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STATION 1.
You are on your GP attachment and the GP has asked
you to take John Murphy’s (55yrs old) Blood Pressure
before he comes in to see him.
EXAMINER SHEET STATION 1
STUDENT NAME____________
Inadequate Adequate
Good
Uses hand gel
Introduces self – first and second names and role
(medical student).
Checks identity of patient
Gains consent to take BP reading
Asks about caffeine / smoking in previous 30mins
Explains procedure – including possible discomfort
Checks radial pulse
Positions arm correctly
Selects correct sized cuff
Places cuff correctly – 3cm above elbow crease point of entry of tubes over brachial artery.
Checks systolic BP by pulse
Reinflates cuff to 30mmHg above palp systolic
Does not leave cuff inflated for too long
Does not reinflate cuff multiple times
Places stethoscope over brachial artery
Deflates cuff slowly – 2mmHg per second
Removes cuff
Thanks patient
Reports BP to within 2mmHg
Please give a global rating of this student: FAIL
BORDERLINE
Comment on strengths:
Comment on weaknesses:
PASS
STATION 2.
You are on attachment in A+E and are asked to
take a history from Michael O’Connor, a 70 yr old
man.
STATION 2
PATIENT SCENARIO
You are Michael O’Connor, a 70 yr old man.
You have come to A+E with moderate retrosternal chest pain 6/10
The pain started an hour ago while you were watching TV after dinner. It feels like
a pressure in the centre of your chest. It got worse when you walked out to the car to
come to the hospital but has eased a bit again now. You would rate it 5/10 at present.
There is no radiation. You think you may have felt a much milder version of this
pain before when out walking but it would go away after a brief stop.
You feel a bit sick with it and sweaty but have not vomited. You have no dyspnoea.
No PND, orthopnoea, palpitations or ankleswelling.
You initially thought you had a bit of indigestion and tried some Gaviscon (antacid)
for it to no effect. You do get heartburn occasionally but it doesn’t feel anything like
this. You have no other GI symptoms.
You are now concerned that the pain might be angina, you have several friends
who have it.
You are a smoker 20pd for over 50 yrs. You don’t drink. You don’t know about
your cholesterol and BP as you try to stay away from doctors if you can.
Your parents died of old age in their 80s. You have two brothers, one of whom has
had Coronary Artery Bypass Grafting in his 50s.
You are on no regular meds.
You are a widower. Your wife died 5 yrs ago. You have two daughters who live
nearby and call in to you frequently but you are fully independent in your activities of
daily living. You are a retired banker and walk 2 miles daily with your dog.
You are otherwise well.
EXAMINER SHEET STATION 2
STUDENT NAME____________
Inadequate Adequate
Good
Introduces self – first and second names and role
(medical student).
Checks identity of patient
Gains consent to take history
Establishes reason for presentation
Elicits patient’s ideas, concerns and expectations.
Establishes duration and pattern of symptoms
Asks about pain – location, type and severity
Asks about relieving and exacerbating factors
Asks about associated symptoms
Asks about palpitations, dypnoea, PND,
orthopnoea, ankle swelling
Asks about upper GI symptoms – heartburn,
indigestion, dysphagia, nausea, effect of food.
Asks about smoking
Asks about cardiac risk factors, cholesterol, BP,
diabetes, family history.
Asks about exercise
Takes full social history
Conducts full systems review.
Checks history back to patient
Addresses patient concerns
Demonstrates empathy
What is most likely to be causing this patient’s symptoms?
ANGINA/ MYOCARDIAL INFARCTION.
UNSTABLE
Please give a global rating of this student: FAIL
BORDERLINE
Comment on strengths:
Comment on weaknesses:
PASS
STATION 3
You are asked to examine John McCarthy a 50 year
old man who has been experiencing palpitations for
the past month. He is currently in hospital for
investigations.
Do not take a history.
EXAMINER SHEET STATION 3
STUDENT NAME____________
Inadequate Adequate
Good
Introduces self – first and second names and role
(medical student).
Checks identity of patient
Uses hand gel
Gains consent to examine patient
General Inspection – comments on pallor
Inspects hands – comments on palmar creases,
clubbing, cyanosis, peripheral temp, cap refill.
Checks for fine tremor in the hands
Takes radial pulse and comments on rate, rhythm,
volume and character
Offers to check BP
Examines face – conjunctival pallor, comments on
thyroid eye disease, xanthelasmata, corneal arcus,
central cyanosis, dentition.
Checks for elevated JVP
Examines for goitre
Inspects the chest
Palpates for apex beat
Palpates for heaves and thrills
Auscultates over the valvular areas, uses bell at
mitral area.
Auscultates over the carotids
Auscultates the lung bases
Checks for ankleoedema
Offers to check peripheral pulses
Summarises examination findings
Ask the student to summarize their examination findings.
Please give a global rating of this student: FAIL
BORDERLINE
Comment on strengths:
Comment on weaknesses:
PASS
STATION 4
You are on your GP attachment. You are asked to
take a history from Anna O’Sullivan, a 60 year old
lady.
Station 4
Patient Scenario
You are Anna O’Sullivan, a 60 year old lady who has come to the GP with episodes
of weakness which have been going on for 4 weeks or so.
You have had 5 episodes in total, 2 this morning which is why you have come in.
The episodes occurred when you were out shopping, on another occasion you were
walking your dog and this morning it happened when you were climbing the stairs.
You feel well up to the point that the episode starts, then you start to feel sweaty,
weak and slightly breathless. You get a “feeling” between your shoulder blades
which is hard to describe, not a pain as such. If you stop what you are doing the
symptoms settle over a period of about 5 minutes.
