Wednesday, June 22, 2005

a whole lot going on, but not a whole lot to show....

I’ve been spreading myself thin between all of my current projects, and thus it doesn’t feel like I’m getting very far on them! The sock is still being knitted, I’m taking yarn out of sweaters that didn’t work the first time around, finishing up some sewing projects so I can start other sewing projects and still spindling. It’s good for my transient project ADD, but not so great for completion or interesting blogging.

(Thanks for the reassurance on Kiri; I’m going to dive into it next, and will follow the directions as written, even if it doesn’t look like it will make sense!)

The Lorna’s Laces from Cassie arrived and I’m thrilled with it. The colors are great, and it’s yarn that I would buy for myself! (now that it’s actually here I think my sock knitting will pick up….)

Yesterday was my final clinical skills assessment (CSA) for the year. I saw 8 different patients in the simulated clinic, and had 14 minutes (not the 18 I thought I had) to speak with the “patients” (they’re actors, or simulated patients) and examine them before having 9 minutes to write up a note, or answer questions based on what I found. The clinic is set up like a doctor’s office and has 8 different small rooms, along with a few other common rooms; one is set up with computers so we can type out our notes and one is a “control center” of sorts. Each of the exam rooms has a camera and microphone in the ceiling, and the feeds are sent to the control room to be viewed while we’re in there, and to be taped for future review and/or further grading. We’ve had three CSA’s this year – we saw 2 pts in the first one, 4 in the second one and both led up to this last one. During the earlier CSAs we had a chance to meet with the patient we had seen and hear first hand how we had done. Yesterday we weren’t given any direct feedback, but we felt prepared for the 8 pt, 4 hour marathon.

Each of the situations is unique, and the wide range of problems spans from ethical issues to the usual “cold” and musculoskeletal problems to end of life care. In one case an older couple presents with one of them showing signs of dementia, and shows us how hard it can be to do an interview with two people in the room, each with a different story. Yesterday I was asked to evaluate a 77 year old (character) to see if he should still be living on his own, and saw a patient/character who wanted a note to get out of work for “back pain” even though he didn’t have any back pathology and he couldn’t keep his story straight. There were a few more usual cases, and overall the standardized patients were great – they kept in character and one person with “real” back pain had me so convinced I found myself helping him stand up and move over to the exam table. While I was in the room with the patients, another person who was trained to do that particular case was watching in the control room. Both the person watching and the patient grade me, and the note or questions I answered after each encounter will be graded. I didn’t look forward to going, but I learned a lot and think it’s a great experience.

(14 minutes doesn’t sound like a very long time to interview/examine someone, but I can finally say that I feel like it’s a manageable amount of time. I don’t want to be the doctor who runs into a room looking rushed and skipping over the “how are you’s” but now I’m more confident that I’ve learned how to use the time I have.)

Now that the half day learning experience is over, I feel even closer to being “done.” I still have class this week and next, but the end is near!

Life is good.


Anonymous Kim said...

Good for you! I am amazed that you can get as much as you do get finished, being in Med school!

7:05 PM  
Anonymous Bridget said...

It sounds like you did really well! Not too much longer and you can relax!

7:14 PM  
Anonymous Laurie said...

It's SO much easier in real life, when patients are invested in believing in you. Then, the interaction is authentic in content, and it feels exactly right.

7:36 PM  
Blogger Norma said...

I get all stressed out just hearing about's amazing that you take it all in stride. We'll be looking for socks around here.....

8:07 PM  
Anonymous Cassie said...

I'm so glad the Lorna's suits you - I hope now that the semester is over you'll have some time to do some sock knitting.

6:13 AM  
Anonymous jess said...

I enjoyed reading about your experience - but glad I wasn't you for the day!

Not long now.

7:28 AM  
Anonymous margene said...

A little insight into how they train doctors. You seem to take it all in stride and knew what to do. Congrats. Do you get to enjoy the summer now?

10:27 AM  

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