I. Station dispanserisation (диспансеризация)

It involves demonstrating the skills of propaedeutics and therapy. It is believed that the patient is not sick, he is healthy and has come for a routine examination so that the parameters of a healthy person can be shown on him. This station is attended both by the robot, and real person, on which you will demonstrate some of the skills.

OBJECTIVE

Demonstration by the student of algorithm for examining respiratory system, methods for measuring blood pressure.

DURATION OF WORK OF THE STATION

Total - 10 minutes (for direct work - 8.5 minutes) 0.5 minutes - familiarization with task (briefing)	0,5'
7.5 minutes - warning about the remaining time to complete the task	8'
1 minute - an invitation to move to the next station	9'
1 minute - change of students	10'

BRIEFING (БРИФФИНГ)

This text will hang on the door in front of the entrance to the station so that the student understands which station will now be. By voice commands, 30 seconds will be allotted to familiarize yourself with this text before starting work.

Вы врач-терапевт участковый поликлиники. Предполагается, что Ваша рабочая смена только началась. В кабинете Вас ждѐт пациент, который пришел на завершение первого этапа диспансеризации. Вы пациента видите впервые. У пациента имеются результаты исследований, которые были получены в ходе предварительного обследования (все они свидетельствуют о норме, суммарный сердечно-сосудистый риск по шкале SCORE менее 1%). Необходимо произвести физикальное обследование дыхательной системы и измерить артериальное давление.

You are a general practitioner of a local polyclinic. It is assumed that your working day has just begun. A patient is waiting for you in the office, who has come to the completion of the clinical examination. This is the first time you see a patient. The patient has research results that were obtained during the preliminary examination (they all indicate the norm, the total cardiovascular risk on the SCORE scale is less than 1%). A clinical examination of the respiratory system and blood pressure should be taken.

STUDENT WORKPLACE AT THE STATION

A room that simulates an outpatient office in polyclinic.

Equipment:

1. Place in front of the entrance to the room for placement of briefing

2. Worktable.

3. Forms of medical documents filled in according to the legend of the simulated patient.

4. Two chairs.

5. Sink with an elbow mixer and elbow dispensers for hand hygiene.

5. Wall clock.

6. Tank for collection of household and medical waste (container of class A and B).

A set of general practitioner:

1. stethoscope;

2. tonometers with different sizes of cuffs (small and large);

3. light source (pocket flashlight);

4. alcohol wipes;

5. examination gloves;

6.cm tape.

Expendable materials:

1. Antiseptic wipes for stethoscope processing.

2. Examination gloves

3. Disposable towels

Simulation equipment

1. Mannequin (vertical torso) to demonstrate the technique of physical examination of the respiratory system.

2. Manikin (arm) for measuring blood pressure with a properly worn cuff and associated equipment.

Important! There is an employee at the station who plays the role of a simulated patient.

MEDICAL DOCUMENTS

This is approximate view, it will be on the table. These documents do not need to be completed. They are needed at the beginning of the station, when the student gets to know the patient and verifies his personal data with the documentations.

Skills that are demonstrated on the patient: communication at the beginning (strictly according to the algorithm of action), assessment of color of skin, fingers, pulse, respiratory rate, nasal breathing, beginning of blood pressure measurement - pulse test without phonendoscope.

Skills that are demonstrated on the mannequin: examination, palpation, percussion, auscultation of the chest, measuring blood pressure with phonendoscope.

1.6. SAMPLE TEXT OF PATIENT-STUDENT DIALOGUE:

When a student in the role of doctor asks the patient to give his last name, first name,, age - patient answers the request. При уточнении аккредитуемым лицом ФИО и возраста пациента – «Иванов Иван Иванович, 30 лет» (" Ivanov Ivan Ivanovich, 30 years old ")

When a  student in the role of doctor tells the patient to sit on a chair, he sits down.

When a student in the role of doctor asks about health, the patient replies that everything is fine, there are no complaints. При вопросе о самочувствии - «Самочувствие нормальное» (" The state of health is normal»)

When a student in the role of doctor asks about the patient's consent for examination (voluntary informed consent), the patient agrees. При попытке спросить данные анамнеза жизни и/или заболевания - «Предоставление данной информации не предусмотрено» (" This information is not provided ")

When a student in the role of doctor asks if it hurt when determining the elasticity of the chest,the patient says that it did not hurt.

When a student in the role of doctor asks patient to repeat phrase "Thirty-three" to determine voice tremor, the patient repeats.

When a student in the role of doctor asks questions about risk factors before measuring blood pressure in patient, patient replies “No”. При вопросах к пациенту о факторах, влияющих на результаты измерения артериального давления (физической активности, употреблении лекарственных средств, курении, употреблении крепких напитков) - ответ «Нет» («No»).

When a student in the role of doctor repeatedly asks about the patient's well-being at end of examination, the patient replies that everything is fine.

1.7. SAMPLE TEXT OF EXAMINER-STUDENT DIALOGUE:

When an attempt is made to measure blood pressure again (second time on second hand)	«Будем считать, что повторное измерение произведено, результат такой же» We assume that the repeated measurement has been made, the result is the same as at the first measuring
At the end of examination, when trying to start washing hands	«Будем считать, что руки обработаны» Let's assume that the hands are processed Т his means that when washing hands, you do not need to show as much detail as the first time

You cannot say anything on your own, enter discussions with the patient or examiner, even if you do not agree with his opinion. No need to ask clarifying questions. All actions are performed in accordance with the following algorithm (Next pages).