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Examining in General Practice & the CSA
The first thing to remember is that the type of examination expected in General Practice or the CSA is NOT the same as the too detailed examination you were taught as a medical student. They are looking for they type of examination that a reasonable GP would do. For example – which do you think is more important in the general cardiovascular examination – looking for splinter haemorrhages or auscultating for the heart sounds? GPs take educated and intelligent shortcuts from the usual comprehensive and detailed medical student type clinical examinations. Why? Because we have the time-limited 10 minute consultation. Something has to give and so we end up focusing on clinical examination things that are more likely to aid us in an accurate diagnosis/management plan than those that are less helpful. So, remember, develop a clinical examination technique that mirrors what the average competent GP does.
In fact, the CSA is also all about the what the average good GP does. Another things to remember for the CSA is that you will never be required to do a general complete examination of the patient. It will be a focused examination of a particular system (usually). The reason for this is that THEY WANT TO SEE if you have the DECISION-MAKING SKILLS to decide which examination to focus on.
Common examinations are chest, cardiovascular, abdo, neuro, ENT and knee, back, hips and shoulders. In terms of a chest examination – undress the patient, do not auscultate through clothes. Work on your neuro examination in particular – get it down to 2 minutes – see clip below.
And finally, once you have decided what to do – SIGNPOST IT – and get on and do a swift examination.
Please wait wait for the video clips BELOW to load...(15 secs)
Video Demos - Basic Systems
Video Demos - Musculoskeletal
Video Demos - Special Areas
Please leave a comment if you have a tip, spot an error, spot something missing or have a suggestion for a web resource. And of course, if you have developed a resource of your own, please email it to me to share with others.
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