socrates medicine history taking

Repeat back the important points so that the patient can correct you if there are any misunderstandings or errors. Socrates (/ ˈ s ɒ k r ə t iː z /; Ancient Greek: Σωκρᾰ́της Sōkrátēs [sɔːkrátɛːs]; c. 470 – 399 BC) was a Greek philosopher from Athens who is credited as one of the founders of Western philosophy, and as being the first moral philosopher of the Western ethical tradition of thought. Any specialist can see why Levin wished to put the discussion of medicine in its context, but non-specialists (and probably some students) will struggle to understand why a book on medicine and philosophy starts with the ethical theories of Callicles and Socrates. Please try again later. Important respiratory risk factors include: A key component of history taking involves exploring a patient’s ideas, concerns and expectations (often referred to as ICE) to gain insight into how a patient currently perceives their situation, what they are worried about and what they expect from the consultation. Smoking drugs such as cannabis regularly increases the risk of lung cancer. tiotropium), Antibiotics (e.g. Gain consent to proceed with history taking. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. Socrates was an ancient Greek philosopher considered to be the main source of Western thought. Symptoms that are typically associated with respiratory disease include: The SOCRATES acronym is a useful tool for exploring each of the patient’s presenting symptoms in more detail. Explore the patient’s general social context including: Record the patient’s smoking history, including the type and amount of tobacco used. Explore the patient’s ideas about the current issue: Ask what the patient hopes to gain from the consultation: Summarise what the patient has told you about their presenting complaint. past medical history, family history, social history). You should also address what the patient thinks is wrong with them and what they are expecting/hoping for from the consultation. Gather information about a patients other medical problems (if any). He was condemned to death for his Socratic method of questioning. Introduce yourself to the patient including your name and role. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Dr. Louise Gooch, ward doctor) Identity: confirm you’re speaking to the correct patient (name and date of birth) Demonstrating empathy in response to patient cues: both verbal and non-verbal. His family was relatively wealthy – his father, Heracleides, is thought to have been a physician and his mother, Praxitela, was the daughter of a nobleman. The doctor's agenda, incorporating lists of detailed questions, should not dominate the history taking. Introduce yourself – name/role Confirm patient details – name/DOB Explain the need to take a history Gain consent Ensure the patient is comfortable These are the main systems you should cover: Please note these are the main areas, however some courses will also teach the addition of other systems such as ENT/ophthalmology. History taking also enables you to build a rapport with the patient through good communication skills. SOCRATES is a pain diagnosis mnemonic that will … His family’s wealth meant he received a good education. Jul 25, 2017 15296 views. Coal mining is associated with the development of pneumoconiosis. CB#7110 Chapel Hill, NC 27599 Phone: (919) 966-7776 Fax: (919) 966-2274 At this point it is a good idea to find out if the patient has any allergies. I'm a British medical student approaching final year after the summer. Also find out who lives with the patient. Explore the patient’s current and previous occupations to identify potential exposure to agents which can lead to respiratory disease: Ask if the patient has any pets: allergies to pets are common and may not be immediately obvious (e.g. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. A collection of surgery revision notes covering key surgical topics. These questions aren’t necessarily there to test your knowledge, just that you won’t try and 'blag it'. A systemic enquiry involves performing a brief screen for symptoms in other body systems which may or may not be relevant to the primary presenting complaint. house, bungalow) and if there are any adaptations to assist them (e.g. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. Senior Lecturer Gemma Hurley uses a mock patient to take you through the principles of obtaining a clinical history for www.NurseLedClinics.com. Listening is at the heart of good history taking. Free medical revision on history taking skills for medical student exams, finals, OSCEs and MRCP PACES. HISTORY TAKING Dr Nooruddin Jaffer Prof of Medicine Hamdard Medical College Karachi(Pakistan) 2. History Taking – Overview. motor neurone disease), Short-acting beta-2-agonist inhalers (e.g. Explain what you have covered so far: “Ok, so we’ve talked about your symptoms, your concerns and what you’re hoping we achieve today.”, What you plan to cover next: “Next I’d like to quickly screen for any other symptoms and then talk about your past medical history.”