Respiratory Examination for OSCEs
In examination of any system there are
2 important points to remember. They are:
1. Correct
method
2. Practice
Method
The method used by the most senior
clinicians and the most junior medical students is one and the same. The
difference is that the senior clinician has practiced it innumerable times and
hence is far better at it.
Learn the method of respiratory
examination. Read ACES for PACES chapter 11,
then practice on patients, read again and refine your method. Repeat ad
infinitum
Ask a colleague to observe you and see
if you are going through every step
Use the summary in the
appendix of ACES for PACES as a checklist
to make sure you are going through every step
Diagnosis
After you are confident that your
method is satisfactory, think of making a diagnosis
Read the preface of
ACES for PACES and learn the hypothetico
deductive method of making a diagnosis.
Study the common lesions of the
respiratory system (ACES for PACES pages 237-245)
Study the symptoms and signs that may
occur in relation to respiratory disease and the causes of these clinical
features (ACES for PACES pages 245-268)
Points to Remember
Marks are awarded for each step of
the examination.
Hence it is essential to have a good
method and go through every step of it
Respiratory
lesions are not diagnosed on auscultation
The signs that one elicits in other
parts of the examination are often much more useful in determining the lesion
present
Examples of this are:
Clubbing is a very important sign and
would give a good clue to the underlying pulmonary lesion
Horner's syndrome would indicate an
apical carcinoma
For examples of analysis of cases using the advanced clinical
evaluation system (ACES) see the examples on this website and the cases
analysed in the blog clinical-skills.blogspot.com
