Simulated patients’ experience of adopting telesimulation for history taking during a pandemic

Tuberculous spondylitis is a chronic infectious disease caused by Mycobacteriumtuberculosis on the vertebral bone. Involved less than 3% of all cases of TB, but the incidencevaries around the world, and is associated with the quality of public health and socioeconomicconditions.The purpose of this study is to investigate the presurgical aspects of nutrition inpatients with tuberculous spondylitis. A total of 39 consecutive patients between January 2011-December 2012 were evaluated retrospectively. All patients diagnosed with spondylitistuberculousis and treated with decompression, stabilization and fusion. All patients had beendiagnosed with Spondylitis tuberculousis based on history taking, physical examination,laboratory finding and MRI. Our study showed that of all subjects, ten male patients and eightfemale patients had cervical (n=1), thoracic (n=15), and lumbar (n=2) tuberculousspondylitis.The average age of the patients was 32.83 ± 12.25 (17-56) years old. The averagepreoperative body mass index (BMI) was 16.67 ± 1.2 kg / m2, albumin levels 3.23 ± 0.21 g / dl,total protein level 6.2 ± 0.34 g/dL. These were lower than normal value. We conclude thattuberculous spondylitis patients experience nutritional deficiencies presurgically andnutritional support should be considered pre-operatively.Keywords: Mycobacterium tuberculosis, nutritional state, presurgical aspect,tuberculousspondylitis

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Assessing clinical reasoning in undergraduate medical students during history taking with an empirically derived scale for clinical reasoning indicators

BMC Medical Education ◽

10.1186/s12909-020-02260-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sophie Fürstenberg ◽

Tillmann Helm ◽

Sarah Prediger ◽

Martina Kadmon ◽

Pascal O. Berberat ◽

...

Keyword(s):

Medical Students ◽

Clinical Reasoning ◽

Medical Training ◽

Diagnostic Procedures ◽

Daily Practice ◽

Simulated Patients ◽

Reasoning Ability ◽

History Taking ◽

Undergraduate Medical Students ◽

Biomedical Knowledge

Abstract Background The clinical reasoning process, which requires biomedical knowledge, knowledge about problem-solving strategies, and knowledge about reasons for diagnostic procedures, is a key element of physicians’ daily practice but difficult to assess. The aim of this study was to empirically develop a Clinical Reasoning Indicators-History Taking-Scale (CRI-HT-S) and to assess the clinical reasoning ability of advanced medical students during a simulation involving history taking. Methods The Clinical Reasoning Indictors-History Taking-Scale (CRI-HT-S) including a 5-point Likert scale for assessment was designed from clinical reasoning indicators identified in a qualitative study in 2017. To assess indicators of clinical reasoning ability, 65 advanced medical students (semester 10, n = 25 versus final year, n = 40) from three medical schools participated in a 360-degree competence assessment in the role of beginning residents during a simulated first workday in hospital. This assessment included a consultation hour with five simulated patients which was videotaped. Videos of 325 patient consultations were assessed using the CRI-HT-S. A factor analysis was conducted and the students’ results were compared according to their advancement in undergraduate medical training. Results The clinical reasoning indicators of the CRI-HT-S loaded on three factors relevant for clinical reasoning: 1) focusing questions, 2) creating context, and 3) securing information. Students reached significantly different scores (p < .001) for the three factors (factor 1: 4.07 ± .47, factor 2: 3.72 ± .43, factor 3: 2.79 ± .83). Students in semester 10 reached significantly lower scores for factor 3 than students in their final year (p < .05). Conclusions The newly developed CRI-HT-S worked well for quantitative assessment of clinical reasoning indicators during history taking. Its three-factored structure helped to explore different aspects of clinical reasoning. Whether the CRI-HT-S has the potential to be used as a scale in objective structured clinical examinations (OCSEs) or in workplace-based assessments of clinical reasoning has to be investigated in further studies with larger student cohorts.

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Attitudes and perceptions of final year medical students on sexual history taking from patients in Ogun state, Southwestern Nigeria

Ghana Medical Journal ◽

10.4314/gmj.v55i2.6 ◽

2021 ◽

Vol 55 (2) ◽

pp. 135-140

Author(s):

Oluseun O. Adeko ◽

Adekunle J. Ariba ◽

Akindele E. Ladele

Keyword(s):

Medical Students ◽

Sexual Health ◽

Cross Sectional Study ◽

Sexual History ◽

Simulated Patients ◽

History Taking ◽

Southwestern Nigeria ◽

Cross Sectional ◽

Ogun State ◽

Sexual History Taking

Background: An important aspect of sexual health is the ability to take a sexual history. Previous studies have shown that most medical students believed that sexual history taking is an important skill for future practice. Still, a majority reported inadequate, inconsistent or no training in this area.Objectives: To assess the attitudes of final year medical students on sexual history taking and perceptions of the training they received in medical schoolDesign: A cross-sectional study using an online surveyParticipants: Consented and conveniently sampled 100 final year medical students.Results: The overall response rate was 74.6%, and the mean age of the respondents was 24.1±2.9 years. The majority (97%) of the students believed it is important for doctors to know how to take a sexual history. Still, only 31% admitted to finding it easy, with 57% of the students admitted to being comfortable taking a sexual history from adult patients. While 70% had exposure on simulated patients, just 54% have observed doctors taking sexual history during clinical rotations, mostly in Obstetrics and Gynaecology (97%) and Urology (60%) postings.Conclusions: Many final year medical students are interested in and appreciated the importance of sexual history taking, but they are not well grounded in many aspects of the topic. Despite the importance of sexual health, many students did not have enough exposure and training on the topic while still in medical schools. There is thus a need for a review of the curriculum of undergraduate medical education in Nigeria.

