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Scenario #2 - Harold Hasty
Harold: I have a patient that is coming in today with
a headache. I have not seen the patient yet but it is probably a migraine.
I plan to
use Imitrex. Is that O.K. with you?
Dealing with Harold
- Although Harold seems like a caricature, the resident on whom Harold
is based works "fast" in the clinic, and the check-outs are
commonly brief and pointed.
- In certain instances, such as the third year
graduating resident, a checkout this brief may at times be appropriate,
as long as the resident
has seen the
patient already. However, too often, residents have a pattern of making
a hasty conclusion without gathering enough evidence or considering
other possibilities.
- Probing for supporting evidence can help the preceptor evaluate the
diagnostic aptitude of the resident using phrases such as "Now that you have already
seen the patient (presuming that Harold did go back and see the patient!) tell
me what features you found that are consistent with this headache being a migraine
type" or "Tell me what other treatments you considered using
for this patient."
    
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