Sample Problem-Focused Standardized Patient Encounter

00:13:42
https://www.youtube.com/watch?v=MzoeBJyVlE0

Résumé

TLDRIn this medical encounter, a student named Britney meets with patient Miss Alexander to discuss her neck pain following a minor car accident. The patient describes the pain as tight and dull, primarily affecting the back and sides of her neck, worsening with specific movements. Britney documents the patient's medical history, performs a physical examination, and suggests osteopathic treatments to alleviate the symptoms. The primary goal of the visit is to help the patient feel better and address her pain effectively.

A retenir

  • 🩺 Patient experiences neck pain after a minor car accident.
  • 🚗 The incident involved a rear-end collision at a low speed.
  • 💊 Patient takes ibuprofen, albuterol, and loratadine.
  • 🩹 The pain is described as tight and dull, primarily in the neck.
  • ⚖️ Pain worsens with forward bending and turning to the left.
  • 🏥 No prior history of neck injuries reported.
  • 📋 Patient is allergic to penicillin, causing a rash.
  • 🧠 Gentle osteopathic treatments were suggested for relief.
  • 🕒 Pain began several hours after the accident.
  • 📚 Medical history includes asthma and controlled family conditions.

Chronologie

  • 00:00:00 - 00:05:00

    The medical student, Britney, meets with a patient, Miss Alexander, who is experiencing neck pain after a minor car accident two days prior. The patient describes the pain as a tight, dull sensation primarily located at the back and sides of her neck, worsening with certain movements. She has taken ibuprofen and applied ice, but the pain persists, rating it a 6 or 7 out of 10. Britney gathers details about the accident, the patient's medical history, and current medications, noting that she has asthma and is allergic to penicillin.

  • 00:05:00 - 00:13:42

    During the physical exam, Britney assesses the patient's neck mobility and tenderness, finding that the patient experiences pain throughout her neck. She performs reflex tests and strength assessments, then applies gentle osteopathic treatment to relieve muscle tension. After the treatment, Britney summarizes the patient's condition and plans to discuss a treatment plan with Dr. Parrot, ensuring the patient feels heard and cared for.

Carte mentale

Vidéo Q&R

  • What were the patient's main complaints?

    The patient reported experiencing neck pain after a minor car accident.

  • What caused the neck pain?

    The neck pain was caused by a rear-end car collision.

  • Did the patient have any prior neck injuries?

    No, the patient has never had neck problems before.

  • What medications does the patient take?

    The patient takes ibuprofen for pain, albuterol for asthma, and loratadine for allergies.

  • Is the patient allergic to any medications?

    Yes, the patient is allergic to penicillin.

  • What treatments were offered during the visit?

    Gentle osteopathic treatments were suggested for muscle tension relief.

