Catherine's Asthma

Catherine’s Asthma Case introduces a 52-year-old woman with a persistent cough as the student’s last patient of the day. The main learning objectives are to take a focused history and identify risk factors and clinical features that increases probability of asthma diagnosis; to develop a broad differential diagnosis of wheeze / cough. (Not all that wheezes is asthma); to become familiar with management of asthma, different medication delivery methods, and other management options; to be comfortable assessing asthma control in follow-up; and to be aware of inhaled glucocorticoid side effects. There is more information about our learning objectives and the project's aims here on the Canadian Health Education Commons (CHEC).The EMR's used in our case include MedAccess and Netcare. This case is designed to make the student consider clinical time management in their decision-making. The student is given 15 minutes to make all of their decisions for the initial visit, including history and patient chart review, a physical exam, an initial diagnosis, initial management and patient education. This visit is followed up 2 months later, and the student is asked whether the symptoms have been controlled. This decision can lead to two separate outcomes for the patient. There is also bonus content for this case, with further management several months later. The learner is encouraged to investigate, explore, ask questions, and make rapid decisions based on realistic clinical encounters with the patient. The learner will be required to engage general principles of history taking, consider principles of reflective practice, see how their assessment may impact a patient’s health following the visit, and consider some of the fears or misconceptions around steroid use. This case was developed as part of the SharcBAIT Project