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Summary

This on-demand teaching session is an interactive review for medical professionals, focusing specifically on the process of standard history taking. These foundational skills are built upon with further learning on pediatric and obstetrics and gynecology history taking. The speaker will also analyze some commonly encountered case presentations to help with revision. The session will be interactive, allowing participants to ask questions within the chat for real-time responses. This workshop offers a comprehensive review, perfect for professionals wanting to refresh their skills, or students preparing for exams.
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Description

History taking part 1: This session will involve a breakdown of how to take a standard history in an ISCE station. It will also focus on more niche history taking such as paeds and obs&gynae histories. Lastly we will cover common presentations for these histories and differential diagnoses to keep in mind

Learning objectives

1. To understand and learn the standard process of medical history-taking including the importance of open-ended questions, pain assessment, and red flag questions. 2. To learn the strategies for a more detailed history taking in Pediatric and Obstetric & Gynecology settings, highlighting the additional questions and considerations. 3. To appreciate the variations in history taking depending upon the time frame such as a quick four-minute history versus a detailed seven-minute history. 4. To learn the importance of asking about the patient's ideas, concerns, and expectations (ICE) and how this affects the medical history. 5. To explore some common pediatric case presentations for study and revision, focusing on how their history might differ and the essential points to consider.
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The following transcript was generated automatically from the content and has not been checked or corrected manually.

Hi, everyone. So thanks for coming this week for our first teaching session. Um, hopefully everyone can hear me and see the slides. Just let me know if you can't. Um, you can hear and see your slides move. Just someone put in the group chat that they can see the slides and can hear. Yeah. Yeah. Um, so it was great to see so many of you at the weekend at the mo um, so, um, I'm sure for some of you we're going over one of the cases in what we go over today. Um, that's my email if anyone wants to email me after about any of this. Um, so in this session, we're just going to be going over like the standard history taking and then going into a bit more detail about, um, pediatric history taking and obs and Gyne history taking. And then, um, we'll be going through just some column presentations that I think would be good to look over for your revision as I think these things sort of, sort of things could come up. Um And yeah, like I said, if you've got any questions, just pop them in the chat um and we'll try and answer them as we go through. So just to start, I'm sure you're all um know the classic history taking that we do, but I'm just gonna go over it briefly now. Um So whenever you're taking the history, um always good to start by confirming the patient's name and date of birth, introducing yourself and explaining that you're gonna be taking a history. Um It's been good to ask some open questions about why they've come in um to find out a bit more. Um and maybe ask one or two open questions. Um And then if there's pain, it's good to go through um Socrates, so that site um onset characteristic, any like radiating pain, um any associated symptoms, um the time like the timeline of it um exacerbating and relieving symptoms and then the severity out of 10. Um And also at this point, it's really important to ask all your red flag questions. Um So like the weight loss fevers, night sweats as well. Um And this, yeah, this is in the Systems Review um as well. So depending on whether you're doing a four minute or a seven minute history, kind of varies depending on what sort of how many of these questions you're gonna be able to ask. But um if you're doing the seven minute history, then it's good to do like a full systems review. Whereas if you're doing a four minute history, it's, it's better to just get the red flags in and then you can always come back at the end if you have time. Um, I've then put the ice in next. Um, never forget. Ice Cos Cardiff are really, really keen on the ice and it often gives you quite a lot of information about what's going on. Um, so I put it in here because sometimes if you ask earlier on, you'll have a better idea of what's going on rather than asking you at the end. Um, and then being like, oh, that's what it is. Um, so, yeah, don't ever forget to ask ice. Um, and then moving on, important to ask about past medical history. Um, sometimes you do need to push the patient, uh, like if you're thinking of certain things, you might need to ask them specifically, like if they've had any, um, history of cancer, um, like that sort of thing cause they won't always tell you everything. Um, and then also you might find out more by asking what medication they're on cause if they're on certain medications you can be thinking, um, of different conditions. Um, and