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All the information required seems commonsense and indeed it is discount buspar 10mg fast delivery, but when you are anxious about speaking to a more senior doctor whom you may not know buspar 5mg sale, it is easy to forget to give or ask the most important details buy buspar 10 mg fast delivery. This is particularly the case in the adrenaline rush of speaking to a senior whom you have woken up or who seems annoyed that you have bothered them discount buspar 10mg online. Examination findings at presentation and provisional diagnosis What treatment have you given? Examination findings now Finally: What would you like them to do – see the patient now, later or just give advice? Specialist Specialist opinion Take over care Provide joint care investigation or management of the patient of the patient Figure 10. Referring and Requesting 63 Often,if you have woken someone up,they will be half asleep too and forget to ask you important information you have forgotten to volunteer. The patient had presented with an acute‘asthma attack’in the early hours of the morning. The medical SHO was dealing with an unwell patient on the ward and was tired. He accepted the referral without protest and left the unwell patient on the ward for the A&E department, thinking that the patient with the asthma attack would be more unwell and therefore take priority. On arrival in the A&E department he dis- covered the patient sitting up talking in full sentences, having been managed through the acute phase by the A&E staff. He rapidly returned to the ward without consequence to the other patient, but cursed himself for having left the ward without asking the vital question of‘how the patient was now’, not‘how were they on arrival’. The lesson here is that the A&E SHO did not refer the patient properly and the med- ical SHO did not‘take’the referral well. When these basic day-to-day tasks become second nature the job gets much easier, but hopefully if you have read this you will be well ahead of the game. These referrals may be urgent (patient seen within two weeks) or routine (patient not usually seen within at least six to eight weeks of referral). Out-patient clinics are run by a clinic manager (usually a senior sister or nurse who has taken on a part managerial, part clinical role). The team is expected to attend in full unless stated otherwise by your seniors. The clinic nurse(s) will pro- vide a computer-generated list of patients that are expected to attend, identifying new patients and follow-up attendees. The consultant will usually highlight those patients to be seen by the senior and junior members of the team. Junior doctors should present their patients to the specialist registrar (SpR) or the consultant (as per the instructions of the consultant) before instigating out-patient management (obviously). If patients are to be admitted from the clinic then they should be clerked and examined there and then. A drug and fluid chart should be completed and any blood or radiographic investigations performed in the out-patients department before the patient goes to the ward. Fracture Clinics The casualty senior house officer (SHO) or occasionally SpR refers patients directly from the accident and emergency (A&E) department. These patients have presented to the A&E department within the last few days with an acute injury. They will have a suspected or confirmed fracture that has been treated in a‘back slab’(half plaster of Paris cast which allows soft tissue swelling in the few days after a bony injury). The patient and their fracture is either treated conservatively in plaster and followed up or admitted from the clinic for fracture fixation (that is sur- gery). These clinics are excellent learning opportunities in orthopaedic management. Being in theatre can be the most incredible experience or your worst nightmare. Aspiring surgeons can hate being on a surgical firm (as I did as an undergraduate) and, equally, career physicians or general practitioners can love their theatre time. With a little knowledge regarding the staff and general running of theatres you will find your time much more enjoyable.

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Write these as questions and find out by reading or talking with peers or lecturers discount buspar 10mg with mastercard. Assimilate in­ formation gleaned from other sources into your lecture notes at the appro­ priate place buspar 5 mg lowest price. For example order buspar 10mg on-line, notes from clinical practice generic buspar 10 mg online, where you have seen a chronic asthmatic, might be filed along with your lecture notes on respi­ ratory diseases. Start with programmes that give simple, straightforward advice, then try documentaries and debates that give opposing arguments. Try to record these programmes so you can compare the information contained in your notes with the original source. Use different note-taking styles to record information from the same programme. How do the different sets of notes compare – do they each contain the same key points and examples? The above material can be used to discuss different styles of note-taking. Each person makes a list of two things about his or her note-taking that are good, and two things he or she would like to improve. Talk about your list with your friend, and set a date when you think you will have achieved them. Arrange to 166 WRITING SKILLS IN PRACTICE meet up again to check out your lists. Your list might include things like improving accuracy, filing notes and keeping your index up to date or trying a different way of recording information. Regularly reading through them will help you remember information and improve your understanding. Try to actively recall the main points or summaries at regular intervals. Summary Points ° Notes are both a learning tool and a study aid for revision. These as­ signments demand an enormous amount of time and effort from both the student and the examiner. However, they are essential in helping tutors gauge the level of each individual’s performance. Essays provide students with the opportunity to demonstrate to the tu­ tor their ability to: ° recall the pertinent facts of a subject ° select and organise information ° understand the relationship between ideas ° express ideas in a coherent and logical manner ° formulate opinions and convey convincing arguments to support their views ° discuss the practical application of theories. As well as demonstrating these abilities to their tutor, it will also give the students feedback on how well they understand the subject. As well as being part of the assessment process, the task of preparing and formulating essays is in itself a learning process. First, the obligation to write such papers is a useful catalyst in encouraging them to read more broadly and in depth about the subject matter in question. Second, the stu­ dents’ thinking about the subject is developed through the process of se­ lecting and organising information into a cohesive account. Studying in 167 168 WRITING SKILLS IN PRACTICE this way aids the retention of information for use in formal examinations and, more importantly, in clinical practice. Some students have had little experience of essay writing before they start their training. Other students, who may have returned to education after working for several years, may feel they need to revise their composi­ tion skills. If this applies to you, the following section gives advice on how to plan, write and understand the assessment of essays. It will help you to: ° understand the breadth and depth of the task ° refine your research task ° organise your notes ° select information relevant to your essay title ° structure your essay. Establishing the terms of reference Find out from your tutor any specific instructions regarding your set essay. What are the guidelines about the format in which the essay must be submitted?

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