
SH - Current Lifestyle living situation, relationships, support system, daily activities, leisure, cultural/spiritual beliefs, advanced directives
SH - Risk Factors nutrition, caffeine, exercise, sleep, safety, environmental exposure, tattoos/piercings, tobacco, alcohol, illicit drugs, sexual habits, economic risks, stress, violence, social impact
Created by: rieves