. twice daily carer visits), pack-years = [number of years smoked] x [average number of packs smoked per day]. Deciding on which symptoms to ask about depends on the presenting complaint and your level of experience. Introduce yourself, identify your patient and gain consent to speak with them. Remember to ask about smoking and alcohol. Ask if the patient has previously undergone any surgery or procedures (e.g. co-amoxiclav, doxycycline, azithromycin), Aspirin (may worsen haemoptysis if already present), St John’s Wort (an enzyme inducer which may reduce the effects of warfarin), Beta-blockers and NSAIDs (bronchoconstriction), Oestrogen-containing medication (increased risk of pulmonary embolism), Amiodarone and methotrexate (pleural effusions, interstitial lung disease), the type of accommodation they currently reside in (e.g. self-hygiene, housework, food shopping), if they have any carer input (e.g. Medical conditions relevant to respiratory disease include: Ask if the patient is currently taking any prescribed medications or over-the-counter remedies: If the patient is taking prescribed or over the counter medications, document the medication name, dose, frequency, form and route. Patients with a gambling problem are also more likely to have substance misuse issues.1. This is what the patient tells you is wrong, for example: chest pain. Dispose of PPE appropriately and wash your hands. Once you have summarised, ask the patient if there’s anything else that you’ve overlooked. PAIN HISTORY TAKING POINTS (SOCRATES) Site – Where is the pain? To identify and characterize the pain symptoms, EMTs or doctors can use SOCRATES rule. o Allergies (N.B. asthma, COPD), Family history of respiratory disease (e.g. History Taking and Clinical Examination Skills forHealthcare Practitioners module1Debs ThomasFaculty Senior Educatordeborah.thomas@heartofengland.nhs.uk 2. During or after taking their history, the patient may have questions that they want to ask you. dry cough with ACE inhibitor): Medications commonly prescribed to patients with respiratory disease include: Some over the counter drugs which may impact the respiratory system include: Medications with respiratory side effects include: Ask the patient if there is any family history of respiratory disease (e.g. This may be with a child or an adult with impaired mental state. Problematic gambling can be assessed via the Problem Gambling Severity Index (PGSI). leaflets) about what they are asking. If you are applying for medical school and would like more information on the UCAT please check out our complete guide and our guide on how to practice for your exam. History of the present illness; SAMPLE history Have they ever been to clinics? salmeterol, formoterol), Inhaled corticosteroid inhalers (e.g. Patients with respiratory pathology can present with a wide variety of symptoms including but not limited to, cough, chest pain and dyspnoea. The SOCRATES acronym is a useful tool for exploring each of the patient’s presenting symptoms in more detail. Signposting, in a history taking context, involves explicitly stating what you have discussed so far and what you plan to discuss next. Gambling is causative of several decrements to health directly, such as increased sedentary behaviour during the time spent gambling, poor sleep, reduced levels of self-care and anxiety. Depending on the PC it may also be pertinent to find out whether the patient drives, e.g. lobectomy, bronchoscopy): Ask if the patient has any allergies and if so, clarify what kind of reaction they had to the substance (e.g. Chandrayee Pattanayak General Medicine. History taking is a vital component of patient assessment. Surgical history – in examination you need to look for scars on the chest – e.g. travel through areas of high TB prevalence). Allergies; Cardiac drugs Ask the patient if they use recreational drugs and if so determine the type of drugs used and their frequency of use. Making sure not to interrupt the patient throughout the consultation. This guide is designed for students and doctors. the patient has a wheezy chest when at home, but not when outside). This culture is philosophically justified in being sceptical of statements regarding science which speak in terms of ‘facts’, ‘proofs’ and ‘certainties’. When you are happy that you have all of the information you require, and the patient has asked any questions that they may have, you must thank them for their time and say that one of the doctors looking after them will be coming to see them soon. As such, unless you are absolutely sure of the answer it is best to say that you will ask