don't forget your over the counter medications, es especially in the Pharmacology stations. Um, that's quite important. Um, thinking about nsaids and the side effects like gi bleeds and that sort of thing. Um, and yeah, never ever forget your allergies. Um, and if somebody does have an allergy, it's really important to ask, um, what their reaction is cause you wanna know whether they have anaphylaxis or maybe something less serious like a rash. Um Once you've done that, then you can move on and ask about family history. Um So any other, just ask if there's any, if they presented with the lung problems, just ask if you've got any lung problems in the family or if you think you need to know about any um cancer history, you can ask about that. Um And then you can move on, ask about um social history. So we've made a little acronym lost. So you can ask about the living situation. That occupation is always really useful to know because sometimes uh their, their medical problem may um have an impact on their occupation. So like for example, I in some cardiac histories, they might be a lorry driver and you can't always, you might need to inform ad VLA about um certain conditions or like if they've had a stroke, for example. Um And then you need to ask about the smoking, alcohol and recreational drugs. Um just practice asking about recreational drugs. The more often you do it, the more natural it'll come across and the less awkward it will be. Um And then you can also think about mentioning travel, especially in like um l like if they've presented with lung problems, like you could be thinking about TB or like in gi history that they've got nausea and vomiting could be like a traveler's diarrhea or something like that. Um, and the other thing that I didn't put on here, but it's important to ask about is surgical history. Um, so it's really good to know if they've had any surgery, especially, um, for example, in like gi history, if they've had their appendix removed, then it's not gonna be appendicitis. Um, and it can give you clues to other things. Um, so now I'm gonna move on to a bit more of the like specialist histories. Um So the first one is the pediatric history. So I know some of you will have done your OBS and Gyne mps rotation now, but some of you might not have yet. Um But these can be a bit harder because you have to remember like additional things on top of all of those things we've already talked about. Um So with the Children, it's a really good thing to start off is finding out who they're coming in with. So most of the time Children will come in with a parent or a carer. Um And just make sure you clarify this and if, if they don't come in with anyone, just maybe find out whether their parents know they're here, um as well. And then again, just to explore the symptom that they've got, um, going back to Socrates, you can bring in your like knowledge from the other histories to do that. Um And then I've just put here like in babies. It's really, really important to ask about their feeding. Um, whether they've had a normal amount of wet nappies, they've got any fevers or like difficulty breathing. Um, so these are all like your red flags of the pediatric history. Um, and then you can do your systems review in Children. It's a lot more important to do a systems review. Um, because, uh, um, they can have a lot of their systems disrupted when they're unwell. And then, um again, it's really important to ask, I especially to the parents um find out what they're concerned about. Um As this can give you a, a bit more of a clue about how, how well they are. Um And then you do your typical past medical drug history, family history and social history. Um And we'll go through some of the like important points to ask about specifically. So once you've done your main or you can do your specific history a bit earlier on if you like in the past medical history, but with a child, it's always really important to ask about pregnancy and birth. So, um when were they born? Were they born on time? Were they premature? Um or not? Um were there any complications with the birth? Um Was it a vagina or c section delivery? Um And did the baby go to special care afterwards cause this can all give you um important clues about what may be causing their problems. Now, um if and if they're still a baby, it's important to ask whether they're being bottle or breastfed. Um You also wanna ask about their growth um and development. So you can just ask, has the mum, has the parents got any concerns about their development? Has the health visitor got any concerns about the development? Um And if it's a child under five, you can also ask to see the red book. Um and then in terms of the drug history, you also wanna add in about their vaccinations. And so you wanna find out if the child is vaccinated, um, because if they're not, they could be susceptible to more um infections. And then it's really important to do a bit more of an in depth social history with um, Children. So you wanna know who else the child is with? Um, does anyone in the household smoke? Um You and you also want to ask about um social services if there's, if they've been involved with the child's care at all. And again, it's just something you just need to practice asking in your histories, the more you practice asking