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Sous-titres
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  • 00:00:06
    you may knock in out of
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    room come
  • 00:00:11
    in hi Miss Alexander hi hi my name is
  • 00:00:15
    Britney and I'm a medical student
  • 00:00:16
    working with Dr parrot
  • 00:00:19
    today try to get this all rubbed in it's
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    nice to meet you nice to meet you so she
  • 00:00:25
    has sent me in just to ask you some
  • 00:00:27
    questions and do a brief physical exam
  • 00:00:29
    and then I will step back out and talk
  • 00:00:31
    to her and then she'll be in behind me
  • 00:00:33
    is that okay yeah that's fine great so
  • 00:00:36
    what brings you in today um I've been
  • 00:00:39
    having pretty bad neck pain oh goodness
  • 00:00:41
    well I'm glad you came in so we can take
  • 00:00:43
    a look and make sure there's nothing
  • 00:00:44
    going on so how long's this been going
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    on probably about 2 days okay did
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    anything happen a couple days ago out of
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    the ordinary well I was in a small car
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    accident okay must have been scary yeah
  • 00:01:01
    what happened um I was at a stoplight
  • 00:01:05
    and the person behind me rear ended me
  • 00:01:08
    we weren't going very fast though I
  • 00:01:10
    think he was maybe going 5 or 10 miles
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    an
  • 00:01:13
    hour and were were you wearing your seat
  • 00:01:16
    belt at the time yeah good and um so you
  • 00:01:20
    said you didn't go to the hospital or
  • 00:01:22
    anything cuz you didn't feel any pain
  • 00:01:24
    initially no so when exactly did the
  • 00:01:27
    pain start about how many hours after
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    the accident um I would probably say
  • 00:01:32
    maybe four to six hours after I think
  • 00:01:35
    maybe I was just in shock at first and
  • 00:01:38
    so I didn't really feel any pain or
  • 00:01:40
    anything all right and where is it
  • 00:01:42
    bothering you specifically can you
  • 00:01:44
    pinpoint a specific area on your neck
  • 00:01:46
    it's mostly just the back of my neck and
  • 00:01:48
    on the sides of my neck both sides yes
  • 00:01:55
    right and did you hear any pops or have
  • 00:01:58
    any numbness tingling that occurred
  • 00:02:01
    during the accident
  • 00:02:02
    no all and is there anything that's
  • 00:02:05
    making the pain
  • 00:02:07
    worse um mostly when I bend my head
  • 00:02:10
    forward and try to turn it to the left
  • 00:02:13
    it kind of I notic it little
  • 00:02:16
    uncomfortable anything you've noticed
  • 00:02:18
    that's helping it uh I took some
  • 00:02:21
    ibuprofen and I put ice on the back of
  • 00:02:25
    my neck and that helped a little bit but
  • 00:02:26
    it still hurts it still hurts and how
  • 00:02:30
    much ibuprofen are you taking I took two
  • 00:02:34
    tablets every 6 hours or so since
  • 00:02:40
    then I'm just taking some notes so that
  • 00:02:42
    way when I go talk to Dr parrot I can be
  • 00:02:45
    thorough and let her know everything
  • 00:02:46
    you're telling me so so it's worse
  • 00:02:48
    whenever you're bending forward into the
  • 00:02:52
    side to the left is that correct
  • 00:02:56
    yes all
  • 00:02:58
    right and can you describe the pain to
  • 00:03:01
    me it's just feels like a
  • 00:03:05
    tight kind of
  • 00:03:08
    dull pain
  • 00:03:11
    okay so tight and
  • 00:03:16
    dull and is this pain radiating or
  • 00:03:19
    moving anywhere not really it just goes
  • 00:03:22
    up and down the back of my neck so
  • 00:03:25
    nothing coming down into the arms no
  • 00:03:28
    okay and on a scale of 1 to 10 with 10
  • 00:03:31
    being the worst pain where would you say
  • 00:03:34
    you're at um probably around a six or a
  • 00:03:38
    seven out of 10 especially when I try
  • 00:03:41
    and Bend forward and turn my head and is
  • 00:03:45
    it a constant pain yes and so but it'll
  • 00:03:49
    get worse whenever you bend forward and
  • 00:03:51
    turn to the left mhm
  • 00:03:54
    okay and would you say since the
  • 00:03:56
    accident since that evening has it been
  • 00:03:59
    constant or is it getting worse better
  • 00:04:01
    what would you say it feels like it's
  • 00:04:04
    getting worse but I don't know if that's
  • 00:04:06
    because the ibuprofen is not
  • 00:04:09
    working okay well I'm glad you came in
  • 00:04:11
    you know the over-the-counter stuff's
  • 00:04:13
    not working and we can do an exam and
  • 00:04:16