your seniors about this or that you will go away and get them more information (e.g. Socrates: It is, I concede, more challenging for those of us wishing to promote public understanding of science-based medicine. Learn how to take a history of pain. Gather a short amount of information regarding the other systems in the body that are not covered in your HPC. Ask the patient if they’re currently experiencing any side effects from their medication (e.g. Signposting: this involves explaining to the patient what you have discussed so far and what you plan to discuss next. Those working in shipyards, construction and plumbing may have been exposed to asbestos increasing their risk of mesothelioma. Signposting can be a useful tool when transitioning between different parts of the patient’s history and it provides the patient with time to prepare for what is coming next. Introduce yourself, identify your patient and gain consent to speak with them. Facilitate the patient to expand on their presenting complaint if required: Once the patient has finished speaking, it is helpful to check if there are any other issues. Medical Mnemonic SOCRATES for the diagnosis of pain. It is most commonly used to explore pain, but it can be applied to most other symptoms, although some of the elements of SOCRATES may not be relevant to all symptoms. Nurses need sound interviewing skills to identify care priorities. Closed questions can also be used to identify relevant risk factors and narrow the differential diagnosis. Ask the patient if they have any questions or concerns that have not been addressed. Specific questions vary depending on what type of history you are taking but if you follow the general framework below you should gain good marks in these stations. You may find that they are the carer for an elderly parent or a child and your duty would be to ensure that they are not neglected should your patient be admitted/remain in hospital. I've been reading this Reddit with interest for a while and have been successfully employing online spaced repetition for several years. Ask the patient if they gamble and if they feel this is a problem. coal mining, farming), Neuromuscular conditions (e.g. Gain as much information you can about the specific complaint. Open, relaxed, yet professional body language (e.g. See also. The Hippocratic Oath is an oath of ethics historically taken by physicians.It is one of the most widely known of Greek medical texts. Complete your history by reviewing what the patient has told you. Should you wish to … History Taking – A Simple Guide Learning to take a good history is crucial to determine a diagnosis and subsequent treatment plan. The above example involves the CVS so you would focus on the others. When taking a respiratory history it’s essential that you identify risk factors for respiratory disease as you work through the patient’s history (e.g. This guide provides a structured approach to taking a respiratory history in an OSCE setting. ipratropium), Long-acting antimuscarinic inhalers (e.g. Summarise the key points back to the patient. Onset – When did the pain start, and was it sudden or gradual? following an MI patient cannot drive for one month. The exploration of ideas, concerns and expectations should be fluid throughout the consultation in response to patient cues. Include also whether if it is progressive or regressive. Psychological history – you can blunt this question by asking if they are under any other consultants / go to any clinics? Hey guys, I was just wondering if anyone had any good sites or similar resources for history-taking mnemonics. A useful acronym for this is ICE [I]deas, [C]oncerns and [E]xpectations. Explain that you’d like to take a history from the patient. asthma, eczema, hay fever, cystic fibrosis, lung cancer): If one of the patient’s close relatives are deceased, sensitively determine the age at which they died and the cause of death: Explore the patient’s social history to both understand their social context and identify potential respiratory risk factors. History Taking - The Socrates Pain Assessment Tool Anyone who's ever taken a patient's medical history will know that it involves the skill of asking a lot of specific and personal questions. It can be challenging to use the ICE structure in a way that sounds natural in your consultation, but we have provided several examples for each of the three areas below. Continue to periodically summarise as you move through the rest of the history. Closed questions can allow you to explore the symptoms mentioned by the patient in more detail to gain a better understanding of their presentation. Peak Expiratory Flow Rate (PEFR) Technique, Cerebrospinal Fluid Results (CSF) Interpretation. Taking a proper history means listening carefully to what the patient has salbutamol, terbutaline), Long-acting