You have no PND, orthopnoea, palpitations or ankleswelling. You have never had
any chest pain. You don’t normally get exertional dyspnoea. You don’t take much
exercise apart from a 10 minute walk with your dog daily.
You would like to be referred urgently to see a consultant. You don’t think much
of GPs and want an opinion from “someone who knows what they’re talking
about”.
You smoke 15 per day for 40+ years. You drink wine 4 glasses per week.
You have been told a number of years ago that your cholesterol was “ a bit high”.
You try to eat healthily but have never had it checked again.
You have no past medical history.
You are on no medications.
Your father died of a stroke aged 55 yrs. Your mother is still alive and well aged
88yrs. She lives with you which can be stressful as she is quite demanding.
You work as a secretary part time, are married with 3 grown up children. Your
husband is in good health but he can’t stand your mother which adds to the stress.
You feel that these domestic issues may have brought on your symptoms.
Your children live locally and you see them regularly.
You have no other symptoms.
EXAMINER SHEET STATION 4
STUDENT NAME____________
Inadequate Adequate
Good
Introduces self – first and second names and role
(medical student).
Checks identity of patient
Gains consent to take history
Establishes reason for presentation
Elicits patient’s ideas, concerns and expectations
(desire to be referred, effect of stress)
Establishes duration and pattern of symptoms
Asks for description of episodes
Asks about pain
Asks about relieving and exacerbating factors
Asks about associated symptoms
Asks about palpitations, dypnoea, PND,
orthopnoea, ankle swelling
Asks about respiratory symptoms cough, sputum,
haemoptysis, wheeze, exertional dyspnoea.
Asks about smoking
Asks about cardiac risk factors, cholesterol, BP,
diabetes, family history.
Asks about exercise
Takes full social history
Addresses patient concerns
Demonstrates empathy
Elicits stress at home and carer role.
Conducts full systems review.
Checks history back to patient
Thanks patient
Please give a global rating of this student: FAIL
BORDERLINE
Comment on strengths:
Comment on weaknesses:
PASS
STATION 5
YOU ARE ASKED TO EXAMINE THE LEGS
OF THIS 65 YEAR OLD HEAVY SMOKER
WHO HAS INTERMITTENT CLAUDICATION.
EXAMINER SHEET STATION 5
STUDENT NAME____________
Inadequate Adequate
Good
Introduces self – first and second names and role
(medical student).
Checks identity of patient
Uses hand gel
Gains consent to examine patient
General Inspection - looks well etc.
Inspects legs – comments on colour, hair, gangrene,
ischaemic rubor, scarring, missing digits.
Specifically looks for ulcers – examines between
toes and under heel.
Palpates for temp, comparing rt and lt.
Checks capillary refill
Checks for dorsalis pedis pulse and comments on
strength comparing rt and lt.
Checks for posterior tibial pulse and comments on
strength comparing rt and lt.
Checks popliteal pulse, comparing rt and lt.
Offers to check femoral pulse
Offers to auscultate for femoral bruits
Thanks patient
Summarises findings.
Ask the student to summarise their findings.
Please give a global rating of this student: FAIL
BORDERLINE
Comment on strengths:
Comment on weaknesses:
PASS
STATION 6
THIS IS AN EXPLANATION STATION.
JAMES MURPHY IS A 33 YEAR OLD MAN
WHO HAS BEEN FOUND TO HAVE AN
ELEVATED CHOLESTEROL OF 7.5 (UPPER
LIMIT OF NORMAL 5).
YOU ARE ASKED BY THE GP TO DISCUSS
THIS WITH THE PATIENT AND GIVE HIM
APPROPRIATE ADVICE.
STATION 6
PATIENT SCENARIO
You are James Murphy, a 33 year old shop manager.
You recently had an insurance medical and have been asked to come in to see the GP
to discuss your blood test results.
You are aware of high cholesterol being a bad thing. You feel that you eat healthily
and are surprised to hear that your cholesterol is high. Your father is taking tablets
for his cholesterol and you don’t want to have to start lifelong treatment at such a
young age.
You eat red meat at least once a day. You don’t like fish. Your wife does the
shopping and cooking, you think she buys full fat dairy produce and you use real
butter because you don’t like the taste of low fat spreads. You eat plenty of fruit and
veg and have never been over weight.
You can’t understand how your cholesterol is high when you are a normal body
weight – it’s something you associate with fat people. Is there any chance there was
a mistake with your blood test? Why is your cholesterol elevated when you do
all the same things as your friends and none of them have this kind of problem?
You are on your feet all day and think of yourself as reasonably fit. You go for walks
with the family at the weekend. You don’t take any strenuous exercise.
You are a non smoker and drink 5 pints at the weekend.
You are married with 2 children, all well at home.
If the doctor doesn’t offer you written dietary advice ask for it at the end of the
consultation.
EXAMINER SHEET STATION 6
STUDENT NAME_____________
Inadequate Adequate Good
Introduces self, first and second name and explains
role.
Checks patient identity
Gains consent for consultation
Ascertains patients understanding of reasons for
cholesterol test.
Tells patient cholesterol level above normal range.
Explains risks associated with high cholesterol
specifically heart disease and stroke.
Asks about other risk factors, smoking, hypertension,
family history, diabetes.
Asks about patient’s intake of saturated fat – red meat
and full fat dairy products.
Asks about fried food vs grilled/baked.
Suggests dietary change as first line of management
Asks about exercise
Does not use medical jargon
Gives opportunity to ask questions
Addresses patient concerns
Offers written dietary advice
Demonstrates empathy
Checks patient understanding
Asks patient to repeat back explanation
Please give a global rating of this student: FAIL
BORDERLINE
Comment on strengths:
Comment on weaknesses:
.
PASS