|
 Isn't
it awful and stressful to be the weak side when facing a 'difficult angry
patient'?
How many
times you were felt hurt and failed?
"How
To Unlock Difficult Medical Encounters"
Is Your Tool In Dealing
with 'Difficult Patients'!
Click here to Buy the full version and save your time!
Download a sample version
'Difficult Patient' OSCE
Scenarios
Common 'Difficult Patient'
topics in Objective Structured Clinical Examinations
The common topics that have
been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II,
PLAB 2,
OSCEs for medical students and medical school clinical finals,
Clinical Skills Assessment for International Medical Graduates are:
'Difficult Patients' in OSCEs
- The Silent or Reticent
patient.
- The Rambling or Talkative
patient.
- The Vague patient.
- The Angry patient.
- The Depressed or Sad patient.
- The Denial patient.
- The Anxious patient.
- Patient with Somatization.
- The Dependent and Demanding patient.
- The Dramatic or Manipulative patient.
- The Long Suffering, Masochistic patient.
- The Orderly and Controlled patient.
- The Manic, Restless patient.
- The Guarded Paranoid patient.
- The Superior patient.
- Breaking bad news.
- Caring for the dying patient.
- Conflicted Roles.
- Solving Conflicts.
|
Common 'Difficult
Patient' OSCEs
Common 'Difficult Patient'
OSCEs cases that have been seen in OSCEs during
USMLE Step 2 CS, MCCQE Part II, PLAB 2,
OSCEs for medical students and medical school clinical finals,
Clinical Skills Assessment for International Medical Graduates are:
-
Elizabeth Noseworthy is a
58 years old diabetic patient who was brought to the emergency by her
husband, Jack Noseworthy, unconscious. Your colleague told you that she
had been received dead and they failed to resuscitate her. Please talk
to Mr Northsworthy in the next 5/10/15 minutes. (Breaking bad
news/ in this scenario you will discover that the cause of death was
an extra insulin shoot given by the husband when he found his wife
unconscious assuming that she ate too much at the party that night. As
you tell him the bad news, he turns very upset and restless blaming him
self for killing his wife).
-
Joan Lavis is the mother
of your 17 year old patient, Sandra Lavis, she came to your office
asking to see you. Please talk to her in the next 5/ 10/15 minutes. (Confidentiality/
Demanding/ in this scenario you will discover that the mother found
an appointment card in her daughter pocket while doing the laundry. She
demands and insists to know the reason of her daughter's visit. Note: no
reason was given for the visit in the stem question).
-
George Baclham is 32 year
old man who came to your office for the first time. Please talk to him
in the next 5/ 10/15 minutes. (Drug seeker/ in this
scenario you will discover that he is out of town and has headache. His
doctor prescribed a pain killer with codeine and wants you to prescribe
it again. He interrupts you repeatedly and rudely during your history
taking telling you that his doctor had already asked him these questions
and there is no point to repeat the process. Note: no reason was given
for the visit in the stem question).
-
Jonathan Simons is 26
year old man who was brought by the police to the emergency after his
wife claimed that he attempted to kill her. You are the physician on
duty today. Please talk to him in the next 5/ 10/15 minutes. (Acute
psychosis/ in this scenario you will discover that the
patient is agitated restless pacing the room and refuses to sit down to
talk).
-
Anthony Rochester is 32
year old business man came to your office because his wife insisted that
he should see you. Please talk to him in the next 5/ 10/15 minutes. (Mania/
in this scenario you will discover that the patient is restless pacing
the room and refuses to sit down to talk, full of joy and happy and
don't want to discuss that being so happy is an illness. Note: no reason
was given for the visit in the stem question).
-
Jane Smith is 53 year old
woman who came to your office complaining from left upper quadrant pain.
In the next 5/ 10/15 minutes take focused history and discuss a plan. (Somatization/
Talkative/ in this scenario you will discover that the patient keeps
talking and don't let you ask her questions or be in control of the
interview) .
-
Marie Price is 57 year
old came to your office because her husband insisted that she should see
you. Please talk to her in the next 5/ 10/15 minutes. (depression/
in this scenario you will discover that the patient is says almost
nothing and doesn't know why she is here. Note: no reason was given for
the visit in the stem question).
-
Lucy Armstrong is 23 year
old woman who came to your office after she felt a lump in her right
side of her upper neck. In the next 10/15 minutes take a focused history
and perform a focused physical exam. (Note: She keeps her bra and thighs
exposed with gestures of seduction and may ask if you are free tonight
(even if your are a female doctor). The case is infectious mononucleosis
and she is sexually active. Take sexual history and safe sex counseling
too.) (Lymphadenopathy/ Seduction/ Safe sex).
Dealing with 'Difficult Patients':
In real medical practice, dealing with 'difficult
patients' are seen almost daily. 'Difficult patients' are ordinary people
who come to your health institute, whatever is that, because they have to,
not because they want to. Sometimes, they have even been brought in
unwillingly by a family member or a friend. They come in with their vast
range of different personalities, cultural background, and current emotional
state.
Being in a health care facility adds more worries and
stresses due to lost time, expenses, and more importantly losing control. People
are usually in control of what they have to do now, well at least they think so.
But on the moment they put their feet in front of your registration desk, they
lose this control. We, the strangers, take control!... We give instructions and
orders to follow starting right from that registration desk... Give me your ID,
.. insurance,.. wait there,.. sit there,.. you have to wait,.. take off your
cloths,.. touching them, .. etc.