    make sure there's nothing we're missing
  • 00:04:18
    and um you know if we need to possibly
  • 00:04:21
    do some osteopathic treatments and we'll
  • 00:04:24
    get on to that later okay okay
  • 00:04:30
    and um as far as your past medical
  • 00:04:32
    history have you ever had a neck injury
  • 00:04:35
    before no no so you've never had
  • 00:04:37
    problems with your neck no okay that's
  • 00:04:40
    good to know and um any medical
  • 00:04:43
    conditions that you're currently being
  • 00:04:44
    treated for or that you've ever been
  • 00:04:46
    treated for I have
  • 00:04:48
    asthma
  • 00:04:49
    um
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    and I take medicine for that that's
  • 00:04:54
    about it ever been
  • 00:04:56
    hospitalized Noom mm ever had any
  • 00:05:00
    surgeries I had my tonsils taken out
  • 00:05:03
    when I was a kid I think I was probably
  • 00:05:06
    nine
  • 00:05:08
    okay and as far as medications you said
  • 00:05:11
    you take the over-the-counter
  • 00:05:12
    ibuprofen and then you take something
  • 00:05:14
    for asthma what do you take for your
  • 00:05:16
    asthma I take
  • 00:05:17
    albuterol do you just take that as
  • 00:05:20
    needed
  • 00:05:21
    MH and do you take any other medications
  • 00:05:24
    I take
  • 00:05:26
    um a a Loratadine or a Claritin for
  • 00:05:31
    allergies
  • 00:05:35
    okay what about any herbal supplements
  • 00:05:38
    vitamins I take a
  • 00:05:43
    multivitamin and I always like to ask
  • 00:05:45
    all my patients any recreational drug
  • 00:05:47
    use no
  • 00:05:51
    none and are you allergic to any
  • 00:05:53
    medications I am I'm allergic to
  • 00:05:57
    penicillin and what happens when you
  • 00:05:59
    take penicillin I break out in a rash in
  • 00:06:02
    a rash well we be sure never to give you
  • 00:06:05
    penicillin for anything thank you and as
  • 00:06:08
    far as family history um any medical
  • 00:06:12
    conditions in the family with your mom
  • 00:06:13
    and dad my mom uh she's pretty healthy
  • 00:06:18
    she has diabetes though okay um and it's
  • 00:06:21
    pretty under control good my dad has
  • 00:06:24
    high cholesterol but he takes medicine
  • 00:06:27
    for that
  • 00:06:29
    any brothers or sisters I have a brother
  • 00:06:32
    and he's healthy he do have any
  • 00:06:34
    conditions or
  • 00:06:36
    anything and no one's ever had um
  • 00:06:40
    problems with joints or arthritis no no
  • 00:06:44
    no okay
  • 00:06:47
    great and I always like to just get a
  • 00:06:50
    overview of my patients kind of get to
  • 00:06:52
    know them a little better um what do you
  • 00:06:53
    do for a living I'm an administrative
  • 00:06:56
    assistant oh where do you work I work
  • 00:06:58
    for the Fish and Wild Child Life
  • 00:07:00
    Services oh wow that must be fun yeah
  • 00:07:03
    you've been doing it for a while yeah
  • 00:07:04
    for a few years okay stressful or pretty
  • 00:07:08
    um it's not very stressful at all that's
  • 00:07:11
    good mhm and are you married I am yeah
  • 00:07:14
    congratulations thanks do you have any
  • 00:07:16
    children no not yet no children no MM
  • 00:07:20
    all
  • 00:07:22
    right and so do you have hobbies that
  • 00:07:24
    you like to do I do I like to cook and I
  • 00:07:27
    like to Garden um um it's been kind of
  • 00:07:31
    difficult to Garden cuz I can't lean
  • 00:07:33
    forward as much for the past two days
  • 00:07:36
    mhm so yeah it's can be frustrating when
  • 00:07:39
    you can't do the things you enjoy yeah
  • 00:07:41
    um any tobacco use I smoke um probably
  • 00:07:46
    maybe half a pack a day if that and how
  • 00:07:49
    long have you been
  • 00:07:50
    smoking oh I want to say maybe seven
  • 00:07:54
    years or so okay any alcohol use uh
  • 00:07:58
    occasion
  • 00:08:00
    I'll have a glass of wine with dinner
  • 00:08:02
    maybe once a week
  • 00:08:06
    okay all right well I believe I got all
  • 00:08:09
    the information I needed from you so
  • 00:08:11
    we're going to go ahead and move on to
  • 00:08:13
    the physical exam portion so what I'm
  • 00:08:15
    going to do is I'm just going to have
  • 00:08:16
    you take a seat up
  • 00:08:25
    here all right for the physical exam I'm
  • 00:08:27
    going to go ahead and listen to your
  • 00:08:28
    heart and long so make sure those S nice
  • 00:08:30
    and
  • 00:08:32
    clear so I'm just to slide this down and
  • 00:08:35
    just breathe
  • 00:08:43
    normal and going to take a big deep
  • 00:08:46
    breath and out
  • 00:08:50
    again
  • 00:08:53
    again and last
  • 00:08:56
    one good
  • 00:09:00
    and so I'm just going to do a structural
  • 00:09:02
    exam here and palpate down your spine
  • 00:09:05
    let me know if there's anything that's
  • 00:09:06
