So last Wednesday I ran the third of the mock OSCEs for the year.
It built on the feedback of the first and second (sadly I did not blog the second), and in terms of smoothness I'm happy, with a few points.
Organising
Firstly the organising changed - In the first OSCE I wrote all nine stations, in the second I wrote five and this time around only wrote one.
Advantages:
- Less time on my part
- More variation in approaches
Disadvantages
- They should all have been proof-read, but
- The mark schemes were variable in how readable they were and this was noted by participants. Readability is key as there is a quick turnaround.
Stations
Previously stations were randomly allocated and people got random stations depending on what I had written, this time I allocated topics to different people and so it was easier (as far as dictation goes) to get certain stations ready.
Overall
It ran well, finished almost on time and there were many thank yous at the end. I gained from it and the format seems to work.
Saturday, 25 June 2016
Thursday, 14 April 2016
Phew, just organised my first practice OSCE station (Where you are put in a clinical situation with actors and need to work accordingly) for my year (4th year currently) - it was rather harder work than I thought it would be at the start, and I'll probably still wake up sweating for a few days.
Nonetheless I am really grateful to everyone's participation, including those in my year who treated it well (and adapted to a few of my lapses), two thyroid clinicians (Paul Dent and Dominic Pritchard), and Josephine Saramunda (a 3rd year), who all volunteered at very short notice to fill in when some of the patient-actors and examiners who could not make it.
Several points for me:
- I need a little more assistance next time, there were a few snags on the day which I didn't quite adapt to so well.
- The sheets need more proof-reading, as there were a few inconsistencies that became apparent.
- The actors felt they needed a little more time to prepare.
- A few people suggested a little more feed-back time, as it was an informal event.
- Some of the stations, particularly in neurology were a little too specific and maybe beyond 4th year level.
Nonetheless, of the three rounds I did, the last one ran pretty smoothly, and in the feedback the participants graded it positively 4.5 out of 5, so with a little more organisation the next one (eeep) should be even better.
The scenarios were:
Nonetheless I am really grateful to everyone's participation, including those in my year who treated it well (and adapted to a few of my lapses), two thyroid clinicians (Paul Dent and Dominic Pritchard), and Josephine Saramunda (a 3rd year), who all volunteered at very short notice to fill in when some of the patient-actors and examiners who could not make it.
Several points for me:
- I need a little more assistance next time, there were a few snags on the day which I didn't quite adapt to so well.
- The sheets need more proof-reading, as there were a few inconsistencies that became apparent.
- The actors felt they needed a little more time to prepare.
- A few people suggested a little more feed-back time, as it was an informal event.
- Some of the stations, particularly in neurology were a little too specific and maybe beyond 4th year level.
Nonetheless, of the three rounds I did, the last one ran pretty smoothly, and in the feedback the participants graded it positively 4.5 out of 5, so with a little more organisation the next one (eeep) should be even better.
The scenarios were:
| Round 1 | |
| Upper limb exam | Syringomyelia |
| Acute neurology hx | Delerium tremens |
| Msk hx + exam | Hand arthritis |
Round 2 |
|
| Cranial nerve exam | Parietal stroke |
| GUM history | Sexual history |
| Endocrine hx + viva | Medication review |
Round 3 |
|
| Thyroid exam | Thyroid exam |
| Acute neurology | Seizure + DVLA |
| Hearing hx + exam | Drug induce Hearing loss |
Thursday, 29 May 2014
Further ideas for leapmotion
So, following the excitement of the NHS hackathon I was at recently, it has been difficult to resume the normal medical pattern of studying 7am - 9 pm. Fortunately Monday was a bank holiday, so nothing was "officially" expected of me. It is also fortunate that we are currently in the neuro modules, which is something I semi-understand a bit of already.
A number of people have expressed excitement at the project - both clinicians and researchers as well as students. Most recently today at a placement with the INS I spoke to one of the Occupational Therapists who was interested in the potential. So far my ideas had focused on the potential for detecting severity and types of tremor in a patient, with maybe the development of games for physiotherapy.
On the way back from the INS placement I was discussing it with a fellow student, and between his feedback and what we had seen during the day, an idea crept in regarding people with Parkinsons.
The disease presents with a severe tremor, such that eating and drinking or dressing and going to the toilet are made very difficult. They also find it difficult to write, a sign that medication is working is regaining the ability to sign your name. Yet it is often still difficult to hold a pen dexterously and typing is similarly difficult.
Now, the app. If it were possible to map out a Parkinsonian tremor and tell the computer what to expect, then someone could trace out the letters they want in the air and, even if their tremors made the writing illegible, by allowing for this the computer could discern where the hand "intended" to go and react accordingly.
