Physical examination couplet station example
This page gives you an overview of the different parts of a physical examination couplet station. The candidate instructions, posted outside the door and also available in the station, and the examiner’s checklist are provided. At the bottom of the page, we provide the patient-encounter probe questions and the answer key.
Joseph Trans, 12 years old, has been brought to your office with a history of right hip pain which occasionally radiates to the knee.
In the next 6 minutes, conduct a focused and relevant physical examination.
As you proceed, explain to the examiner what you are doing and describe any findings. At the next station, you will be asked to answer questions about this patient.
What the examiner completes
Fill in the bubble for each item completed satisfactorily
|1.||Observes patient walking|
|– looks at leg lengths and measures|
|– checks for Trendelenburg sign [standing on each leg alternately]|
|– extension [patient on side or front]|
|– internal rotation|
|– external rotation|
|If UNSATISFACTORY, please specify why:|
|Inadequate medical knowledge and / or provided misinformation|
|Could not focus in on this patient’s problem|
|Demonstrated poor communication and / or interpersonal skills|
|Actions taken may harm this patient|
|Actions taken may be imminently dangerous to this patient|
|Did this candidate demonstrate a lapse in professional behaviour? Yes No|
|Disrespectful to others (e.g., to patient, nurse)|
|Over-investigated / over-managed the patient|
|Actions raised ethical and / or legal concern|
|Briefly describe the behaviour for any of the above reasons or any other observed lapse:_________________________________________________________|
Patient-Encounter Probe questions
Q1. Examine the antero-posterior / frog x-ray of both hips of this patient. List the abnormalities, if any. If normal, state so.
Q2. What is the most likely diagnosis?
Q3. What is the appropriate management of this patient?
Patient-Encounter Probe answer key
Candidates are provided with the antero-posterior / frog x-ray of both hips for this patient.
|Q1.||Examine the antero-posterio / frog x-ray of both hips of this patient. List the abnormalities, if any. If normal, state so.||Score|
|A1.||Posterior inferior slip of epiphysis of metaphysis||4|
|Mention made in any way of opposite side (bilateral approx. 50% in this condition)||1|
|Abnormality of the hip||1|
|Q2.||What is the most likely diagnosis?||Score|
|A2.||Slipped epiphysis OR slipped capital femoral epiphysis||4|
|Q3.||What is the appropriate management of this patient?||Score|
|A3.||Medication OR urgent referral to orthopedic surgeon within 1 week||3|
|Crutches until sees orthopedic surgeon||1|
|Elective referral to orthopedic surgeon||0|
|Decrease activity, stop gym before consultation||0|
|Anti-inflammatory medication only||0|
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