Moving onto Symptom-Based Learning!

With Christmas term over, we now begin the second term which will take us up to Easter. In this section, we are doing symptom-based learning.

As I mentioned previously, the teaching is usually done by individual systems. So we are taught about the gastrointestinal system, the cardiovascular system etc. However, now, we are being taught about particular symptoms that patients could present with. This is really helpful for marrying that content that I had mentioned earlier. For example, “chest pain” can be caused by many things. It could be caused by the respiratory tract, it could be caused by the cardiovascular system, or even caused by upper abdominal organs. Pain can be referred so even if you have a pain at your shoulder tip, it doesn’t mean your shoulder is hurting but could be an organ towards the back of your upper abdomen!

Surrounding each symptom, we are being taught all the relevant details. So with chest pain, we are learning about cardiac problems and red flag symptoms of dangerous conditions like heart attacks. Each of the red flags we learn are fundamental in our history taking when we ask patients to describe what brought them into the GP or hospital.

Southmead Hospital at night, on the way home from a night shift on the wards as a healthcare assistant.

With the system involved, we are being taught the examinations as well. So we are able to examine a patient and be able to link up what we have learnt. For example, in abdominal pain, gastric malignancy can be shown by an inflamed lymph node above your collarbone called the Virchow’s node. In lectures, we learn about how malignancy will cause the node to be a clinical feature of gastric malignancy, whereas our examinations teach us how to feel and locate this node, as well other associated symptoms we may be able to observe, palpate or percuss.

The symptom-based learning is far more interesting as the answer is not as direct as before. We still have our tutorial discussions based on cases that represent real patients. Whereas before, during say the respiratory case, we could exclude the chest pain of endocarditis because ‘we wouldn’t be taught this in this case as we are not doing cardiovascular’. However, now we have a broad scope of what the cause of the symptoms we are giving is. This is much more like real life and makes it more enjoyable in our tutorial sessions.