Possibly a simpler method (no complicated algorithms) - a virtual keyboard that moved itself relative to the finger position. Since the Leapmotion software isolates each finger, it knows which one has moved to where and can move the virtual keyboard accordingly. Even if ten-fingered typing were still impossible and it only worked with one finger, it could still improve communication.
Of course, this requires a library of different tremor types first which as far as I'm aware does not yet exist - but that is my summer plan. It may also require a more in depth knowledge of how tremors present, but I'll be at the weekly neurology grand round at the hospital tomorrow so I will pick the brains of the learnèd faculty.
A number of people have expressed excitement at the project - both clinicians and researchers as well as students. Most recently today at a placement with the INS I spoke to one of the Occupational Therapists who was interested in the potential. So far my ideas had focused on the potential for detecting severity and types of tremor in a patient, with maybe the development of games for physiotherapy.
On the way back from the INS placement I was discussing it with a fellow student, and between his feedback and what we had seen during the day, an idea crept in regarding people with Parkinsons.
The disease presents with a severe tremor, such that eating and drinking or dressing and going to the toilet are made very difficult. They also find it difficult to write, a sign that medication is working is regaining the ability to sign your name. Yet it is often still difficult to hold a pen dexterously and typing is similarly difficult.
Now, the app. If it were possible to map out a Parkinsonian tremor and tell the computer what to expect, then someone could trace out the letters they want in the air and, even if their tremors made the writing illegible, by allowing for this the computer could discern where the hand "intended" to go and react accordingly.
Possibly a simpler method (no complicated algorithms) - a virtual keyboard that moved itself relative to the finger position. Since the Leapmotion software isolates each finger, it knows which one has moved to where and can move the virtual keyboard accordingly. Even if ten-fingered typing were still impossible and it only worked with one finger, it could still improve communication.
Of course, this requires a library of different tremor types first which as far as I'm aware does not yet exist - but that is my summer plan. It may also require a more in depth knowledge of how tremors present, but I'll be at the weekly neurology grand round at the hospital tomorrow so I will pick the brains of the learnèd faculty.
Monday, 26 May 2014
NHS Hackathon
I've just had an awesome weekend of awesome. Honourable mention in the NHS hackday, won a t-shirt and surgical book, and was a far cooler bank holiday weekend than...for instance...playing in the sun. I met lots of awesome people, and if anyone wants to see the presentation it is here over at google docs
And a video of it (skip to 11:45)
We were an honourable mention (the first honourable mention, which I count as runner up ;) and I have a team photo (as well as other photos of the day) here.
(Edit - I'm putting in here a better discription of what we did - apologies, I've spent too long staring at medical textbooks and not long enough writing creatively)
Hackathons are a day where all manner of people (programmers, business managers, mathematicians etc) get together to discuss problems and find solutions. In this case, I got attached to a group of programmers who were looking for possible uses of a Leap Motion device (https://www.leapmotion.com/). The device uses infra red to detect the position of the palm of the hand and all five fingers and records the position.
The possibilities of what we created seem colossal, and I was excitedly talking to other clinicians about how neurological diseases could be monitored, and how GPs, on seeing a new patient can exactly track the extent of a disease, or when transferring patients around a hospital, a doctor can look at a graph and see instantly the extent of a patient's tremor.
It opens possibilities for further subdividing tremors which currently consist of "does it interfere with a patient's life or not", and (excitingly) it may uncover new types of tremor to subdivide existing disease classifications, discover new syndromes, and find ways to assess the early onset of conditions.
And a video of it (skip to 11:45)
We were an honourable mention (the first honourable mention, which I count as runner up ;) and I have a team photo (as well as other photos of the day) here.
(Edit - I'm putting in here a better discription of what we did - apologies, I've spent too long staring at medical textbooks and not long enough writing creatively)
Hackathons are a day where all manner of people (programmers, business managers, mathematicians etc) get together to discuss problems and find solutions. In this case, I got attached to a group of programmers who were looking for possible uses of a Leap Motion device (https://www.leapmotion.com/). The device uses infra red to detect the position of the palm of the hand and all five fingers and records the position.
Working
with the team over the weekend, we discovered how it could be used to
measure tremors in the hand. Amongst the possibilities this opens, it
can be used to objectively record a patient's progression over time,
whether it is monitoring a disease such as Parkinsons, assessing the
effect of medication or rehabilitative physiotherapy. So far as I am
aware, there is no clinical objective measure on the severity of tremor, there
only seems to be approximations based on quality of life measures.
The possibilities of what we created seem colossal, and I was excitedly talking to other clinicians about how neurological diseases could be monitored, and how GPs, on seeing a new patient can exactly track the extent of a disease, or when transferring patients around a hospital, a doctor can look at a graph and see instantly the extent of a patient's tremor.
