Thursday, 27 October 2016

Tutorial 27 October 2016


27 October 2016

39
Role-play. Hydatidiform mole
40
Role-play. Maternity Dashboard
41
Viva. Laparoscopy & bowel injury.
42
Role-play. Laparoscopy & bowel injury. See patient.

39. Role-play. Hydatidiform mole.
Candidate's Instructions.
You are the SpR in the gynae clinic. The consultant has said that it will be a good experience for you to see the next patient.
She was recently an inpatient for evacuation of retained products after an apparent miscarriage at 8 weeks.
The histology report showed a complete mole.
The GP was contacted and asked to see her. An appointment was sent to her to attend today.
Your task is to take a history and explain the implications of the diagnosis

40. Viva. Maternity Dashboard.
Candidate’s instructions.
This is a viva station about the RCOG’s maternity dashboard.
The examiner will ask you 14 questions.
When you have finished a question, you will not be allowed to return to it as later questions may indicate the answer. If you return, no marks will be awarded, even for correct answers.

41. Viva. Laparoscopy & bowel injury.
Candidate’s instructions.
This is a viva station.
You are a SpR. You are in the process of performing laparoscopy for a patient with 1ry. infertility. On inserting the laparoscope you suspect that the cannula is in the bowel.
Your task is to explain to the examiner all the steps you will consider taking from recognising the possibility through to the woman’s discharge.
This is an “open” viva and the examiner will not assist you.
It is up to you to ensure that all the relevant issues are discussed.

42.  Role-play. Laparoscopy & bowel injury.
Candidate’s instructions.
This is a follow-on from the previous station.
It is now 4 hours since the operation: the woman had a laparotomy to repair the bowel defect. The woman has asked why she has not been allowed to go home. Her sister has come to collect her. The patient is still feeling drowsy and has some pain, so has asked her sister to find out what happened, when she can go home and what it means for her fertility.
are Mary White. Your sister Jane had laparoscopy as investigation of 1ry. infertility this morning. Something went wrong and she is to stay in hospital. She has delegated you to find out what happened, when she can go home and what it means for her fertility.
You are a solicitor and specialise in medical litigation. You also want to know whether the doctor was qualified to do the operation, what investigation will be done and what will be done to assist her in making a complaint, which you are sure she will want to do.
You want answers to the following questions, but don’t ask them until it is clear that the doctor is not going to give any answers.
1.           what went wrong?
2.           why did it go wrong?



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