Background (110-030-06-0) Michal and Moriah
This scenario is a classic example of “the door-handle question by a patient who holds back the essential reason for the visit until he/she is leaving the room, figuratively with a hand on the door-handle.
In this specific scenario, the patient has found a lump in her breast when showering. The finding is particularly frightening to her since her mother died of a recurrence of breast cancer at age 70 a few years ago.
The patient’s excuse for this visit is to follow up on a mildly twisted ankle a week earlier. In some versions the scenario may include a second unrelated question (such as the utility of flu vaccines) to fill up time.
At the discretion of the instructor, the scenario can leave more or less time between asking the revelation about finding the lump and the scheduled end of the consultation.
The action
In this specific video the patient reported on her ankle and asked a question about vaccines and was responded to appropriately.
Before she got a chance to ask belatedly about her newly discovered breast lump (as demanded by the scenario) the doctor- without any prompting- exploited the opportunity of the visit to raise the issue of her family history of breast cancer. That move by the doctor allowed the patient to reveal her story not at the door-handle.
The doctor then proceeds with examining the patient and in handing-over a plan for further investigations. Based on the exam she reassures the patient of the apparent benign nature of the
Lesion, and closes with a statement of her desire to be a partner with the patient at all stages of the investigation.
Educational opportunities
- In this specific video the patient reported on her ankle and asked a question about vaccines and was responded to appropriately.Before she got a chance to ask belatedly about her newly discovered breast lump (as demanded by the scenario) the doctor- without any prompting- exploited the opportunity of the visit to raise the issue of her family history of breast cancer. That move by the doctor allowed the patient to reveal her story not at the door-handle.
The doctor then proceeds with examining the patient and in handing-over a plan for further investigations. Based on the exam she reassures the patient of the apparent benign nature of the
Lesion, and closes with a statement of her desire to be a partner with the patient at all stages of the investigation.