It opens possibilities for further subdividing tremors which currently consist of "does it interfere with a patient's life or not", and (excitingly) it may uncover new types of tremor to subdivide existing disease classifications, discover new syndromes, and find ways to assess the early onset of conditions.
Tuesday, 2 July 2013
Burning!
Mmmm, time for a quick look over of burn data and statistics. Its times like this that I wish I had a tutor to guide me in which articles to read. There are some good looking publications like The journal of Burn Care and Research, but sadly like so many journals, it is pay-for-view. I'm a little unwilling to pay at the moment, because I will get free access in a month, plus I don't know how much use it will be just now.
So I am left with searching for free sources. Harder, though I can only try.
Some of the basic advice is readily available from the World Health Organisation, from the NHS and also one from patient.co.uk. All say more or less the same thing - douse in water, prevent infection, elevate and seek help from someone who doesn't have to look things up. The people who don't have to look things up will then consider factors such as the depth of the burn, possible complications from smoke inhalation, anything relevant to the type of burn such as chemical and electrical burns.
This seems to be a good video from Youngstown State University which shows two senior nurses treating a patient who is in with ~40% body burns.
So, onto something juicily scientific. Types of burn.
Though firstly, I thought it amusing to show the beginning of my youtube search results for "different types of b...". Oddly, buns seems to come in long before burns do.
Aaaaanyway...
Articles used
http://journals.lww.com/burncareresearch/pages/default.aspx
http://www.who.int/surgery/publications/Burns_management.pdf
http://www.nhs.uk/Conditions/Burns-and-scalds/Pages/Treatment.aspx
http://www.patient.co.uk/doctor/Burns-Assessment-and-Management.htm
http://www.youtube.com/watch?v=BDBXO9fmpmw
So I am left with searching for free sources. Harder, though I can only try.
Some of the basic advice is readily available from the World Health Organisation, from the NHS and also one from patient.co.uk. All say more or less the same thing - douse in water, prevent infection, elevate and seek help from someone who doesn't have to look things up. The people who don't have to look things up will then consider factors such as the depth of the burn, possible complications from smoke inhalation, anything relevant to the type of burn such as chemical and electrical burns.
This seems to be a good video from Youngstown State University which shows two senior nurses treating a patient who is in with ~40% body burns.
So, onto something juicily scientific. Types of burn.
Though firstly, I thought it amusing to show the beginning of my youtube search results for "different types of b...". Oddly, buns seems to come in long before burns do.
Aaaaanyway...
Articles used
http://journals.lww.com/burncareresearch/pages/default.aspx
http://www.who.int/surgery/publications/Burns_management.pdf
http://www.nhs.uk/Conditions/Burns-and-scalds/Pages/Treatment.aspx
http://www.patient.co.uk/doctor/Burns-Assessment-and-Management.htm
http://www.youtube.com/watch?v=BDBXO9fmpmw
Monday, 17 June 2013
Synthetic organs
Mmmmmmm, tasty.
Oh, wait, they aren't edible? Oh well.
It happened some time ago (for the internet age), artificial blood vessels were implanted into a person. Previous methods included using superfluous pieces of the patient's own vessels, or donations - each of which carries its own risk of infection etc.
Of course medicine is never a single invention and here is a precursor.
Links used
http://www.sciencedaily.com/releases/2013/06/130606110026.htm
http://www.sciencedaily.com/releases/2011/06/110627134521.htm
Oh, wait, they aren't edible? Oh well.
It happened some time ago (for the internet age), artificial blood vessels were implanted into a person. Previous methods included using superfluous pieces of the patient's own vessels, or donations - each of which carries its own risk of infection etc.
Of course medicine is never a single invention and here is a precursor.
Links used
http://www.sciencedaily.com/releases/2013/06/130606110026.htm
http://www.sciencedaily.com/releases/2011/06/110627134521.htm
Tuesday, 4 June 2013
A bit on space medicine
Mmmmmmm, space medicine. The idea of putting human physiology under strains it didn't evolve for is... :)
It seems that UCL has a department for space station. This is interesting, since Britain only seems to have ever had one astronaut, who has not been into space yet. I'd like to think this raises the possibility that Britain will play a greater role with ESA, which has often been my hope, but it seems unlikely, so I wont get to be a space doctor for a little while just yet.
It seems that UCL has a department for space station. This is interesting, since Britain only seems to have ever had one astronaut, who has not been into space yet. I'd like to think this raises the possibility that Britain will play a greater role with ESA, which has often been my hope, but it seems unlikely, so I wont get to be a space doctor for a little while just yet.
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