I’ve realized that I probably give a rather skewed impression of medical school through what I’ve been posting to these pages. Not everything that we learn is clinical skills! In fact, most of the time we’re sitting in our dungeon classroom for hours on end just trying desperately to stay awake. That’s what medical school is really about. Or, at least the first phase.
But of course, that brief Thursday afternoon when we dress up all fancy and head down to the Clinical Education Centre to play doctor is the absolute high of the week. Thus it is also mostly what I blog about! This post will be no exception.
Today we learned the cardiovascular exam, with the help of both volunteer patients and standardized patients (actors/actresses who have been trained to present like a patient with a particular condition). I’m glad that we had patients helping us, because the cardiovascular exam requires quite a bit of disrobing, and would have been awkward to perform on classmates to say the least.
The basics of a cardiovascular exam are visual inspection, palpation, and finally auscultation. That is: you look at the superficial anatomy of the heart and the great vessels; you feel for pulses, heaves, lifts, or thrills; and finally you listen for the heart sounds, murmurs, or bruits. I found it surprising just how much information can be gleaned about the heart without any more equipment than your hands and a stethoscope.
Of course, mostly what we learned today was the motions of executing the rituals of a cardiovascular exam -where to palpate, where to listen, and how to communicate effectively with the patient. What’s still lacking, I feel, is a good appreciation of the findings! I’m probably not going to be able to hear and identify a carotid bruit, until I’ve actually met and examined a patient with a carotid bruit! Seems obvious eh?
