In mid-February, I started term 4. Irrespective of what I had heard from other students, going into term 4, I knew it would be a lot of work. I knew time management would be tested for 16 weeks straight. I do not mean to scare any future term 4 students. This is just to prepare future students for what is to come.
In terms of blogging, I think the best way to organize my perspective of term 4 is to begin with a brief overview, explain the difference between term 1+ 2 and term 4, and discuss each term 4 class in detail. This particular post will focus on CPD. Future posts will focus on Pathology, Nutrition, Microbiology, and I plan to write a post on time management during term 4. If any readers have suggestions or questions, feel free to email me at meyouandsgu@gmail.com and I will try to incorporate ideas into the posts.
Brief Overview of Term 4
Term 4 consists of 4 classes (Pathology, Microbiology, Nutrition, and CPD) over 16 weeks. Students will devote majority of their time studying for microbiology and pathology, which are worth the most amount of credits. Nutrition is a 1-credit, 2 week long class that is placed in the middle of the term directly after term 4 midterms. CPD is a 3 credit class that focuses on communication and physical examination skills. Students are able to improve their patient interviewing skills and practice their physical examination skills on a weekly basis.
Difference between term 1+2 and term 4:
Personally, I think term 1 and 2 courses formed the basic foundation that is needed to understand material in term 4. The major challenge in term 1 and 2 is adjustment to the amount of material presented on a daily basis and getting accustomed to life in Grenada. In term 4, however, I think the major challenge is time management. In term 2, the schedule consists of only few labs/small group discussions per week giving students plenty of personal study time. In term 4, however, every afternoon is filled with labs and small group discussions. So, there were many days I had lecture from 8am-12pm and labs from 1-5pm. So, personal studying time did not start until after 5pm. For this reason, I had to find a way to review the material for the day at a quicker, more efficient manner. I will clearly explain a few methods that worked for me in the next few posts.
Communication Skills and Physical Diagnosis (CPD):
CPD is a 3-credit class that consists of 1 weekly lecture and 2 weekly labs that last about 2 hours. Each lab group consists of about 7 students. Each lab session will focus on one system for physical examination. Students are given 30 minutes to practice the proper protocol for physical examination with their lab groups. Following the practice session, a standardized patient will enter each of the patient rooms. 1 student of the lab group will conduct the patient interview, 1 student will conduct the appropriate physical examination, and 1 student will conduct a summary and closing remarks. As the term progresses, the lab will start writing SOAP notes in 10 minutes. By the end of the term, the SOAP note will become second nature. I was lucky to be a part an awesome CPD group. We all helped each other and always took turns on the role that we played during the patient encounter. I think this was helpful so that we all conducted interviews, learned how to do the physical exam, and learned how to close an interview. Following each part of the patient encounter, the lab group, the clinical tutor, and the patient will provide valuable feedback. I thought the feedback was very important to help improve my communication skills.
Although there are videos that are helpful to watch before each lab session, I am thankful that there wasn't a substantial amount of outside of class work for CPD. There are 2 quizzes each worth 10% of the total grade and 1 OSCE (Objective Structured Clinical Exam) that is worth 40% of the total grade at the end of the term. Each quiz is a team quiz. Each team is responsible for interviewing a patient thoroughly, conducting the physical examination, and closing the patient encounter within 15 minutes. The grade for the quizzes will only be based on the SOAP note. For OSCE, our last final exam for term 4, each student had to individually conduct a thorough patient encounter in 15 minutes. We then had 10 minutes to type the SOAP note. The OSCE exam consisted of 4 patient cases. Each part of the patient encounter was evaluated for the OSCE examination.
Here are a few things that I did to prepare for OSCE and the 2 quizzes:
1) Physical examination was my weakness. So, I watched the videos for each physical examination a couple times and formulated a pattern to follow for each physical examination. For example, irrespective of what part of the body I am examining, I always start with inspection, then check for tenderness/pain, etc.
2) I practiced interviewing my roommates and a few friends. If I practiced interviewing a person who wasn't in term 4, I usually asked them to tell me about their personal medical history or gave them some sample SOAP notes to read that are provided by the CPD department and asked them to act like a patient.
3) I made up a mnemonic to help me remember each part of the interview. I used this mnemonic throughout the term to make sure I asked all the necessary questions during each patient encounter and it worked like a charm.
4) TIMED MY INTERVIEW!!! Initially, we were given 15 minutes to interview during the lab sessions. By the end of the term, the instructors expect that students interview in about half the time. The more you practice the interview, the better the interview will be. During both quizzes, my team decided that I would be the interviewer. So, I started cutting down my interview time early in the term.
5) For OSCE, I tried to break up my 15 minute patient encounter as follows: 8 minutes for interview, 5 minutes for physical examination, and 2 minutes to close the encounter. This is just a rough idea. The timing also depends on how much the patient talks and the type of symptoms.
6) I became familiar with the differentials provided for each case that we had for each lab session. That way, as I interviewed the patient, I could ask pertaining questions to narrow down my list of differentials.
7) I listened to strategies my lab members used to ask questions during the patient interview and tried to incorporate ideas into my own interview. This helped immensely. Because this is a communications class, it is definitely helpful to learn from classmates.
8) Bring a watch that is non-digital to both quizzes and OSCE. During the quizzes, have one person in the group who is not interviewing tell the interviewer when 5 minutes have passed. Prior to each quiz, my group had decided that if I (the interviewer) spent more than 8.5 minutes interviewing, the person timing must notify me immediately. This way, we had enough time for physical examination and closing the patient encounter. During the OSCE examination, there was a big clock in each room, so I had a rough estimate of how much time had passed during each patient encounter.
