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.

Tutorial 4 October 2012

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We started with an incomplete audit.

In a recent exam there was an "incomplete" audit.

The audit was about ECV.

The data was that:

Consultant A offered ECV to one group of women and had an 70% success rate,

Consultant B offered ECV to a different group and had a 30% success rate,

Consultant C did not offer ECV at all.

You were given this data and were asked to discuss how you would go about completing the audit process.

We followed this with 3 vivas:

    uterine inversion

    the uses of magnesium sulphate in obstetrcs

    vitamin supplementation in obstetrics.

The data for the uterine inversion viva was:

Candidate’s instructions.

You are the SpR on call for the labour ward.

You are called urgently to deal with the patient for whom a brief history is given below.

Basic clinical information.

Para 2 ⁺⁰.  25 years old. Previous elective Caesarean section for breech presentation.  40 weeks. Normal pregnancy, labour and delivery of child. Active management of the 3^rd. stage Syntocinon and CCT. As the placenta emerges from the vulva she complains of severe lower abdominal pain. CCT stopped. Pulse rate 120 beats per minute; BP 90/50 mm. Hg. Cold and sweaty.

Justify your immediate actions.

You were then asked question of given information by the examiner.

 

Tutorial 1st. October 2012

Tutorial  1st. October 2012
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Tonight we had a series of vivas.
The first related to a laparoscopy. As you insert the laparoscope you realise that the 'scope has gone through the bowel.
In the first viva you discuss with the examiner what you do.
In the second viva, you see the patient next day to explain what happened.
In the third viva, you discuss what you would put in a statement for the risk management committee as the surgeon involved.
We then had a roleplay about pre-pregnancy counselling, the sister having had a baby with Down's syndrome.