So, by the time of their medical encounter with us, the
physicians, they are already up on the edge in their stress and comfort levels.
And guess what, we as the highest ranking authority here and thus have to
receive all the blame and deal with them in these 'difficult patient'
situations. Although, some of these people will look like trouble makers by
personality, most of the exaggeration is due to the building up stress and
worry, or simply part of their illness!
Dealing with 'difficult patients' in medical encounters needs a lot of
communication skills to sooth them and calm them down or to let them at ease and
open for effective communication. However, although this is part of our duty in
addition to establishing rapport and friendly environment, it is not our goal in
medical encounters! We are not social workers. Our goal is to figure out what is
going wrong with them physically and psychologically in order to help them.
These good communication skills are not the goal, they are wonderful magical
means to achieve our goal, the patient well being. Communication skills are our
vehicle to take a thorough medical history, perform accurate safe physical
examination, and assure patient compliance, and yet efficiently in respect to
our time and resources limits.
As you may realize now, it is important to learn the
specific communication skills to deal with these 'difficult patients' in
real life. This will make us friendly caring clever doctors and build a good
reputation while staying thorough, focused, organized, and efficient. This is
what successful considerate physician know very well!
'Difficult Patient' OSCEs:
As Objective Structured Clinical Examination
stations (OSCEs) are simulation of real life medical encounters.
'Difficult to deal with patient' scenarios will be also seen in these exams.
These difficult behaviors will be seen either embedded as a short part of
the station scenario or as a full station by itself.
We need to prepare ourselves to these 'difficult patient'
OSCEs because we will be assessed mainly for our communication skills in these
OSCE exam stations. These OSCE Exams need a lot of empathy too but be careful
don't act as a social worker. Act as an attending caring efficient physician and
use the communication skills as a mean, not as a goal.
Now how to
improve your way of dealing with each of these 'difficult patient' OSCEs?
Ask yourself:
What would I do if
my OSCE standardized patient (SP) was angry and threatening me?
Is what am I doing with this difficult patient correct ethically? Dose it serve
me well? Dose it resolve the situation? How to improve my way of doing
that?...
What would I do if
my OSCE SP was a depressed woman who refuses to talk?
Again, is what am I doing with this difficult patient correct ethically? Dose it
serve me well? Dose it resolve the situation? How to improve my way of
doing that?...
What would I do if my
OSCE SP was a restless young man who kept pacing the room refusing to calm down
and sit to talk? ...
What would
I do if my OSCE SP was a talkative middle
aged woman who kept telling me her stories wasting my valuable exam time?
...
What would
I do if my OSCE SP was a teenage boy or
girl who wants me to go out with him/her for a date? ...
What would
I do if my OSCE SP was an HIV positive
man who refuses to inform his wife about his illness? ...
What would
I do if my OSCE SP was a sixteen year
old boy with history of epilepsy and insisting to have a letter to the
driving license authority? ...
What if?....... & what
if?....... & what if?............
Check our ebook for how to
deal with 20 'difficult patients' scenarios!
"How To
Unlock Difficult Medical Encounters"
Click here to Buy the full version and save your time!
Download a sample version
Do you want
to be distinguished?
"How To Unlock Difficult
Medical Encounters" is an ebook that helps you recognize and deal
with 'difficult patient' medical interviews and issues. It provides proven
steps to follow to unlock 'Sick encounters'!. Short, condensed, well
organized and easy to read and memorize.
Almost every day, you, medical students, residents, and
physician face 'Difficult Patients' in your clinical practice. All OSCE
organizers, like USMLE, MCC, GMC, and medical schools, include difficult to deal
with patient scenarios in their exams to test your communication skills and
reactions.
Limited resources are out there to help you deal with
these 'Difficult Patients'. Most of these resources deal with the etiology
behind these situations hoping that the understanding of the etiologies will
help you to figure out the right ways to deal with them!
Learning to take medical history or perform a physical
exam is easy. You will be amazed how well your colleagues is doing with these
clinical tasks. There are tons of resources to train yourself these skills. But
what about communication skills with 'difficult patients'? You will be amazed
how bad your colleagues is doing with these clinical tasks that need special
communication skills!.. Imaging yourself mastering these skills!.. Definitely,
you will be distinguished form the crowd!... Your colleagues will ask your help
to teach them your secrets to master these situations!... Nurses will recommend
that you, the expert with a human touch, to deal with such situations!.. Your
OSCE examiner or clinical supervisor will admire you.
This is the first ebook that is written focusing on
techniques, strategies, and practical proven steps to help you deal with
'Difficult Patients'. It is focused on practical tools ready to learn, adopt,
and implement to improve your way of dealing with difficult patients in
both OSCE exam scenarios and real life settings.
You have no time to read and you need to learn quickly
proven skills. You can download and start studying it now!
For your security, payments are processed by PayPal, a 100%
secure service for all major credit cards in addition to PayPal members. By
clinking below you will be transferred to PayPal secure service for payment.
ACT NOW !!.. Be distinguished!
Note: You need Adobe Acrobat Reader to open this ebook in
PDF format.
Start the
change NOW!... Be distinguished!
"How To
Unlock Difficult Medical Encounters"
US$ 17
Buy it now! Don't
waste your study time!
Click here to Buy the full version and save your time!
Download a sample version
| 
