Situation Examples
Give a quick snap shot of the context for this encounter. why is the patient here? What type of outpatient visit is this? A 1 line BRIEF context will better prepare listeners- this can include:
- Patient age/gender - (are there others involved?- 78 yo patient with dementia, here with most history given by partner)
- Visit type- urgent care, preop, new patient, regular follow up
- Chief concern: can be symptoms, worries, or requests (for testing, meds, forms..). Or the patient is a f/u “here for follow up of diabetes and hypertension”. If the patient is specifically asking for a CT for a headache for a week, do tell us "patient is here for acute headache and request for imaging"
- How can you help your colleagues or preceptor to help you
- For advance learners- Starting with a learning question- can help focus preceptor discussion
- Constraints - for example time limits- Let them know if you are running late and can't talk for long
Examples:
“Hi this is my first week in clinic, I am seeing a new patient just discharged from the hospital after an admission for sepsis. She doesn't look well to me.”
This will get your preceptor immediately to the bedside and walking with you through the H&P, clinical reasoning, and care plan implementation
“This is a patient with asthma, HTN, and DM, that I am seeing on the walk-in clinic, she has an appt with her PCP in 2 weeks but is here with 3 days of right knee pain.”
Hearing chronic issues are being addressed, your preceptor will focus their attention and teaching on the knee pain
“My patient is here to follow up on a change we made to her antihypertensives a month ago. She is hoping to leave soon to pick up her son after school in 20 minutes.”
The preceptor will focus and help in a timely fashion
“I am seeing a new patient who has never been here. The patient reports a complex medical history, and she is presenting with numerous discomforts many chronic diffusely, she is particularly concerned about chest pain and dyspnea. I will do my best to put everything together, but there is a lot to cover and she doesn't look very well to me”
Your preceptor will help explore the EMR along the way, and be ready to assist with the care of a complex and potential ill individual.
“This is a patient whom I have followed for several years, she is elderly, had dementia, and slowly is losing a lot of weight. My main question today is how to figure out what is going on as well as how far to take a cancer workup”