Tutorial 29 October 2012

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Tonight's tutorial was by Ahmed Yassin on uro-dynamics. I was unwell and unable to attend the tutorial, which was held at Stepping Hill Hospital, so it was not recorded. Fortunately, I had kept a copy of the tutorial he gave on the same subject on the 21st. February. The only thing that will be different will be the questions asked.

Our grandchildren started their half-term holidays on Friday. Emma, our daughter, decided to take her children to our holiday cottage in Anglesey and invited us to join them. Valerie and I had 'flu jabs booked for Saturday morning - Simon, our excellent GP likes all his geriatrics to be immunised! Eliza, our 4-year-old granddaughter decided she would stay with us on Friday night and come to Anglesey with us on Saturday. She sat in the front passenger's seat and I had highlighted the route for her on a map. She sat there ticking off the towns we passed, reading the sign posts, telling me the road numbers and looking for the turn-offs. I had turned on the Sat Nav as an added interest for her and she had a great time coordinating the two. The only downside was a barrage of questions about how a Sat Nav works. How does it know which road we are on? How does it know the names of all the roads? etc. etc. If you think explaining recessive inheritance in an OSCE is hard, try explaining the principles of Sat. Nav to a 4-year-old!
We visited the sea zoo, which is a great adventure for little girls - and elderly gents! You go from one tank to another round a series of passages. On turning one corner you are face with a glass panel that goes to the ceiling. Behind is a mock-up of a rock pool. As you peer in to see the inhabitants, there is suddenly an explosion of sound as a huge wave breaks in from the side and pours into the pool, When you are not expecting it, you are much startled. Of course, once Cecilia, at 22 months, was over the initial shock, we had to stay there to watch it over and over.....
A walk on Rhosneigr beach meant that Eliza had to strip to her underwear to go for a paddle. How she managed with sea temperatures of little more that 10 degrees and air temperatures rather less is beyond me! The paddle soon developed into jumping over the waves and this led to jumping while pirouetting with inevitable consequences as she fell into the briny. Fortunately, Emma had predicted this might happen and had brought her car, with lots of large bath-towels, onto the beach. But that was the end of the walk as Eliza had to be dried off, wrapped up and brought home for immersion in a hot bath.
Rhosneigr beach is a great favourite with wind surfers and has a webcam so they can see the conditions and decide if they make a trip worthwhile. http://www.wirralcam.org/rhosneigr.shtml. The quality of the picture is poor - it must be a low-quality camera - and it does not do justice to a very attractive beach.
On Saturday night I ran a fever and had episodes of vomiting. I did not get out of bed until the Sunday afternoon, which is a rarity for me as I tend to be up an about early. We decided that we would risk the journey home. By the time we got home, we both felt pretty lousy and there was no way I felt up to attending the tutorial. I am more or less back to normal today, but Valerie seems to be having the same symptoms, but with a 24 hour time lag as she is still in bed, though improving.

Tutorial 25 October 2012

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Tonight we managed 2 vivas, a discussion about prescription-writing and 1 role-play.

Viva 1.
You have been asked to deliver a lecture to the hospital staff on modern approaches to optimising surgical outcomes. Outline the key points you will include.

Viva 2.

Breast feeding: viva. Discuss the main issues relating to breastfeeding.

 Prescription-writing.
 The form below is not quite as it appears in real life. If you did not get an e-mail me with a Word version of the form, you are not on my e-mail list. Send me an e-mail and I'll add your name and send you a copy of the form.

Candidate’s instructions.

Writing a prescription would only be part of a station and would probably not get more that 2 or 3 marks. But they are easy marks if you know what you are doing.

In this case, you would probably see her with a batch of results that show no abnormality other than infrequent or absent ovulation. You would be told to discuss the results, the diagnosis and to write a prescription if one is appropriate.

Or, more probably, you would have a structured viva about a series of results at the end of which the examiner would ask you about treatment and you would decide on clomiphene. The examiner would ask you to write a prescription. They might also ask you about the advice you would give about monitoring the effects of the treatment, the number of cycles, the doses to be used in each cycle and the possible side-effects.

Now, write a prescription for this

Roleplay: Woman of 88 years with PMB. Has Alzheimer’s. Roleplay with daughter.

The next tutorial will be on Monday coming at 7pm. on the labour ward at Stepping Hill Hospital. Dr. Yassin will be talking about urodynamics and uro-gynae investigation.

There will be a podcast.

Tutorial 14. October 2012

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Today we went over the stations that had caused difficulty on yesterday's OSCE course at Bolton.

Tutorial 11 October 2012

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We managed a roleplay and a viva.

With the roleplay, you are the registrar and have been instructed to teach a new trainee doctor about shoulder dystocia. The roleplayer acts as the new trainee.

Then we had a structured viva on diathermy. Most doctors only have a basic idea about electricity, but this is an easy station if you do your homework.
The topic is covered on the website: http://www.drcog-mrcog.info/diathermy.htm.

1.    What is diathermy?

 

2.    What kind of current is used?

 

3.    Why use high frequency current?

 

4.    What types of current are used?

 

5.    How is diathermy applied?

 

6.    Risks of diathermy.

7.    Discuss direct coupling and its implications

8.    Discuss capacitive coupling and its implications.

Send me your answer and I'll send mine.

Tutorial 8th. October 2012

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We started with two vivas.
In the first you were to devise a tutorial for junior obstetricians and midwives on how to take an obstetric history.

Obstetric history.

Candidate’s instructions.

You are to conduct a tutorial with hospital’s junior obstetricians and midwives about how to take an obstetric history.

You have 15 minutes to prepare the headlines you would put in a model for  taking an obstetric history and to consider how you would conduct the tutorial.

Then you will have a viva with the examiner.
I had the examiner ask three questions:
1. What headings would they have for the history.
2. What clinical settings would they cover.
3. Which educational methods would be useful for the tutorial and why?

I did not record the discussion.
I want you to write the headlines you would use in the viva and answer the above questions.
Send them to me and I'll send my version.

The second was a critique of a website.
Send me an e-mail and I'll send a copy of the extract from the website we used.
For some reason it is not copying correctly onto the blog.

Then we had a role play.

GP referral letter:
Please see Mrs. Jones. She is planning her first pregnancy. Her father was recently diagnosed with Huntington's disease.