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Observations: 5 minutes
Student information: please check resp rate, pulse rate, temperature and oxygen saturation. 1. Does the student introduce themselves and explain what is to be done? 2. Thermometer: is student competent in its use (shakes it down, places it sublingually, gives adequate tome, reads it carefully) 3. Thermometer: does the student get the right temperate (+/- 0.5oC) 4. Pulse rate: is the student competent (finding pulse, timing, charting in bpm) 5. Pulse rate: does the student get it right (+/- 10 bpm) 6. Oximeter: is student competent in its use (switches it on, waits for it to self calibrate, applies finger probe, waits for suitable reading) 7. Oximeter: does student get the O2 saturation right (+/- 2-3%) 8. Respiratory rate: is student competent (times it, charts it in breaths/min) 9. Respiratory rate: does student get it right (+/- 4 breaths/min) 10. Chart: does student chart the results competently and clearly Total: 10
3. Potential ADRs responsible clinical state a. NSAIDs causing GI bleeds b. Digoxin toxicity causing nausea 4. Further information required to adjust pts prescription a. Renal function tests b. Patients cognitive state and compliance attitudes 5. a. b. c. Counselling points: SCORE 2 MARKS FOR 2 OR MORE, 1 MARK FOR 1 Warfarin booklet/risks of OTC medicines e.g. aspirin, NSAIDs Avoidance of UV light with Amiodarone Potassium rich diet
Total Marks: 10
Suturing: 5 mins
Student information: None 1. 2. 3. 4. 5. 6. 7. 8. 9. Explains to patient what is going to happen (2) Mentions skin preparation (1) Mentions local Anaesthetic (1) EXAMINER: please ask what anaesthetic must not be used on fingers (Adrenaline containing preps) (1) Opening of suture packet (1) Putting needle in needle holder (1) Use of forceps during procedure (1) Tying of knots (1) Closure of skin 2 sutures maximum (1)
Total marks: 10
Ophthalmoscopy: 5 mins
Student information: the person has been complaining of headaches for about 4 months and recently had blurred vision. Using the ophthalmoscope, please examine the fundi and tell the examiner what you are doing as you go along. 1. Student comments that would self and explains what she is going to do (1) 2. Does the student use the right eye to pts right eye and left eye to pts left eye (2) 3. Does student appear optimally positioned in relation to pt and appear comfortable (1) 4. Does student begin by eliciting red reflex (1) 5. Does the student initially focus on anterior structures before concentrating on the fundus (1) 6. Does the student appear to focus on the disc (1) 7. Appears to examine the surrounding structures (1) 8. Gives adequate description of the fundus using the correct terminology (1) 9. Gives an adequate attempt at diagnosis(1) Total marks: 10
Total marks: 10
PEFR: 5 Mins
Student information This patient has asthma. Please check PEFR. Then demonstrate ho wo to use a MDI and check their technique 1. 2. 3. 4. 5. 6. 7. 8. general approach to patient. Explains procedure clearly. (1) Measures PEFR with Wrights meter. Demonstrates best of three. (2) Shakes container and removes cap of MDI (1) Exhales gently (1) Places mouthpiece in mouth and closes lips (1) Inhales and presses canister whilst breathing in (1) Hold breath for 10 seconds (1) Checks pts technique. (2)
Total Marks: 10
Venesection: 5mins
Student information: This arm belongs to a patient with presumed renal failure. Please take some bloods for Urea, creatinine, and electrolyte measurement. Speak to the examiner as if they were the patient. 1. Addresses the patient and informs them of what is to happen and asks for consent (1) 2. Applies the tourniquet, feels the veins, cleans with sterile swab (1) 3. Assemblers needle, holder, vacutainer correctly (1) 4. Enters vein and withdraws blood (2) 5. Removes tourniquet (1) 6. Removes needles from vein and applies pressure (1) 7. Disposes of sharps adequately (1) 8. Mentions labelling the vacutainers (prompt the student) (2) Total marks: 10