General principles Clinical assessments are integral to undergraduate and postgraduate medical education and training, and are designed to verify that those involved in the care of patients meet safe clinical standards. Assessments can be formative and/or summative. Formative assessments (such…
The previous chapters have covered the idealised process of taking a history and examining each system in depth. This chapter considers how this ‘toolbox’ of skills can be used selectively and adaptively to address the patient’s needs in specific circumstances.…
History taking, examination and investigation are the methods by which clinicians gather information to allow them to understand patients’ problems. Clinical reasoning is the analytical process by which this information is translated into diagnoses, therapeutic possibilities and prognoses. This chapter…
Anatomy and physiology Understanding the surface anatomy of the lungs ( Fig. 5.1 ) and their relation to adjacent structures is essential for the practice of respiratory medicine. At the end of tidal expiration, the dome of the diaphragm extends high…
General principles of physical examination The process of taking a history and conducting a physical examination is artificially separated in classical medical teaching, to encourage learners to develop a structured approach to information gathering. However, your physical assessment of patients…
The importance of a clear history Understanding the patient’s experience of illness by taking a history is central to the practice of all branches of medicine. The process requires patience, empathy and understanding to yield the key information leading to…
The clinical encounter The clinical encounter between a patient and doctor lies at the heart of most clinical practice. At its simplest, it is the means by which people who are ill, or believe themselves to be ill, seek the…