Clinical Medicine: A Clerking Companion / Edition 1

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Overview


Students starting on the wards are often bewildered at their role and unable to make the most of the learning opportunities presented to them. The hardest thing is to adapt to a new way of learning, where books and lectures take a back seat and the subjects for study are the patients whose beds line the wards. Rather than being asked to go to the library and write an essay on the physiology of the kidneys, you are told to go and clerk the patient in bed 3 with acute renal failure. The problem lies in knowing where on earth to begin.

Clinical Medicine: A Clerking Companion is written for inexperienced clinical students, and helps them to use their patients to learn medicine. It aims to transform students who know a bit about the medical sciences into young doctors who can draw knowledge and experience together to diagnose and treat real patients.

At heart, it is a workbook that provides students with a framework for approaching patients with a range of common conditions. It is a 'friend over the shoulder' - guiding students through interviewing and examining a patient, and then evaluating the patient's current condition and their future management. A list of questions then helps students explore the topic in more detail - sending them back to their textbooks to read about what they have seen and understand the science underlying it.

It is also a self-directed learning portfolio, helping students to assess their progress by seeing where they are lacking clinical exposure, and by recording key cases they have seen to function as a revision aid.

Clinical Medicine: A Clerking Companion falls into three main sections.

The introduction explains briefly how to use the book to make the most of time spent on the wards - how to interview and examine patients, how to use the book in recording findings, and then how to present patients to doctors. It emphasises the importance of anonymising patient information and ensuring patient consent before interviewing and examining them.

The section on presentations covers over 30 undiagnosed presenting complaints such as 'chest pain' or 'acute confusion', suitable for use in A+E or in outpatient. Proformas for each presentation take students through the dynamic process of diagnosis and initial management.

The largest section, conditions, covers around 100 common medical and surgical problems, grouped according to speciality. Each chapter (for instance 'cardiology') begins with an introductory section offering basic approaches to the symptoms, signs and investigations encountered in that specialty - for instance, how to recognise common murmurs or a simple guide to reading an ECG. The subsequent clerking proformas are similar to those for the clinical 'presentations', allowing students to interview and examine ward patients who already have an established diagnosis, reviewing their investigation results, and then evaluating the severity, aetiology and management of the condition.

The book aims to:
DT Transform patients into useful learning resources: helping students to use patients to develop skills and build knowledge.
DT Be a 'near patient resource': something to be carried onto the ward and used when seeing patients.
DT Enable students to be pro-active: Lots of time can be wasted as a medical student waiting for doctors to be free to teach you. This allows even very junior students to get on with clerking and evaluating patients.
DT Build student confidence: Presenting patients you have clerked to senior doctors can be daunting. With this book students can do so more confidently knowing that they have at least covered all the more important points.
DT Train students to think clinically: So much of medical education involves teaching a mindset - actively resuscitating a patient whilst also trying to diagnose them, or weighing the relative importance of various pieces of information. Other books present information - this book teaches students to use it.

A completely new concept, with a unique focus on the learning needs of inexperienced students, Clinical Medicine: A Clerking Companion is the one friend you won't want to be without as you begin your journey onto the wards.

Online Resource Centre
The Online Resource Centre to accompany Clinical Medicine: A Clerking Companion features:
DT Dynamic, annotated figures - enlarged, fully annotated copies of key images from the book, including ECGs and X-rays.
DT PDFs of the proformas in the book, avalible to download

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Editorial Reviews

Doody's Review Service
Reviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences)
Description: This workbook for U.K. medical students on their clinical rotations (clerkships) pays particular attention to the skills they must master.
Purpose: It is a guide to acquiring the fundamental skills to "clerk patients" in a competent and professional manner. The workbook gives students a template for learning how to obtain a history, perform a physical examination, and develop a management plan while showing the proper care and respect for patients.
Audience: The audience is fairly limited to medical students in the U.K, but it provides an interesting read for any clinician who precepts medical students, presenting another perspective on how other medical systems do their training.
Features: An outstanding and entertaining aspect of the book is a quotation in every chapter, from the likes of Yogi Berra to William Osler, reminding readers that medicine is concerned with humanity. The book begins with the basics that students must learn, in particular recognizing the acutely unwell and summoning help immediately, a potentially overlooked problem. It then outlines an approach to diagnosing abnormalities by organ system, how to make a succinct and meaningful presentation with hints on what to consider in different systems. Each chapter has a number of basic questions to test students' working knowledge, with answers focusing on what students must remember, and selected readings.
Assessment: This helpful and well-organized book will be valuable to medical students beginning their clinical orientation to medicine.
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Product Details

  • ISBN-13: 9780199574377
  • Publisher: Oxford University Press, USA
  • Publication date: 6/25/2011
  • Edition number: 1
  • Pages: 432
  • Product dimensions: 8.30 (w) x 11.60 (h) x 0.60 (d)

Meet the Author

David Randall is currently a Foundation Year 1 doctor at Homerton University Hospital in Hackney, East London, having previously completed his undergraduate medical training at Barts and the London School of Medicine and Dentistry.
Adam Feather is Senior Lecturer in Medical Education at the Institute of Health Science Education, Barts and the London School of Medicine and Dentistry. Adam is a Lead for Clinical Skills with a particular interest in the teaching and learning of clinical examination skills. He is the co lead for part 6a (written Finals) assessment with particular interest in the development of new and innovative written, computer based and clinical assessments.

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Table of Contents

Part 1: Introducing clinical medicine in practice
1. Recognising and resuscitating the acutely unwell patient
2. History taking
3. Examination
4. Forming a clinical impression
5. How to present patients to senior colleagues
6. Writing in medical notes
7. Prescribing skills
Part 2: Cardiology
1. Introduction to cardiology
2. Acute coronary syndrome (ACS)
3. Myocardial infarction and secondary prevention
4. Heart failure
5. Arrhythmias
6. Valvular and structural heart disease
Part 3: Respiratory medicine
1. Introduction to respiratory medicine
2. Acute asthma
3. Chronic obstructive pulmonary disease (COPD)
4. Deep vein thrombosis and pulmonary embolism
5. Pneumonia
6. Lung cancer
7. Pneumothorax
8. Tuberculosis
9. Interstitial lung disease
Part 4: Gastroenterology
1. Introduction to gastroenterology
2. Upper gastrointenstinal bleeding
3. Gastric and oesphageal
4. Acute hepatitis
5. Chronic liver disease
6. Inflammatory bowel disease
Part 5: Renal medicine
1. Introduction to renal medicine
2. Acute renal failure
3. Chronic kidney disease
4. Urinary tract infection
Part 6: Endocrinology
1. Introduction to endocrinology
2. Hyperglycaemic emergencies
3. The diabetic review
4. Thyroid disease
5. Steroid disease
Part 7: Neurology
1. Introduction to neurology
2. Stroke and TIAs
3. Acute confusion
4. Seizures
5. Headache
6. Spinal and peripheral newve lesions
7. Parkinsonism and movement disorders
Part 8: Multisystem diseases
1. Introduction to multisystem diseases
2. Acute arthritis
3. Anaemia
4. Haematological malignancies
5. HIV and AIDS
6. Skin ulcers
7. Tropical diseases
Part 9: Surgery
1. Introduction to surgery
2. Acute abdominal pain
3. Intestinal obstruction
4. Pancreatitis
5. Hernias
6. Colorectal carcinoma
7. Lumps and bumps
8. Breast lumps
9. Peripheral vascular disease
10. Haematuria
11. Prostate disease
12. Trauma
7. Falls, faints and funny turns

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