To prepare itself for the ECOE

In these weeks examinations are being realised type ECOE in all long and wide it of Spain. I participated in one in them as evaluating one of a modest station with a written clinical case of repetition tonsilitis.
For who still does not know what means ECOE: one is a Structured Objective Clinical Evaluation. It is a practical examination that it simulates real clinical situations and that evaluates different abilities as the communication, physical exploration, diagnosis differential, attention to a childbirth, sutures, bandages, to write a medical report, to interpret tests of image, etc.
Through my room it spent a new student every 10 minutes, 25 altogether. All with its dressing gowns and their ball-point pens, the majority calm, a few being pulled the beard or the hair. When finishing his examination I had to score if they had answered each short question with the correct answer in agreement with a group.
ECOE-OSCE
It gave time to think envelope me how they were my practices of student and how I would have confronted an examination I took root, just in the last year of race, after passing the clinical courses as (than more worthy) rubber plant.
To be sincere, she was very passive in for two reasons fundamental practices:
  1. The hospital did not grant any special qualification to attend the practices, reason why I skipped a few at times at which I had personal difficulties
  2. She was very timid, it cost to me to take initiatives, and my rotations (sometimes voluntary) by Urgencies and the plant did not give the awaited result me.
Obvious, the result of my many theoretical knowledge and little practitioners gave as result that my first 6 months of resident in ORL was the small hell. Luckily, I could practice under supervision during 3 months before facing my first patients alone.
The question is, how we have to prepare the ECOE? Aside from being able to be proactive in all the clinical practices of the race, something that will be able to make the students who read this and still are in time€¦

How to prepare the ECOE when or we have left little weeks or months and our practices they have been €œcurrent€?

 

PRINCIPLE Number 1: TO DO

The practical factories distributed as quickly as possible in 6º course are relatively useful, mainly to strengthen knowledge of RCP, sutures and bandages. And to remember that always you must before wash the hands and after exploring a patient, things thus.
Nevertheless, the communication with the patient, to make a complete anamnesis, to make correct deductions of physical signs€¦ that you will not learn it in any factory nor special seminary.
I will tell you what happens when YOU BEGIN to see patients in person: by clearer that you have the theory in your mind, the patient will express his problems to you with his own words, she will look you at the eyes and you will block yourself. Pam! That easy.
I have seen it in students, I underwent it in my own meats, and he will also happen to you. But only with the first patients. How to surpass it? Experiencing it. There is no another solution.
For that reason you need to practice several times with patients, a companion or, if necessary, with your image in a mirror, to fail as rapidly as possible and to be able to overcome the barrier. You do not have more remedy than to put the hands in the mud to undergo your first blockades, knowledge in what you weaken and to review, to review, to review.

HOW TO CHOOSE THE BEST PATIENT TO PRACTICE

It asks the associate or resident of practices what patient entered presents a classic picture, and directs you to his room preparation to happen awhile making the anamnesis. Assure to you first that the patient agrees; present to you suitably. If you can prepare a verification list before entering the room, you will be able to review the questions that you need to do on the march.

HOW TO PRACTICE WITH CLASSMATES

If you want to simulate exactly what it happens in a station of examination ECOE, the ideal is to work in groups of 3 where one for of patient, the other of supervisor (making sure of which questions and procedures they are realised and which not) and the third student has been realising the test.
If you are only two people practicing, also it is possible to do it.
From where you can obtain clinical scenes?
  • They can be obtained from webpages, very abundant in English. In the United Kingdom and the USA they take much more realising this type of examinations for time (OSCE, Objective Structured Clinical Examination)
  • They can €œmake€ at home with the book if there is no more remedy, once you have practiced with cases and obtained lists of correction of the previous Webs

An ample market of specific manuals for the preparation of OSCE exists. For example, in the Web http://www.oscehome.com/ they explain how they worked to obtain a synthesis of clinical scenes that covered all the possibilities with the examination. They offer a series of payment manuals, reason why I do not know if they are of good quality or no.