it, the more like the less awkward it will become and just more natural. Um, like parents don't mind you asking if there's not been involved and if they have, then it's important to find out I was going to interject for you. So the social services is very important. It's, it's quite dependent on the presentation. Um, but if there's any evidence, like if you're taking a history on something like a child not developing correctly, not eating milestones or even like you're bruising in Children, which can be medical but sometimes, you know, have a social element. Yeah, definitely include the social services. But yeah, every case is dependent on it. But if there's any signs that it could be something like a, um, uh, an issue with the parents then, then absolutely ask it. Yeah, it's very important. Yeah. No, that's definitely been something you don't want to miss. Um And I know last year in um our, we had a patient with bruising, a child with bruising. So it was important, you asked about whether there was any concerns at home. Um OK, fine. So now we're just gonna move on to some common like pediatric presentations that um we think might come up in your s and they're good to look over before, before the exam. Um So the first one is um failure to thrive. This is quite a common pediatric history and if you've been on peds or you're going on peds, you're likely to um um sea sea failure to thrive. Um So you can kind of split it into um gi causes and non gi causes. Um So with um the gi causes, you wanna be thinking about celiac disease um like dairy or lactose intolerance, you can also be thinking about pyloric stenosis in younger Children. Um IBD um which we had last year and um also gon esophagitis. Um and then in terms of the non gi um presentations, um like we've mentioned, you wanna be thinking about that, I wanna make sure to rule that out also be thinking about eating disorder and mental health conditions in Children. Um And then um it could be any, any sort of chronic illness really um that could be causing it. Um So it's always good to do a good systems review. Um Like po could also be like cystic fibrosis or something like that. Um So important to, to not miss these things. Um And then like I've mentioned, um which we had in our exam was is childhood bruising. So there's quite a lot of different causes for bruising in Children. Um So it's important to try and make your differentials as you're going through. So, um don't miss um your Children um with abuse or ne neglect. It can also be cancer and leukemias, um ITP or HSP um which is where you get like the bruising on the legs. Um and like the low platelets and ITP. Um And then also don't forget a meningoc call septicemia, this can present um and look like bruises on the child. So it's important to ask your red flags here um about whether they've got fever um and been generally unwell as well. Um And then moving on to another common area which is like developmental delay. Um So I think that would be quite mean for them to ask you to do like a developmental history. Um But it is important to just have, have a look over the different um milestones. Um and thinking about what could be causing it, causing things like this um in Children. Um And then lastly, which is also quite important, I think it's quite a big topic and could come up uh in a child and your ski is mental health and like behavioral issues. So I put specifically here like AD HD and autism um as well. Um as this, um these are seem to be um presenting more often, especially in the GP um at the moment. So it's good to have an idea of how these are um diagnosed and what sort of things you wanna be asking about. Um And yeah, also just other mental health issues. Um like eating disorders and depression. I was looking to add an extra detail for the AD HD um diagnosis, especially in GP. We see a lot of parents and patients coming in querying. Do they have ADHD? And the really important questions to ask in those histories is, is the behavior consistent. So what they'll be testing if they give you a station like that is, have you distinguished that the behavior happens? Not only where the parents say it is happening, but also is it happening in school? Is it happening elsewhere? Because if it's only happening when they're at home with mum and dad, but yet they're not getting in trouble at school, they're not getting kicked out of classes. They, you know, the teachers haven't mentioned anything. It makes the diagnosis very unlikely and that's how we actually kind of refer people in GP based off those details alone. Um, so, yeah, if you include that in your history, it makes you look really good. Yeah. Yeah. No, definitely. And I think it is becoming a lot more common in um becoming a lot more common in like GP practice at the moment. So I think it's definitely a good thing to be looking over um for your revision. Um So that's the end of the pediatric section. So if anyone's got any questions about the PS history or the like just general history, then pop them in the chat. Um Yeah, someone's asked if it's been recorded. Yeah, it will be recorded and you can watch it um afterwards and see the slides. If you not got any questions, we'll move on and then feel free to ask them throughout or at the end. Um So moving on now to the obstetric history. Um So I remember