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Tonight's topics
31.
|
Viva. Adverse incident
report. 4th. degree tear.
|
32.
|
Viva. Neonatal jaundice.
|
33.
|
Viva. Write a model for
taking an obstetric history for tutorial.
|
34.
|
Viva. Headache
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35.
|
Role-play. Pre-menstrual
syndrome. Use prepared papers.
|
31. Viva. Adverse incident report. 4th. degree
tear.
Candidate’s
instructions.
Mrs Penelope Jane Brown sustained a 4th.
degree tear after the delivery of her second baby.
Dr. James Peter White conducted the delivery and was
asked to write a statement for the Risk Management Team (RMT), to whom the
incident has been reported as an adverse clinical incident.
You have been asked to look at Dr. White’s report,
comment on it and identify issues that the RMT needs to explore further. You
have 15 minutes to read Dr. White’s report, after which you will have a viva
with the examiner. The examiner will not lead the discussion and will simply
listen to what you have to say.
Dr. White’s Report.
I am Dr. J. White. I have been SpR in obstetrics and
gynaecology at the Royal Infirmary for over a year.
On the 27th. September I was bleeped by a
midwife on the labour ward and asked to see a Mrs Brown who needed to be
delivered as there had been delay in the second stage and she was becoming
exhausted.
On arrival on the labour ward I felt that Mrs Brown was
not trying very hard to deliver the baby naturally and that the midwives were
not making much effort to encourage her. I advised that they should get her
pushing properly and that I would go for a coffee and return in half an hour.
I returned in 50 minutes, having had an important phone
call from my wife about arrangements for our forthcoming holiday which was
under threat of cancellation. The situation was unchanged and I was not
impressed with either the woman’s endeavours or the midwives’ encouragement of
her efforts.
Examination showed the head to be mid-cavity. I felt that
it could get it out using forceps. The midwives told me that her bladder was
empty. I applied the forceps with ease. The baby delivered in good condition. I
then noted that she had a 4th. degree tear. I repaired this in the
usual way.
I went on holiday the next day for two weeks and did not
see this woman again.
32. Viva. Neonatal jaundice.
Candidate's
Instructions.
This is a viva station.
The examiner will ask you 5 questions.
33. Viva. Write a model for
taking an obstetric history for tutorial.
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.
The
examiner will ask 4 questions.
1. What are your headings?
2. Which clinical situations do you envisage covering?
3. Which teaching methods would you consider for use in the tutorial?
4. Which teaching methods would be most suitable and why.
34. Viva. Headache.
Candidate's
Instructions.
This is a viva station.
The examiner will ask you 13 questions!
35. Role-play. Pre-menstrual
syndrome.
Candidate’s Instructions.
You are a 5th. year SpR and about to see Jane Williams in
the gynaecology clinic.
You are to take a relevant history and advise her about management of
her problem.
Referral Letter.
The Surgery,
Main Road,
Blacktown,
Herts.
Phone 0845 689 432.
Re. Mrs Jane Williams,
35 High Street,
Blacktown.
BK88 4EU
d.o.b. 1 January 1990.
Dear Doctor,
Please see Mrs Williams who has pre-menstrual syndrome. She has tried
vitamin B6 with no benefit.
Yours sincerely,
John P. Evans MRCGP, DRCOG.
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