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Read the following case study and follow the guidelines below to write a short essay based on this assigned case study.
Case Study (1000 words):
A 32 year old female presents herself in an outpatients’ clinic where you have been recently attending as part of your clinical attachment. You are new to the hospital system, your colleagues do not seem particularly very warm or helpful and you wish that you had not taken up this new venture. You have had a long day and you are encountering a series of personal difficulties in your private life of which no one really knows about. The presenting patient seems annoyed and exhausted at the same time and slumps down into the seat in front of you. The patient says she has suffered with headaches all her life however over the past 4 months they have gotten worse to the point that she cannot function at work and needs to sit in the dark for an hour. Her husband is with her, he seems dismissive at times and keeps interrupting, however you gather information that when her pain is at its worse she stops eating, suffers from bouts of diarrhoea and insomnia. She is worried something may be seriously wrong. Upon taking a clinical history you find out that the patient also experiences heart palpitations. She also reveals that she has found very little support from anyone following the miscarriage of their first child 6 months ago.
Guidelines:
Always keeping in focus this case study assigned, for this essay, draw from:
 Your clinical experiences during your ward rounds
 The reflections on practice you learnt from your tutorials
 Make reference to what you have learnt during these three years in the medical leadership seminars
1) Write about 10 lines of a typical doctor- patient conversation to show how you would engage with the patient.
2) At the side of the conversations (as per example below), note down your reactions, feelings, thoughts, sensations and your reflections
3) In the next column (as per example below, write down some reflections referring to some of the basic theory learnt from the four medical leadership seminars.
Note: As a reminder the four medical leadership seminars were: Interpersonal Communication, Teamwork, Intrapersonal skills I (Dealing with stress and burnout) Intrapersonal skill II (Our seminar this weekend).
Below is an example:
Dr-pt conversation
My feelings/thoughts/ reactions
Reflections on Medical leadership content
Line 1:
Dr: Good morning Pt: morning (visibly wincing in pain)
Feeling tired, Thinking that shift is nearly over Not particularly warmed up to this patient
Aware of my personal troubles but keeping a boundary between private life & work situations, Going beyond first, impressions. Engaging genuinely.
Line 2:
Dr: How can I help you?
Pt: I am not sleeping at night and its difficult to breathe at times
He deserves to be treated well and with respect
Listening Skills, Open-ended question to invite him to elaborate on his problem; Giving message to patient that this is a collaborative interview; To show I am genuinely interested in pt’s subjective and objective experience of pain. To start formulating a hypothesis of what is going on.
Line 3:
Dr: When did you start having these symptoms?
Pt: Soon after my brother passed away.
I need to check whether pt has any other underlying medical conditions.
I need to clarify if he is on any medications
Important to probe on the emotional aspect of this person. Possibly referral (importance of multi disciplinary team input).
2) Final reflections & Conclusion of this doctor- patient conversation (500 words)
Looking at the conversation grid you have created, as well as reflecting on your hospital experience this year, which skills do you feel you have acquired during these 3 years of medical leadership seminars and which do you feel you still need to develop?
Which particular skills do you feel are going to be really useful and will further enable you to develop both as a person as well as a future practitioner?
Important
You will naturally not be evaluated on your ability to carry out a medical differential diagnosis but on your ability to integrate the various strands of knowledge, communication skills and competencies that you have assimilated from these seminars mostly in terms of doctor- patient relationship, self awareness and self growth as well as team-work.
During the seminar you will be given the deadline for handing in your assignment. Handing the assignment after the deadline incurs a deduction of 5 marks per working day.

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