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Pitfalls in Training Simulated Patients to Respond Appropriately to Questions from Medical Students in Family History-taking Activities: The Current Situation Surrounding the Training of Simulated Patients for Learning Activities at Nippon Medical School

Journal of Nippon Medical School ◽

10.1272/jnms.80.57 ◽

2013 ◽

Vol 80 (1) ◽

pp. 57-62

Author(s):

Ryoko Aso ◽

Chikako Inoue ◽

Akinobu Yoshimura ◽

Toshiro Shimura

Keyword(s):

Medical Students ◽

Family History ◽

Medical School ◽

Current Situation ◽

Learning Activities ◽

Nippon Medical School ◽

Simulated Patients ◽

History Taking

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Computer based simulated patient for teaching history-taking

Journal of Dental Education ◽

10.1002/j.0022-0337.1973.37.8.tb00718.x ◽

1973 ◽

Vol 37 (8) ◽

pp. 27-31

Author(s):

HA Brody ◽

LF Lucaccini ◽

M Kamp ◽

R Rozen

Keyword(s):

Simulated Patient ◽

History Taking ◽

Teaching History ◽

Computer Based

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698 Lifestyle advice in hospitalized heart failure patients: experience from the EuroHeart failure survey

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(06)80449-2 ◽

2006 ◽

Vol 5 (1) ◽

pp. 159-159

Author(s):

M LAINSCAK ◽

I KEBER ◽

M LENZEN ◽

F FOLLATH ◽

K SWEDBERG ◽

...

Keyword(s):

Heart Failure ◽

Lifestyle Advice ◽

Heart Failure Patients ◽

Patients Experience

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The self and schizophrenia: a cognitive approach

Swiss Journal of Psychology ◽

10.1024//1421-0185.62.1.45 ◽

2003 ◽

Vol 62 (1) ◽

pp. 45-51 ◽

Cited By ~ 5

Author(s):

Marek Nieznanski

Keyword(s):

Normal Subjects ◽

Control Group ◽

Cognitive Approach ◽

Schizophrenic Patients ◽

Self Schema ◽

Persons With Schizophrenia ◽

Basic Features ◽

Trait Words ◽

Patients Experience ◽

Normal Controls

The aim of the study was to explore the basic features of self-schema in persons with schizophrenia. Thirty two schizophrenic patients and 32 normal controls were asked to select personality trait words from a check-list that described themselves, themselves as they were five years ago, and what most people are like. Compared with the control group, participants from the experimental group chose significantly more adjectives that were common to descriptions of self and others, and significantly less that were common to self and past-self descriptions. These results suggest that schizophrenic patients experience their personality as changing over time much more than do healthy subjects. Moreover, their self-representation seems to be less differentiated from others-representation and less clearly defined than in normal subjects.

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Observer Variation in Clinical Diagnosis - A Computer-Aided Assessment of its Magnitude and Importance in 552 Patients with Abdominal Pain

Methods of Information in Medicine ◽

10.1055/s-0038-1636102 ◽

1973 ◽

Vol 12 (02) ◽

pp. 108-113 ◽

Cited By ~ 20

Author(s):

P. W. Gill ◽

D. J. Leaper ◽

P. J. Guillou ◽

J. R. Staniland ◽

J. C. Horhocks ◽

...

Keyword(s):

Abdominal Pain ◽

Clinical Diagnosis ◽

Error Rate ◽

Diagnostic System ◽

Diagnostic Error ◽

Observer Variation ◽

History Taking ◽

Computer Aided ◽

Computer Based ◽

Initial Survey

This report describes an evaluation of »observer variation« in history taking and examination of patients with abdominal pain. After an initial survey in which the degree of observer variation amongst the present authors fully confirmed previous rather gloomy forecasts, a system of »agreed definitions« was produced, and further studies showed a rapid and considerable fall in the degree of observer variation between the data recorded by the same authors. Finally, experience with a computer-based diagnostic system using the same system of agreed definitions showed the maximum diagnostic error rate due to faulty acquisition of data to be low (4.7°/o in a series of 552 cases). It is suggested as a result of these studies that — at least in respect of abdominal pain — errors in data acquisition by the clinician need not be the prime cause of faulty diagnoses.

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Computerization of the Patient History -Patient Answers Compared with Medical Records

Methods of Information in Medicine ◽

10.1055/s-0038-1635472 ◽

1986 ◽

Vol 25 (04) ◽

pp. 222-228 ◽

Cited By ~ 5

Author(s):

M. J. Quaak ◽

R. F. Westerman ◽

J. A. Schouten ◽

A. Hasman ◽

J. H. Bemmel

Keyword(s):

Internal Medicine ◽

Medical Records ◽

Patient Record ◽

Frequency Of Occurrence ◽

History Taking ◽

Patient History ◽

Patient Complaints ◽

Computerized Patient Record ◽

Extensive Information ◽

Experienced Physician

SummaryComputerized medical history taking, in which patients answer questions by using a terminal, is compared with the written medical record for a group of 99 patients in internal medicine. Patient complaints were analysed with respect to their frequency of occurrence for all important tracts, such as the respiratory, the gastro-intestinal and the uro-genital tracts. About 36% of over 3,200 patient answers were identical in the patient record and the written record, but a considerable percentage of complaints (56%), that were present in the patient record, were missing in the written record; the reverse was true for 4.5%. A computerized patient record appears to contain more extensive information about patient complaints, still to be interpreted by the experienced physician.

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