Reflection: Clinical Assessment

A REFLECTION ON THE APPLIED CLINICAL ASSESSMENT AND INVESTIGATION IN CARDIOLOGY AND STROKE MODULE EXAMINATION

Reflection is an important tool in learning and has become an acceptable framework for professional preparation and practice (Boud & Walker, 1998).This has made it an important element of contemporary medical education. Boyd and Fales (1983) define reflection as “the process of internally examining and exploring an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self, and which results in a changed conceptual perspective”. This learning tool serves as an opportunity for professionals to appraise themselves as regards to what is happening or what has happened in a view to make sense of their

The preparation for the exam involved me studying the materials available both in the teaching resource section on StudyNet and at the Learning Resource Centre. The day finally came and I was quite confident and relaxed. I arrived the exam venue appropriately dressed, and at 9.45am, I found out that a group of students were having their examination that same day, so I went to a quiet place to revise. After some time, I came over to check the time allotted to me with the Staff in charge of assigning students to patients. It was then I became aware that I was the first to start the examination which will be at 11.20am. Unexpected situations can serve as a source of anxiety to students during examinations (Putwain, Woods & Symes 2010; Zohar, 1998). This made me tense and nervous at first, but with time my anxiety dissipated. Furthermore, there was a delay in commencing the examination due to some logistic reasons. It finally kicked off at 12.10pm and the Staff in charge ushered me into the room where my patient

The discomfort was central in the chest region, gradual in onset and characterised by a feeling of heaviness. The discomfort usually spreads to the left shoulder, worsened by exertion and had a severity score of 7 (1 the least and 10 the most severe). The shortness of breath was sudden in onset, occurred mostly along with the palpitation, and relieved by resting. This symptom worsened overtime and became distressing to her. Interrupting patients during a discussion make them hesitant to introduce new issues (Gask & Usherwood, 2002), leading to important information being missed (Kaufman, 2008). Therefore, I allowed my patient express herself with minimal interruptions. I asked for the character of the chest discomfort to note the likely cause but the shortness of breath was not thoroughly cross-examined by me. Although I asked for ankle swelling, fatigue and dizziness, I however did not ask for orthopnoea and paroxysmal nocturnal dyspnoea which the patient might have had. I also did not ask for the duration of each symptom episode which may have helped to assess the severity and prognosis of my patient. The review of systems revealed dry cough, ankle swelling, fatigue, exercise intolerance, dizziness, syncope, weight gain, cold intolerance, poor sight and limitation of movement but there were no history of weakness in her face or limbs, fever, wheezing,