I hope this post provides a general overview of CPD. I thoroughly enjoyed CPD because it helped me connect textbook material learned in other courses to the clinical world.
Hope everyone is having a great day! :)
~N
In terms of blogging, I think the best way to organize my perspective of term 4 is to begin with a brief overview, explain the difference between term 1+ 2 and term 4, and discuss each term 4 class in detail. This particular post will focus on CPD. Future posts will focus on Pathology, Nutrition, Microbiology, and I plan to write a post on time management during term 4. If any readers have suggestions or questions, feel free to email me at meyouandsgu@gmail.com and I will try to incorporate ideas into the posts.
Brief Overview of Term 4
Term 4 consists of 4 classes (Pathology, Microbiology, Nutrition, and CPD) over 16 weeks. Students will devote majority of their time studying for microbiology and pathology, which are worth the most amount of credits. Nutrition is a 1-credit, 2 week long class that is placed in the middle of the term directly after term 4 midterms. CPD is a 3 credit class that focuses on communication and physical examination skills. Students are able to improve their patient interviewing skills and practice their physical examination skills on a weekly basis.
Difference between term 1+2 and term 4:
Personally, I think term 1 and 2 courses formed the basic foundation that is needed to understand material in term 4. The major challenge in term 1 and 2 is adjustment to the amount of material presented on a daily basis and getting accustomed to life in Grenada. In term 4, however, I think the major challenge is time management. In term 2, the schedule consists of only few labs/small group discussions per week giving students plenty of personal study time. In term 4, however, every afternoon is filled with labs and small group discussions. So, there were many days I had lecture from 8am-12pm and labs from 1-5pm. So, personal studying time did not start until after 5pm. For this reason, I had to find a way to review the material for the day at a quicker, more efficient manner. I will clearly explain a few methods that worked for me in the next few posts.
Communication Skills and Physical Diagnosis (CPD):
CPD is a 3-credit class that consists of 1 weekly lecture and 2 weekly labs that last about 2 hours. Each lab group consists of about 7 students. Each lab session will focus on one system for physical examination. Students are given 30 minutes to practice the proper protocol for physical examination with their lab groups. Following the practice session, a standardized patient will enter each of the patient rooms. 1 student of the lab group will conduct the patient interview, 1 student will conduct the appropriate physical examination, and 1 student will conduct a summary and closing remarks. As the term progresses, the lab will start writing SOAP notes in 10 minutes. By the end of the term, the SOAP note will become second nature. I was lucky to be a part an awesome CPD group. We all helped each other and always took turns on the role that we played during the patient encounter. I think this was helpful so that we all conducted interviews, learned how to do the physical exam, and learned how to close an interview. Following each part of the patient encounter, the lab group, the clinical tutor, and the patient will provide valuable feedback. I thought the feedback was very important to help improve my communication skills.
Although there are videos that are helpful to watch before each lab session, I am thankful that there wasn't a substantial amount of outside of class work for CPD. There are 2 quizzes each worth 10% of the total grade and 1 OSCE (Objective Structured Clinical Exam) that is worth 40% of the total grade at the end of the term. Each quiz is a team quiz. Each team is responsible for interviewing a patient thoroughly, conducting the physical examination, and closing the patient encounter within 15 minutes. The grade for the quizzes will only be based on the SOAP note. For OSCE, our last final exam for term 4, each student had to individually conduct a thorough patient encounter in 15 minutes. We then had 10 minutes to type the SOAP note. The OSCE exam consisted of 4 patient cases. Each part of the patient encounter was evaluated for the OSCE examination.
Here are a few things that I did to prepare for OSCE and the 2 quizzes:
1) Physical examination was my weakness. So, I watched the videos for each physical examination a couple times and formulated a pattern to follow for each physical examination. For example, irrespective of what part of the body I am examining, I always start with inspection, then check for tenderness/pain, etc.
2) I practiced interviewing my roommates and a few friends. If I practiced interviewing a person who wasn't in term 4, I usually asked them to tell me about their personal medical history or gave them some sample SOAP notes to read that are provided by the CPD department and asked them to act like a patient.
3) I made up a mnemonic to help me remember each part of the interview. I used this mnemonic throughout the term to make sure I asked all the necessary questions during each patient encounter and it worked like a charm.
4) TIMED MY INTERVIEW!!! Initially, we were given 15 minutes to interview during the lab sessions. By the end of the term, the instructors expect that students interview in about half the time. The more you practice the interview, the better the interview will be. During both quizzes, my team decided that I would be the interviewer. So, I started cutting down my interview time early in the term.
5) For OSCE, I tried to break up my 15 minute patient encounter as follows: 8 minutes for interview, 5 minutes for physical examination, and 2 minutes to close the encounter. This is just a rough idea. The timing also depends on how much the patient talks and the type of symptoms.
6) I became familiar with the differentials provided for each case that we had for each lab session. That way, as I interviewed the patient, I could ask pertaining questions to narrow down my list of differentials.
7) I listened to strategies my lab members used to ask questions during the patient interview and tried to incorporate ideas into my own interview. This helped immensely. Because this is a communications class, it is definitely helpful to learn from classmates.
8) Bring a watch that is non-digital to both quizzes and OSCE. During the quizzes, have one person in the group who is not interviewing tell the interviewer when 5 minutes have passed. Prior to each quiz, my group had decided that if I (the interviewer) spent more than 8.5 minutes interviewing, the person timing must notify me immediately. This way, we had enough time for physical examination and closing the patient encounter. During the OSCE examination, there was a big clock in each room, so I had a rough estimate of how much time had passed during each patient encounter.
I hope this post provides a general overview of CPD. I thoroughly enjoyed CPD because it helped me connect textbook material learned in other courses to the clinical world.
Hope everyone is having a great day! :)
~N
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