    tender it's tender everywhere everywhere
  • 00:09:09
    okay and I'm going to work my way
  • 00:09:17
    down okay and I want to check the range
  • 00:09:20
    of motion in your neck so what I want
  • 00:09:21
    you to do is try to put your chin down
  • 00:09:22
    to your
  • 00:09:25
    chest it's about as far as I can go and
  • 00:09:28
    then looking up to the ceiling
  • 00:09:30
    pretty
  • 00:09:33
    stiff okay and what about looking
  • 00:09:35
    turning and looking over to the
  • 00:09:40
    shoulder okay all right and turn and
  • 00:09:42
    look to that shoulder for
  • 00:09:46
    me right there and then ear to your
  • 00:09:49
    shoulder trying to touch your ear over
  • 00:09:51
    to your
  • 00:09:52
    shoulder and then ear to the other
  • 00:09:55
    shoulder that's as far as all right and
  • 00:09:59
    I'm going to go ahead and check just
  • 00:10:01
    some
  • 00:10:01
    reflexes this will kind of tell me if
  • 00:10:03
    there's any nerves that are involved so
  • 00:10:05
    just relax your
  • 00:10:07
    arm and we're going to rest your arm
  • 00:10:09
    right here on your
  • 00:10:13
    lap and just
  • 00:10:15
    relax good and I'm going to do the same
  • 00:10:18
    thing on this arm just relax your
  • 00:10:23
    arm and just
  • 00:10:25
    relax and then last one just let your
  • 00:10:28
    arm hang
  • 00:10:31
    and now I'm going to test and see how
  • 00:10:33
    strong you are so place your arms like
  • 00:10:34
    this for me and don't let me move your
  • 00:10:37
    arms
  • 00:10:39
    good and arms up and don't let me push
  • 00:10:43
    them good and fingers out for me don't
  • 00:10:46
    let me squeeze them and fingers together
  • 00:10:49
    and try to push them out okay all right
  • 00:10:52
    if it's okay with you as an osteopathic
  • 00:10:54
    student we learned some treatments so
  • 00:10:56
    I'm going to do some soft tissue to try
  • 00:10:57
    and break up some of this tension that
  • 00:11:00
    you're having if that sounds okay okay
  • 00:11:03
    hurt too bad no it's not going to hurt
  • 00:11:06
    and if there's any pain I want you to
  • 00:11:07
    let me
  • 00:11:10
    know and so I'm just going to do just
  • 00:11:13
    very gentle it's called mile FAL I'm
  • 00:11:16
    just kind
  • 00:11:17
    of slowly
  • 00:11:27
    up and if this is something that you do
  • 00:11:30
    get some relief from after this evening
  • 00:11:33
    then you can come back and we can be a
  • 00:11:36
    little more aggressive but since the car
  • 00:11:37
    accident was just two days ago I want to
  • 00:11:39
    be very gentle
  • 00:11:44
    okay okay I'm just going to hold this
  • 00:11:47
    right here all those muscles that are
  • 00:11:50
    tight and spasming right now attach
  • 00:11:53
    right up where my fingers are at so I'm
  • 00:11:54
    just trying to get them to relax and
  • 00:11:56
    loosen
  • 00:12:03
    so this is supposed to relax all the
  • 00:12:06
    muscles of my neck yep
  • 00:12:11
    okay all right I think that'll be enough
  • 00:12:14
    for today I don't want to do too much
  • 00:12:16
    since it was such an acute injury so I'm
  • 00:12:18
    going to go ahead and help you
  • 00:12:24
    up and then I'm going to go ahead and
  • 00:12:26
    summarize everything that you told me
  • 00:12:29
    from earlier if that's okay um would you
  • 00:12:31
    prefer sitting back down in the chair
  • 00:12:37
    sure okay so you started having some
  • 00:12:40
    neck pain two days ago after a motor
  • 00:12:42
    vehicle accident um you were rear ended
  • 00:12:45
    but you were wearing your seat belt you
  • 00:12:47
    didn't hear any pop or have any numbness
  • 00:12:50
    or tingling that occurred and it's just
  • 00:12:52
    been real tight um for the past 2 days
  • 00:12:56
    real constant but it's worse whenever
  • 00:12:58
    you flex your head down or turn to the
  • 00:13:01
    left is that correct yes and as far as
  • 00:13:04
    your past medical history um you just
  • 00:13:06
    have asthma and you're taking some
  • 00:13:08
    medication for that um okay and you're
  • 00:13:12
    not allergic to anything anden a or
  • 00:13:14
    excuse me yes that's right you are
  • 00:13:15
    allergic to penicillin all right what I
  • 00:13:18
    will do is I will go talk to Dr parrot
  • 00:13:20
    and then we will be back in to put
  • 00:13:23
    together a treatment option plan for you
  • 00:13:26
    okay um any other questions or concerns
  • 00:13:28
    you have for me today no I don't think
  • 00:13:30
    so just want to feel better all right
  • 00:13:33
    well that is our main goal so I'm glad
  • 00:13:35
    you came in today great thank you thank
  • 00:13:37
    you
Tags
  • neck pain
  • car accident
  • medical exam
  • osteopathic treatment
  • patient history
  • physical examination
  • pain management
  • medical student
  • family history
  • allergies