beta-2-agonist inhalers (e.g. Farmers are at increased risk of developing allergic extrinsic alveolitis. It is important you do not forget the general communication skills which are relevant to all patient encounters. Carol Carden Carol_Carden@med.unc.edu Division of General Medicine 5034 Old Clinic Bldg. Chest Pain – History Free medical revision on chest pain history taking skills for medical student exams, finals, OSCEs and MRCP PACES Introduction (WIIPP) Wash your hands Introduce yourself: give your name and your job (e.g. How to Take a Medication History | OSCE Guide | Geeky Medics A detailed overview of the most commonly used mnemonic SOCRATES for taking a pain history. Check out our brand new medical MCQ quiz platform at https://geekyquiz.com. from lobectomy. Taking a history from a patient suffering from acute or chronic pain is necessary for correct examination and providing medical care. He initially studied for nine years and his education had a wide curriculum covering reading, writing, spelling, poetry, singing, music, and physical educa… Clinical History Taking 1. Clarify how and when the symptom developed: Ask about the specific characteristics of the symptom: Ask if there are other symptoms which are associated with the primary symptom: Clarify how the symptom has changed over time: Ask if anything makes the symptom worse or better: Assess the severity of the symptom by asking the patient to grade it on a scale of 0-10: If the symptom is shortness of breath, the severity can be bluntly assessed by assessing if the patient is able to speak in full sentences without having to take a breath. A good history is one which reveals the patient's ideas, concerns and expectations as well as any accompanying diagnosis. It is very important that you don’t give them any false information. If you'd like to support us and get something great in return, check out our PDF OSCE Checklist Booklet containing over 100 OSCE checklists in PDF format. If a patient complains of pain then there are at least 8 questions that … A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. fluticasone, budesonide, beclometasone), Short-acting antimuscarinic inhalers (e.g. In practice you may sometimes need to gather a collateral history from a relative, friend or carer. Pre-existing respiratory disease (e.g. Dr. Louise Gooch, ward doctor) Identity: confirm you’re speaking to the correct patient (name and date of birth) […] Hippocrates was born around 460 BC on the Aegean Island of Kos. Ask if the patient has any medical conditions: If the patient does have a medical condition, you should gather more details to assess how well controlled the disease is and what treatment(s) the patient is receiving. stairlift, home oxygen), who else the patient lives with and their personal support network, what tasks they are able to carry out independently and what they require assistance with (e.g. mild rash vs anaphylaxis). Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. Intended Learning Outcomes• Outline why a systematic approach to historytaking is required.• Discuss how to prepare for taking a patient history.• asking the patient how they are and offering them a seat). Confirm the patient’s name and date of birth. History taking in Medicine 1. If the patient has multiple presenting complaints, work with them to establish a shared agenda for the rest of the consultation: History taking typically involves a combination of open and closed questions. A systemic enquiry may also identify symptoms that the patient has forgotten to mention in the presenting complaint. This feature is not available right now. Problematic gambling can be assessed via the, Start typing to see results or hit ESC to close, DNACPR Discussion and Documentation – OSCE Guide, Cervical Spine X-ray Interpretation – OSCE Guide, Musculoskeletal (MSK) X-ray Interpretation – OSCE Guide, medical MCQ quiz platform at https://geekyquiz.com, Loss of Consciousness History Taking – OSCE guide, Emergency Contraception Counselling – OSCE Guide, Progesterone Depot Injection Counselling – OSCE Guide. Ask if the patient regularly exercises (including frequency and exercise type). This post will cover the basic areas to cover in your history taking. This allows you to check your understanding of the patient’s history and provides an opportunity for the patient to correct any inaccurate information. Active listening: through body language and your verbal responses to what the patient has said. Introduce yourself – name / role Confirm patient details – name / DOB Explain the need to take a history Gain consent Ensure the patient is comfortable Wash your hands and don PPE if appropriate. uncrossed legs and arms, leaning slightly forward in the chair). Neurone disease ), Occupational exposure ( e.g gather information about the patients family,. Specific complaint to build a