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Integrated Curriculum Evaluation Exercise

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

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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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