>> So again Mrs. Jones, I'm Dr. Glaser. Sorry you have to be here today. Tell me about about this episode that brought you in today. >> Well I'm having some chest pain right here, and some shortness of breath. >> Gotcha. Have you ever had this shortness of breath before? >> No. >> Okay. Are you having any cough or fever? >> No. >> Do you have any allergies to medications? >> penicillin. >> Do you have any family history of allergies or asthma? >> I don't think so. >> Have you ever had surgery before? >> A Caesarian. >> Okay. Did you take medications for this episode? >> I took some Tylenol. >> Do you normally take medications at home? No. >> Okay. Let's see, what else. So you've never had an episode like this before? >> No. >> How long did it last? >> I still have it. >> Okay. All right. And did you take medications for this episode? >> I told you I took Tylenol. >> Okay, that's right. So have you ever been hospitalized for something like this before? >> No, I never had this before. >> Oh, gotcha. do, do you have a regular doctor in town? >> Sometimes I go see one. >> Okay, but never for something like this? >> No. >> All right, because you said you never had something like this before. >> Mm-hm. >> Okay let's see. Any new medications that you're taking? >> No. >> Okay. >> Boy, that was pretty bad. >> There it was. Yes, I would have been frustrated if I was that patient. >> Yeah, I think she was. Yeah. So if I remember correctly the patient was there with chest pain and shortness of breath. >> Mm-hm. >> And he just couldn't take a history. >> No. >> So he's not even at a reporter level, basically. >> Yeah, yeah. >> And, and I felt like he, you know, he didn't have a sense of kind of a driving differential of what questions he was asking around. He seemed rather focused on medications, and I'm not really sure why. >> Yes. >> If whether or not there was something in the history that would have alerted him to that earlier, that there was a problem with medications. But I felt like he wasn't, he wasn't listening, he wasn't even able to report back to her what she said, and then really couldn't interpret at all about what the, where he was going with what the differential was. >> Absolutely. You could even talk to him a little bit about his professionalism in this case. Remember RIME is still the structure for talking about professionalism, because I think he wasn't really respecting the patient by asking her in a very disorganised manner, I think she probably felt not listened to, not heard. >> Mm-hm. >> And so that's, I think, professionalism issues as well. >> Hm. >> All right Jenny. So if you had to give him some feedback, what would you do? So if you're kind of thinking about it and preparing, I mean you'd of course, you'd ask him kind of what he thought. And he would say, because he's pretty clueless, oh, I thought it went fine. >> Mm-hm. Right. Then, then how would you [INAUDIBLE]? So I think, again, when you're giving feedback, so you don't want to prep them for something bad coming. So I think I would say, I'm a little concerned with you, kind of what I saw in the room. You know, what do you think went well? What do you think didn't go well? >> Mm-hm. >> And hopefully, he'll be able to have some insight. >> Mm-hm. >> And I think this also goes back to a little bit about our orientation module that we had. So again, he, we don't even feel he's at a basic reporter level. >> Mm-hm. >> So for somebody like that, what I might do is prime him a little bit. So he's going in the room to look at a shortness of breath chest pain case. >> Mm-hm. >> So I might talk to him a little bit about, okay. What are important history questions you want to ask in this case? >> Mm-hm. >> What is going to be really important that you can't forget in the physical exam? So, get this reporter a little bit ready to be able to do some reporting. >> Mm-hm. >> So he can get some confidence and be able to do that in an organized fashion. >> Mm-hm. >> I think that right now I don't know if he just, just didn't have the medical knowledge to know what to ask. >> Mm-hm. >> Or, if he just got frustrated, or, or, if he's thinking about what he's going to do when he gets off his shift. >> Yeah. >> And so I, I don't know where he's at right now. >> Yeah. But certainly, a failure at probably both reporting [INAUDIBLE] when it was reported out. And as well as interpreting what's going on with that. >> Absolutely. >> Good, thanks. >> Mm-hm.