Today, February 12, 2013, I had a preceptorship with 5 UPCM LU5 students at the Head and Neck Clinic of the Department of Surgery.
We saw 2 patients.
I taught them Problem-oriented Clinical Assessment and Medical Advice (POCAMA)
Initial Essential Data to Gather:
- Concern or Chief Complaint (which is the Problem)
Relevant data to be gathered on the Problem:
History or Interview:
- When problem noted
- Associated symptoms
- Previous medical consults and treatment
- Characteristics of the problem
- Associated physical signs
Process the above data (and others as gathered) using pattern recognition and prevalence processes to come out with primary and secondary clinical diagnoses. Quantitate the degree of certainty of clinical diagnoses.
Decide on whether there is a need to recommend a paraclinical diagnostic procedure. As a rule, if one is quite certain of the clinical diagnosis, there is no need for a paraclinical diagnostic procedure.
If there is a need for a paraclinical diagnostic procedure, advise the patient which is most suitable after comparison of the benefit, risk, cost, and availability factors of all possible options.
If there is no need for a paraclinical diagnostic procedure, advise the patient on treatment after considerations of the benefit, risk, cost and availability factors of all possible options.
Medical advices are given on the clinical diagnosis, paraclinical diagnostic procedures, and treatment.
That’s Problem-oriented Clinical Assessment and Medical Advice (POCAMA) in a nutshell.