finding this one really hard because it's quite different from your normal history um that you're normally doing so with the Ors RIC history. The first thing to do is find out um the Gravida and parity of the um mother. So you want to um you want to find out like how many pregnancy they've already had, um, including any terminations or, um, like still births. And then also find out, um, how many times they've given birth. So it's slightly different. So it's good to just look over those two different, um, terms and then you find out what's going on with them at the moment. You wanna find out how many weeks pregnant they are right at the beginning of your um history. Um as um this can give you help you differentiate your differentials down. Um And then um you can do your, your find out a bit more about the symptoms and do your systems review before moving on to a bit more of an obstetric and gyne history. Um We will be talking about the Gyne history a bit more detail after this and you kind of need to be asking both in the obstetric history. Um But I put here the four ps that you need to be thinking about. So have they got any abdominal pain or pain anywhere else? Have they got any discharge from down below? If so, is it, is it like fluid? Could it be that the water's breaking or is it um like an infection? Um that sort of thing? You also wanna find out if they've got any bleeding cause if this is early on, this could be like a miscarriage um or later on, you could be thinking about um like placental abruption, um uh percent previa. And then I put preeclampsia as ap as well because this is a really important thing to rule out in your history. Even if it doesn't sound like preeclampsia. It's really good to ask the questions to make, to make it obvious to the examiner that you've been thinking about preeclampsia. So the key symptoms of preeclampsia is abdominal pain, headaches, um and visual disturbances. So make sure you ask all of those. Um And then I put a um in bold here, fetal movements. So don't forget to ask about the fetal movements. Um And I always found this one really hard to remember because it's not like any of your other symptoms. Um It's not like any of the other symptoms in your normal history, but it can be really, really important to pick this up in the history. Um And then again, you can ask about ice and find out what they're worried about if the woman's been pregnant before, she might be able to um she might have had similar symptoms and might be able to give you a bit of insight into that. Um And then when you're finding about out about her current pregnancy, you wanna um ask a bit more information. So you wanna find out about um any problems on the scans. So I think usually um if it's a normal pregnancy, like a single pregnancy, they normally have 22 scans. So you can just ask how many scans they had and if they've had a lot more, you want to be finding out why they've had extra scans, um, you also want to find out if they've got um, like twins um or like multiple pregnancies. Um It's also really important to find out the rhesus status. Um And it can be really helpful to ask about whether it's um, midwife lead or obstetric lead. Um As if it's midwife lead, it's usually a bit more, um, like, just not as, um, complex. So that can be quite useful to know about. Um, you wanna know if they've had any problems so far. So for example, if the morning sickness or if they've got ge gestational diabetes, so it's important to have all of these things in the back of your mind as you're doing the history. Um, and then, yeah, like, um, ca said in the, um, chat, it's important to find out about any other pregnancies that, um, they've had. So for example, miscarriages, ectopics or terminations, um, this can be really sensitive, um, for, for the parents. So just make sure you warn them, um, before you give them a little warning shot, um, before you ask about it, um, but it is really important, you find it out and if they have had other pregnancies, um, that have gone to term to find out if there was any other complications and if they had a normal vaginal deliveries or c section as if you've had, um, in a couple of c sections, you can't have a vaginal delivery. So it's important to find that out. Um And then again, just find out the general past medical history, um, drug history, family history, social history as well. Um Yeah, and then it's good if you can just practice how you're gonna present these patients because often you found out a lot of information in the history. So it's good to just practice um saying how old they are, how many weeks pregnant they are. Um They're gravida and parity. Um And like with this being her 1st, 2nd or third pregnancy and what they pre presented with um as that just sounds, it's a lot more slick at the end when you're presenting to the examiner. Um So moving on now to like the common obstetric presentations and the sort of questions you wanna be asking in these um presentations. Um So it's good to be um it's good to start with um like work your way through the pregnancy. So if it's a pregnancy at the beginning and you wanna be thinking about like ectopic pregnancies and miscarriages, um So these often present with um PV, bleeding um and pain. So it's important to find out about this. Um And then as you move throughout the