Back pain
2.6 BACK PAIN
1. Introduction and approach to patient
No elements
1
2
3
4
All elements
5
3
4
All elements
5
3
4
All elements
5
2. Main presenting symptoms
No elements
1
2
2
3. Relevant supporting information
No elements
1
2
4. Patient’s perception and understanding
No elements
1
2
3
4
All elements
5
2
3
4
All elements
5
4
All elements
5
5. History-taking skills
No elements
1
6. Diagnostic reasoning and management
No elements
1
2
3
Overall impression
Clear fail
1
Borderline fail
2
Pass
3
Good
4
Excellent
5
Please record specific feedback below for discussion:
44e1
Back pain
2
SPECIFIC CHECKLIST FOR THIS STATION
1. Introduction and approach to patient
•
•
•
•
Introduces themselves to patient
Obtains consent for interview
Indicates confidential nature of consultation
Sets patient at ease
2. Main presenting symptoms
• Elicits character of the pain including site, radiation, and exacerbating and relieving
factors
• Elicits timescale of symptoms
• Asks specifically about ‘red flag’ symptoms
3. Relevant supporting information
•
•
•
•
Elicits social history including employment history
Asks how pain is affecting function
Asks about linked conditions—previous fractures, history of osteoporosis
Asks about family history of relevant conditions
4. Patient’s perception and understanding
• Asks for patient’s ideas, concerns and expectations
• Responds to concerns and expectations appropriately
• Specifically elicits and responds to fear of cancer
5. History-taking skills
•
•
•
•
Develops rapport with patient
Use of open questions
Questions follow from patient’s responses
Focuses history to ask about red flag symptoms
6. Diagnostic reasoning and management
•
•
•
•
44e2
Reaches likely diagnosis of vertebral fracture
Discusses supporting features for this
Considers differential diagnosis
Discusses likely diagnosis with patient, avoiding medical terminology and checking
understanding