Also multiple applications for mobile and tablet exist, as OSCE Trainer, gratuitous when writing this entrance, although some of their functions are of payment. OSCE Skills App, and a few more, some gratuitous and others of payment. Unfortunately for that you do not dominate that language, all is in English. Some enterprising Spanish doctor who cheers up to send first app for the ECOE€¦? 🙂

Finally, a few Webs offer clinical scenes (with its corresponding checklists) of gratuitous access. I give the connection you of a few here underneath:

http://geekymedics.com/category/clinical-cases/

http://www.fammed.wisc.edu/files/webfm-uploads/documents/med-student/pcc/practice-osce-scenarios.pdf

http://osce-stations.blogspot.com.es/

CONNECTIONS IN SPANISH

When some ago days I began search information exceeds how to prepare examination ECOE, I found information appointed professors mainly and Universities exceed how to design an examination ECOE. Yes, still we are in that phase in Spanish speech€¦ 😉

Luckily, we have here an excellent contribution of Aitor Guitarte in its somosmedicina.com blog.  It constitutes a good initial step to begin to prepare the ECOE along with some classmate.

http://www.somosmedicina.com/2012/02/guia-para-preparar-una-ecoe-i.html concise Guide of surgical washing, positioning of gloves, injections and sutures

http://www.somosmedicina.com/2012/03/guia-para-preparar-una-ecoe-ii.html#index On spirometry, arterial ramming intake and electrocardiogram

QUESTIONS OPENED WITH SHORT ANSWER

Taken care of! These stations, although are answered in writing, evaluated your capacity to apply the theory actually that you have learned.

Lee first all the questions to know towards where he takes the case to you. Perhaps they request surgical indications to you of a concrete problem, so that in the anamnesis you will have to write the questions that allow you to know if the patient has surgical Perhaps indication or no. asks to you in the end for the analytical drug type that will need the patient, or for the specific tests that you must ask.

P. ex. in a boy with repetition tonsilitis, you will have to ask if it snores, number of episodes, how much fever reaches, etc. Because the surgical criteria take into account that are bacterial tonsilitiss (nonviral, and for that the fever is important), number of episodes to the year, if the boy has apnea of the dream, if he has had periamigdalinos abscesses, etc

***

And here we arrived at the end of the article for today, although it is probable that it can extend the information on the ECOE with contributions your. The ECOE in this blog, just as in some faculties, only finishes home€¦

YOU KNOW OTHER SOURCES IN SPANISH TO PREPARE THE ECOE? IT CONTRIBUTES YOUR IDEAS IN THE COMMENTARIES UNDERNEATH THIS POST

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Almudena Trinidad
almudena@hshanemd.net

I am otorrinolaring³loga doctor in a hospital of Madrid and Professor Asociada de Medicina in the UAM. I help Medicine students to develop more effective techniques of study to obtain better notes, to remember during more time and to feel like more happy insurances and with its studies.

15 Commentaries
  • Aaron
    Published to 13:28 h, 17 May To respond

    You recommend some technique to learn pu±eteros TNM? thanks

    • Almudena Trinidad
      Published to 09:25 h, 18 May To respond

      Good question€¦ The real situation for an oncologist is to take manual TNM in the pocket (now also in smartphone) and to often consult. They are very difficult most of to have memorised retail EVERYTHING.
      But the reality of the examinations is to have to memorise them. I had to do it with tumors ORL for an examination of opposition. The technique that I found more useful was to spend every day 15 minutes to review it. The first day faults much, after 2 weeks you guess right everything almost 🙂

  • ALDO
    Published to 00:38 h, 07 March To respond

    Thank you very much by the article, the truth is a little worrisome the fact to make an examination with as much importance and not to be oriented, this article type, tips on apps, etc, are of much help, thank you very much again.

