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All students will be allocated to one session.  You may swap your session by  emailing the Course Administrator -  you will be advised if and when a space becomes available, or by swapping with a colleague (please let us know the details).

  • To make the most of your case based learning session, you will need to do some preparation. 
  • Select a patient on your surgical firm whose journey you can follow through and report back to the group
  • You will present your patient to the group and highlight the important issues in your patients assessment, management and holistic care
  • Please email your notes to lesley.gosden@nds.ox.ac.uk in WORD format and also bring them along to the session.
  • We will follow your patients through their surgical journeys from presentation to discharge home
  • Each session will be divided into 3 x 20 minute discussion areas so please prepare to present your case in all 3 areas below:

 Presentation and admission

 Include a full history for your colleagues to ascertain the salient features

  • Describe the signs on examination and how you document these on the case notes
  • Identify the differential diagnoses; be prepared to discuss how a definitive or working diagnosis was reached
  • Describe the investigations performed, report the results for your colleagues to interpret and identify the interpretation yourself
  • Describe what happened to the patient from the time of their presentation e.g. in clinic, transfer to the ward, who they saw, what documentation was completed, VTE assessment, nutritional status etc...

Peri-operative course

Describe the pre-operative preparation for operation including consent, medications, shaving / washing instructions and how the patient coped with these

 Report the WHO checklist and preparation details, anaesthetic type, intubation, lines for access, antibiotics, catheterisation  etc..

 Describe the operative details including:

  •  Position of the patient
  • Surgical preparation used
  • Access incisions
  • Findings at operation
  • Procedure performed
  • Closure
  • Anaesthetic details throughout e.g. fluid balance, drugs given, untoward events

Detail the post-operative course including fluid balance

  • Analgesics used
  • Surgical doctors review and actions
  • Nursing review and actions
  • Patient’s perception of their care and what issues are important to them during this journey

Post-operative course and discharge

Where did the patient go after operation e.g. ITU or ward?

Explain the fluid balance and calculate what was needed / added and why

Describe the analgesia used and whether it was effective for the patient’s pain control

Outline antibiotics used and why

Describe any complications and their management

How was your patient fed? Did they require dietetics input?

Report what was in the drains, when were they removed and how was that decision made?

Report the state of any surgical wounds

Was there an OT / physio input and what did it entail?

What arrangements were made for discharge? Did this have an impact for the patient?

What arrangements were made for removal of stitches etc..

What are the plans for review after the patient leaves hospital?

Help

Written notes by students attending sessions from previous years can be accessed here to help you with this session.