By Charles Warlow, The University of Edinburgh
From The Clinical TeacherVolume 2 Page 111 - December 2005
Curtain rises on an outpatient clinic, two 4th year students are sitting rather tensely with the professor who is in shirt sleeves, and a patient
Professor (seeing a patient who has had a stroke some years ago and now complains of brief attacks in which the affected arm stiffens and rises in the air out of his control): What do you think is going on here?
Student (nervous, almost terrified): is it, er…a …stroke?
Professor (astonished): during a stroke do you think the arm goes up in the air or flops to the side? What do you think happens in an epileptic attack?
Student: um………
An hour or so later…………
Professor (after seeing a man with tricky epilepsy, and hoping to strike one of those vertical themes): do you know the difference between compliance, adherence and concordance?
Student (visibly cheering up): oh yes, concordance is when you and the patient agree together with a course of action…
Professor smiling as lights fade, curtain.
I am frustrated; the students seem to know so very little about neurology and how to sort out what is wrong with patients and yet they know so much about how to be nice to them. What on earth has gone wrong?
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