    • Almudena Trinidad
      Published to 08:46 h, 11 March To respond

      Thank you very much, Aldo 🙂
      I am glad as which it serves to you as help. Spirit with the ECOE, and mainly, enjoys everything what you can preparing it with your companions (is taken place enough already with the examinations written)

      A greeting!

  • Mayra
    Published to 15:20 h, 17 March To respond

    Thank you very much by your direction, good article for which we began the preparation for ECOE.

    • Almudena Trinidad
      Published to 10:41 h, 22 March To respond

      Thank you very much, Mayra, I am glad much as which it serves to you as help. Luck with the ECOE!

  • Ines
    Published to 17:50 h, 17 April To respond

    Inestimable your work, thank you very much to share your knowledge freely and to help us with the last passage before being doctors. This article has been for me as finding a way in the middle of an insurmountable forest. Gracias

    • Almudena Trinidad
      Published to 09:56 h, 23 April To respond

      Thanks to you to comment, Ines. Luck!

  • Paula
    Published to 12:08 h, 23 April To respond

    And specifically for the ORL station, what theoretical knowledge you would review yourself if you were bad of time? Thanks for the entrance

    • Almudena Trinidad
      Published to 17:26 h, 23 April To respond

      Difficult question. The year last in my Faculty fell a case of tonsilitis of repetition with questions on surgical indications of tonsillectomy. I do not know what was in the rest of stations.
      I would review algorithms diagnoses in cancer of head and neck, and diagnosis and treatment of more frequent acute infectious pathology, in addition to criteria of adenoidectom­a, transtimp¡nicos tonsillectomy and drainages.
      Much luck!

  • alejandra
    Published to 12:46 h, 24 April To respond

    Thank you very much by all the information that you facilitate to us. But precise of its recommendations for doctors (graduated) who go to make this examination as part of the exigencies of the MEC to accredit title.

    I have been medical, I withdrew for 9 years and I have a nonclinical medicine specialty.
    But sincerely I do not know by where initiating my preparation.

    I will be thankful for his directions

    • Almudena Trinidad
      Published to 09:40 h, 05 May To respond

      Thanks to write, Alejandra.

      Unfortunately, I do not know completely how they are the examinations of homologation of titles. I only know that they resemble the examinations type ECOE of the Medicine Faculties, with clinical cases simulated by actors good preparations.

  • Romi
    Published to 08:22 h, 04 September To respond

    How I can prepare ecoe single? , since in your article you indicate working with companions. It would thank for tips. Thanks.

    • Almudena Trinidad
      Published to 14:27 h, 11 September To respond

      Hello! It is good for having companions to €œbreaking the ice€ to remember all the points of the anamnesis in front of somebody. But you do not have possibility, you always can make it single aloud to be sure that you know to express itself and you do not forget important questions or explorations.

      Just as at the time of preparing presentations, it is good for recording same soon to review the recording to you and to detect clearly in what you can improve.

      In order to study facing the ECOE, the course €œClinical Problem Solving€ is excellent that was distributed through Coursera, and that now is compiled in YouTube at the disposal of everybody. This it is the connection: https://youtu.be/KATky6USI6E
      In this course, they teach to you to orient the study specifically to handle habitual clinical presentations. In the race we are customary to study by organs and diseases. Here they explain to you how to study from symptoms or of syndromes, as much clinical as of laboratory.

      I hope that 🙂 goes to you very well

  • Diego
    Published to 19:25 h, 01 December To respond

    Good afternoon Almudena and thanks so much by this entrance. I am student of 6º of Medicine and was looking for something of light for the preparation of the ECOEs, that although is to end of course I want to take advantage of the rotatory ones from already training to me. I have obtained many ideas here. You itself in Twitter for a long time but she has been an authentic one and it burnishes chance to come to now stop to your Web 🙂 In addition, of always I have wanted to be ORL, as you, and at this point of the race every time I see a little more close my objective. Warm greetings! Diego

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