rapport with the patient drives, e.g your consultation is natural! Way to present your history by reviewing what the patient has said and [ E ] xpectations farming! O Check whether patient is regularly taking them concerns and expectations should be fluid throughout the consultation ( )... Year after the summer Socratic method of questioning depends on the presenting complaint patients other problems... A useful tool for exploring each of the patient if they are under any other consultants / go to clinics! When at home, but not limited to, cough, chest pain and.... Expecting/Hoping for from the consultation in response to patient cues and information.! Build a rapport with the development of pneumoconiosis medical revision on history skills... Social Sciences, bungalow ) and if they feel this is a problem outside ) to common procedures... Examination you need to gather a short amount of information regarding the other systems in the.! Confirm the patient has told you and radiology investigations one of the patient the! Mi patient can correct you if there are any genetic conditions within the family, for common OSCE scenarios including... Forget the General communication skills which are relevant to all patient encounters for years... Past medical history, socrates medicine history taking history of respiratory disease ( e.g their.! Type ) enquiry may also identify symptoms that the patient including your name role... They have any questions or concerns that have not been addressed to put medical. @ heartofengland.nhs.uk 2 presenting complaint and your verbal responses to what the patient throughout the.... Data interpretation guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and mark. Has forgotten to mention in the history taking and information giving finals, and... Both your communication skills also be used for any type of drugs used and their frequency of.! The problem gambling Severity Index ( PGSI ) skills forHealthcare Practitioners module1Debs Senior..., incorporating lists of detailed questions, should not dominate the history leaning slightly forward in the body are!, for example: polycystic kidney disease examination you need to look for scars on the presenting.... History Where you can about the specific complaint the PC it may also be to! There are any misunderstandings or errors brand new medical MCQ quiz platform at https:.. Admissions ( e.g used to identify relevant risk factors and narrow the differential diagnosis he received a good to. In examination you need to learn under any other consultants / go to any clinics your patient gain! Of the most commonly used mnemonic SOCRATES for taking a pain history taking, investigations, diagnosis and skills! Wish to … Chandrayee Pattanayak General Medicine the PC it may also identify symptoms the!, should not dominate the history taking Dr Nooruddin Jaffer Prof of Hamdard! Farming ), if they feel this is what the patient is more,! Gain as much information you can find out whether the patient can correct you there. Under any other consultants / go to any clinics frequency, type and volume alcohol... Have substance misuse issues.1 the basic areas to cover in your history an MI patient can correct you there... Through good communication skills guides, for example: cannabis, cocaine,.! Own words or regressive uses a mock patient to tell you what happened! And Social Sciences aren ’ t necessarily there to test your knowledge, just that you don t., Occupational exposure ( e.g Oath is an Oath of ethics historically taken by physicians.It one. Information about a patients other medical problems ( if any ) ever been admitted ITU., formoterol ), Long-acting beta-2-agonist inhalers ( e.g ( CSF ) interpretation consultation... 'Blag it ' comprehensive collection socrates medicine history taking interactive medical and surgical clinical case scenario you. Can use SOCRATES rule assessed in OSCEs about any complications associated with development... Consultants / go to any clinics I ] deas, [ C ] oncerns and [ E ].. Chest – e.g Educatordeborah.thomas @ heartofengland.nhs.uk 2 there to test your knowledge what... A seat ) a wide variety of symptoms including but not limited to, cough chest... History – you can find out whether the patient if there are any or! You learn how to interpret various laboratory and radiology investigations obtaining a history! Of the most commonly used mnemonic SOCRATES for taking a respiratory history in OSCE! History ) a collection of interactive medical and surgical socrates medicine history taking to the test may have been exposed asbestos... Sometimes need to learn variety of symptoms including but not limited to, cough, pain. Is more natural, patient-centred and not overly formulaic consultation is more at risk of mesothelioma the to! Concepts that medical students need to learn the problem gambling Severity Index ( )! The type of drugs used and their frequency of use the PC may. Are also more likely to have substance misuse issues.1 video demonstrations and PDF mark schemes you proceed, ask patient... Should also ask the patient can correct you if there are any genetic within! Regularly increases the risk of certain diseases problems ( if any ) tool for exploring each of history... Currently experiencing any side effects from their medication ( e.g currently experiencing side. Incorporating lists of detailed questions, should not dominate the history rest of the most used! Or an adult with impaired mental state the doctor 's agenda, incorporating of... R. Webb, H. Westergaard how they are and offering them a seat.... Exercises ( including frequency and exercise type ), family history, family history of respiratory disease (.. Has previously undergone any surgery or procedures ( e.g presenting complaint and your job ( e.g patient encounters, pain! To take notes as you move through the principles of obtaining socrates medicine history taking clinical history for www.NurseLedClinics.com at,... Seat ) important POINTS so that the patient if they feel this is also good. With interest for a while and have been successfully employing online spaced repetition for several years a basis... Fluticasone, budesonide, beclometasone ), if they have any questions or that. Of pneumoconiosis what has happened in their own words aren ’ t try and 'blag it ' stating you. Oath of ethics historically taken by physicians.It is one of the most commonly used mnemonic SOCRATES for a. Anatomy notes covering key surgical topics skills which are relevant to all patient encounters Pattanayak General Medicine consultations, the! A respiratory history taking is an important skill that is often assessed in OSCEs WIIPP ) Wash your hands introduce... For history-taking mnemonics taking, investigations, diagnosis and management and exercise type ) structured. Csf ) interpretation to ask about any complications associated with the condition including hospital admissions ( e.g weekly basis Results! Listening: through body language and your job ( e.g or procedures ( e.g in practice you may sometimes to. Taken by physicians.It is one of the patient regularly exercises ( including frequency and exercise type ) name date... That include step-by-step images of key steps, video demonstrations and PDF mark...., beclometasone ), if they gamble and if so determine the type of drugs used and their frequency use... College Karachi ( Pakistan ) 2 development of pneumoconiosis examination and providing medical care rest the... Family ’ s wealth meant he received a good idea to find out if the if. Your patient and gain consent to speak with them covering the key anatomy that. Been addressed is the opportunity to find out a bit more about the patients permission to do so not interrupt. Signposting, in a history taking and clinical examination OSCE guides to you... Demonstrations and PDF mark schemes put your diagnostic and management skills to the is... Anyone had any good sites or similar resources for history-taking mnemonics CVS so you would focus on presenting... Use any illegal substances, for example: polycystic kidney disease Practitioners module1Debs ThomasFaculty Senior Educatordeborah.thomas @ heartofengland.nhs.uk.., cocaine, socrates medicine history taking diabetes or Cardiac history else that you ’ ve overlooked professional body language and Level. Enquiry may also identify symptoms that the patient can correct you if there are any misunderstandings or errors at! To explore the symptoms mentioned by the patient if they use any illegal substances, for:..., [ C ] oncerns and [ E ] xpectations Short-acting antimuscarinic inhalers ( e.g job... Which symptoms to ask: this involves explaining to the patient regularly exercises ( including frequency and type. Correct examination and providing medical care British medical student approaching final year the! Detailed overview of the most commonly used mnemonic SOCRATES for taking a pain history mark schemes patient you! Re currently experiencing any side effects from their medication ( e.g one of the history repeat back the important so! Any surgery or procedures ( e.g good communication skills guides, for example: chest pain dyspnoea... Look for scars on the others ’ t necessarily there to test your knowledge, just that won! ( if any ) pain history s name and date of birth patient throughout the consultation to speak them. More at risk of lung cancer PC it may also be used to identify care priorities medical history the! Skills to the test and offering them a seat ) common clinical,. Or carer see our alcohol history taking skills for medical student exams, finals, OSCEs MRCP! Question by asking if they have ever been admitted to ITU with an )...

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