Dear All

Thank you for participating in the session today. We practised A development scenario of a 4 year old with developmental issues – mentored b Dr P.

Dr S & Dr M took the hotseat and covered focused history and the examination respectively. The emphasis on history in this station is to identify the Aetiology that may have caused the presenting symptoms. Do NOT waste time in not necessary details that may be relevant in a different scenario. You can waste upto six minutes of history time without having a clue to what causative aetiology might be. Examination – follow a sequence and IMAGINE the child in front of you.

The Learning points are:

• Focussed history to elicit aetiology
• Open questions will get Role player to offer a lot of important information.
• WHEN DID CONCERNS FIRST NOTED – gives a good point to spend more time.
• Do screen for birth and related history BUT do not spend TOO much time.
• COMORBIDITIES – always ask and DONOT forget.
• Can check to compare ‘how child is comparing with a sibling’ if appropriate
• Social history is important
• How is ‘mother’ coping, affecting other family members
• What help is available – DLA etc – check document on .gov website
• General physical examination is a MUST for every station.
• Sequence in examination is essential: check with & without aids / orthosis
• Sit – stand – walk – run – Ball. Check if Normal or different / abnormal
• If a child cannot walk steadily – do not ask to tip toe – be cautious.
• Small ball vs Big ball. Defines level of control & dexterity of child.
• SAFETY of child is MOST important – show you are taking precautions

Please visit www.mrcpchclinicals.org to add your comments or add points I may have missed.

Anil Garg