Polymyalgia Rheumatica
Polymyalgia Rheumatica
Polymyalgia Rheumatica
Len lives with his wife and beloved dog Lucy (an Old English Sheep dog) who he takes on
walks every day. These last few weeks he has been feeling his age, aching and stiff
especially in the morning which has curtailed Lucys walks. This is proving a real nuisance to
both dog and owner!
Len is normally fit and well other than having hypertension which is well controlled,
He smokes the occasional cigar on a Saturday with his glass of Grahams 10 year old Tawny
port when he and his wife go out with the neighbours.
In these last few weeks Len has struggled in the mornings to get up and down the stairs, get
out of the bath and brush his hair due to painful stiff muscles.
He has had no joint swelling or redness, he has had no scalp tenderness or problems with
his vision
Case Title:
Context of case
Assessment Domain:
1.
Data-gathering, technical and assessment skills
Positive descriptors:
Negative descriptors:
Assessment Domain:
2.
Clinical Management Skills
Positive descriptors:
Negative descriptors:
Incomprehensible explanation
No investigations
Inappropriate Rx
Warned re symptoms of TA
Rx plan explained
Assessment Domain:
3.
Interpersonal skills
Positive descriptors:
Negative descriptors:
Misses ICE
Establishes rapport
mins
Negative descriptors:
Over running
(max = 9)
General
Feedback/Comments
their interpretation. Demonstrating proficiency in performing physical examinations & using diagnostic and therapeutic instruments
Positive Indicators
Negative Indicators
2. CLINICAL MANAGEMENT SKILLS: Recognition & management of common medical conditions in primary care. Demonstrating a structured & flexible approa
to decision-making. Demonstrating the ability to deal with multiple complaints and co-morbidity. Demonstrating the ability to promote a positive approach to health
(Blueprint: Primary Care Management, Comprehensive
approach)
Positive Indicators
Negative Indicators
3.
INTERPERSONAL SKILLS Demonstrating the use of recognised communication techniques to gain understanding of the patient's illness experience and devel
a
shared approach to managing problems. Practising ethically with respect for equality & diversity issues, in line with the accepted codes of professional
conduct.
(Blueprint: Person-Centred Approach, Attitudinal
Aspects)
Positive Indicators
Negative Indicators
Does not inquire sufficiently about the patients perspective / health understanding.
Pays insufficient attention to the patient's verbal and nonverbal communication.
Fails to explore how the patient's life is affected by the problem.
Does not appreciate the impact of the patient's psychosocial context
Instructs the patient rather than seeking common ground
Uses a rigid approach to consulting that fails to be sufficiently responsive to the
patient's contribution
Has a positive attitude when dealing with problems, admits mistakes &
shows commitment to improvement.
Backs own judgment appropriately
Demonstrates respect for others
Does not allow own views/values to inappropriately influence dialogue
Shows commitment to equality of care for all
Acts in an open, non-judgmental manner
approach that
facilitate or
CF
The candidate clearly fails to demonstrate competence, with clinical management that
is
incompatible with accepted practice or a problem-solving approach that is arbitrary
or technically incompetent.
The patient is not treated with adequate attention, sensitivity or respect for their
contribution.
Note: All three CSA domains must be assessed in order to make the final global judgement. The descriptors in
italics address interpersonal skills. The rest of the text addresses
the other two domains.
The standard for competence is at the level required for the doctor to be licensed for general practice.