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Integrated Curriculum Evaluation Exercise

Learn appropriate and inappropriate approaches in history taking, interview techniques, and physical examinations for a thorough patient assessment. Avoid common mistakes and ensure patient comfort throughout the evaluation process with expert guidance from Anita C. Mercado, MD, ICEE Director.

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Integrated Curriculum Evaluation Exercise

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  1. Integrated Curriculum Evaluation Exercise Approach to Interview and PE Skills Anita C. Mercado, MD ICEE Director

  2. History of Present Illness(HPI) • Appropriate • Move from open to directed questions • “What brings you in today?” • Inappropriate • Leading: “It’s not a sharp pain, is it?” • Multiple choice: Is your pain sharp, dull or aching?

  3. HPI • Appropriate • Clarify answers when needed • Ask questions in sufficient detail • Inappropriate • “I get the pain when I walk” (how far/fast) • “I’m a social drinker.” (quantify amount) • “I eat a balanced diet.” (explore details)

  4. Interview: PMH, FMH, SH, ROS • Appropriate • Relevant positive and pertinent negative items • ASCVD*: Presence or absence of risk factors • Inappropriate • ASCVD: Questions not relevant to chief complaint *ASCVD- atherosclerotic cardiovascular disease

  5. Interview: PMH, SH, ROS • Appropriate • Introduce sensitive subjects appropriately • Social history: “I need to ask you some personal questions. Is that ok with you? • Inappropriate • Sexual or drug use history without introduction

  6. Physical Exam: Position • Appropriate • Place patient in correct position • Examine the patient from the right side- if possible • Inappropriate • Examine patient over their gown • Heart exam in sitting position only • Fail to drape properly • Fail to raise leg support

  7. Physical Exam: Relevance • Appropriate • ASCVD: Heart and vascular exams • Inappropriate • HTN: omit fundoscopic exam • Bleeding: omit conjunctiva color/pallor • Weight loss: omit thyroid exam

  8. Physical Exam: Common Mistakes Ensure appropriate distance from the patient.

  9. Physical Exam: Common Mistakes Ensure proper technique when using oto- / ophthalmoscope.

  10. Physical Exam: Common Mistakes

  11. Physical Exam: Patient Comfort • Appropriate • Warn before painful/surprising maneuvers • Inappropriate • Abrupt PE maneuvers • Palpate thyroid gland from behind without warning

  12. Interview Challenges

  13. Questions about the ICEE Please read ICEE orientation content or contactAnita C. Mercado, MDacmercad@utmb.edu

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