We are planning to start another Interactive session on Tuesday at 6:00-7:00 pm UK time soon to assist in preparation of the Exam in November.

This is to facilitate our participants in UK, Ireland, Canada & Switzerland who find 4:00-5:00 pm UK time not very helpful with work schedules.

Please send a note if you will like to know more.

Thank you for participating in the session on communication.

I took the plunge and attempted the scenario which we had discussed previously of a newborn baby who is noted to be dusky at four hours and the clinical assessment is that he may have a cyanotic heart disease likely to be transposition of the great arteries. Dr Tamal was and excellent role player and did get across his anxiety very well. He was however, satisfied in the end.

The second scenario we did was of a one-year-old admitted following a febrile convulsion due to otitis media. The following morning during the ward round he was felt to be better and fit for discharge. However his father who had just arrived, was not happy with the medical decision and wanted the child to have a CT scan as he had found on Google. Maria was an excellent role player but technology did let us down in getting a clear understanding of communication between role player & candidate.

Learning points:

• Ensure you have Good internet connection.
• Vitally so as you can opt to take the exam from home now.
• Technology failures on your end are unlikely to get sympathy from RCPCH – I am guessing.
• “Will the child die?” is a common question – practice how to respond satisfactorily to it.
• No medication can completely eliminate the chances of future convulsions
• Tepid sponging / Cooling – can be different in context of different countries / climates
• After introductions – keep QUIET and give parent /RP chance to get across everything they want to say – DO NOT interrupt.
• This will also give you information of their prior knowledge.
• Then pick up salient points – from THEIR perspective and address them

Add your comments or points I may have missed.

Video recording of the sessions are available to participants.
Anil Garg

Comment

A real learning treat today.
Specially, the middle part management, and the succinct summary .
Enriched.

Dr TL

08 June Kolkata

Communication role player expected to cry.

Offer tea/coffee/water (usually available) or at least a tissue.

Take regards from the bottom of my heart ,Sir.

We need a teacher like you to captain us so that we can have a flawless sail to the reach our cherished destination.

Pranams.
🙏🙏
Tamal.

Happy teachers day to a wonderful teacher😇😇

Dr AJ

I found guidance, friendship, discipline, and everything in one person. And that person is you. Happy Teachers’ Day!🙏🙏🙏🙏🙏

Dr UP.

We have received tremendous support from you all and have filled all our seats – 14 in total – for the Interactive Zoom Sessions. We limit the number so as to be able to provide individual attention to each participant.

Our online modules on Communication, History & Management, Video, Development and Clinical stations are available.

For Interactive Zoom sessions we have a waiting list and will consider a second session to start soon. Please register your interest.

Anil Garg

We started with a PowerPoint presentation on communication station, what it entails, where the marks are, the do’s and don’ts.

This was followed by a scenario of talking with parents of a new born baby, 4 hours old, noted to be dusky, clinical examination suggestive of Transposition of Great Arteries (TGA).

Task was to discuss your concern with parents and answer their queries and address their worries and concerns. Misbah, Anish and Tamal did the role play and hot seat.

The learning points were:

• Read the information given VERY CAREFULLY.
• Do not assume information not written.
• Anxious parents – clearly elicit their concerns first before ‘jumping’ in with your ‘plan’
• Go about in a systematic manner in establishing diagnosis
• Remain clam, take 5 seconds to collect your thoughts and then reply if not sure
• remember to visualise: WHAT I WOULD NORMALLY DO.
• Dusky babies are not normally time critical transfers hence be systematic.

Add any point I may have missed or to add your comment.

Video of the session will be available in for 2 weeks – if you could not attend or wish to review.
Anil Garg

Thank you for attending and making today’s session so lively and interesting.

We discussed a scenario in which a 21 day old baby presented with lethargy, poor feeding and weight loss. Serum Na: 110 mmol/l. Ankita was the role player and Anurag took the hot seat. The history and communication were appropriate. Consanguinity needs to be confirmed if there is suggestion of a recessive condition.

The differential diagnosis could be done better and appropriate management can only be correct if our differential diagnosis is on track.

Learning points:

• In a neonate with lethargy and poor feeding NEVER forget sepsis
• Differential diagnosis should be most likely first
• If results or information suggests a life threatening condition – MANAGE that first
• In this child sepsis and hyponatremia have to be priority in treatment
• Frequency of medications – can make an educated guess and ask for confirmation.
• Is it drug x – Hydrocortisone and other – Fludrocortisone
• Role player is likely to clarify even if they have not given the name on drugs first
• Investigations to support or rule out your differential
• Discuss with your consultant

If there are points I have missed or comments you wish to add.
Anil Garg