pregnancy, um there's other like other conditions that may present. Um So fetal movements usually felt around 20 to 24 weeks, I think So after that, you should, you should be asking about that and finding out um if they are, if they're usual and if the, if there are fetal movements, just find out whether this is usual for the mum as well, that's really important. Um And there's lots of different causes that could be causing reduced fetal movements. So it's good to look over the different things that could be causing it to like infection. Um And like obstetric um cholestasis, these can all cause reduced cholest, um fetal movements. So it's good to look over these. Um And then in terms of placental abruption and placenta Praevia, it's good to be able to differentiate between these. So, placental abruption, there'll be um PV, bleeding with painful, like painful tummy. Whereas placenta Praevia is usually painless PV bleeding. Um And then like I've already mentioned preeclampsia, um headaches, um vision disturbances, abdo pain and leg swelling. Um And then you can also have chorioamnio. So this is like an infection of the um fluid, the amniotic fluid. Um it's really important to pick this up. So um look for any signs of infection in the mother. So like fever or foul smelling discharge. Um There is other presentations as well. It's not just confined to this list, but these are just some common things that have a good, good history that you'd be able to take. Um And even when you're taking the history, it's really important that you're trying to rule these, these different things in and out. So, asking questions that rule these in and out make you look really good to the examiner. Um So just have some key symptoms that you want to be asking about in your obstetric histories. Um And yeah, we had no obstetric stations last year um or the year before. So I do think it could definitely be something that um could come up in your year. Um So yeah, definitely look over your obstetric presentations. Um So that's the end of the obstetric sec section. If anyone has any questions, just pop them on the chat or we will move on to the Gynae next. Yeah, you can also just have a UTI in pregnancy. Um That's quite, um that could definitely come up as you would treat it. Um Knowing the antibiotics you can use in pregnancy. It's quite important. Um I was going to uh at least kind of say something which I noticed from the um uh the mock is that we ran over the weekend. Um Is when you're taking most of these histories where it's something like it's like a Gyne presentation or Abdo history for female or something along those lines, you always have to cover all of these ones and your diagnoses can always switch midway through. So you may go in thinking it's something like gyne relate and then it turns out it's, as you've said, like a uti in a pregnant woman, they can try and throw you off and give you woman who's pregnant and then you go down the route of thinking abdo pain. It must be placenta previa or placental abruption or something. And they do that to throw you off. And in reality it's actually, you know, a simple uti or the woman has appendicitis. So it's not out of the question and they could do that to challenge you guys on the day, which I think would be fair. Yeah, definitely. Don't forget the non, the non obstetric causes and non gyne causes of all these different symptoms. Um Yeah, I definitely think that could be something they throw in there right next, we're gonna move on to the Gyne history. Um So this kind of overlaps with the obstetric history. If you're ask if you're asking the obstetric history, it's important to also ask the Gyne history. Obviously, you don't need to ask the some of the obstetric stuff in the Gyne histories, but they do overlap. Um So again, just out of your, your system, like you're exploring your symptoms, relevant systems review. Um Like you said, it could be something not Gyn related um as well. And then the three ps are the pain, the PV discharge and the PV, bleeding. Um And then it's important to ask about pregnancy history and like the terminations um as well. Um And find out if, if they haven't had any pregnancies, if that was true. Choice or if, um, they, they're infertile at all. Um, because this can be, um, often a sign in, um, endometriosis. It's good to find out about whether they've been trying for a baby at all. Um, and then, um, a really important part to ask about is the menstrual history. Um, so when they started their periods, um, like how regular their periods are, um, how heavy the periods are. So that's menorrhagia, they've got painful periods, that's dysmenorrhea. Um And then if they're a bit older, it's important to ask about menopause when their last period was, um, as well. And it can also still be useful to find out if they're regular, um, as well. Um And then again, a bit of an obstetric history that I've already mentioned if they've got any Children, if they've had Children, like, how were they born with it? C section of vaginal delivery is this, um, can lead you towards some di diagnosis. So, like prolapse, um, may be more common if you've had a vaginal delivery. Um And then it's also really important to ask about, um, your sexual history. Um, so are they sexually active? Um, if they are, are they using contraception? Um, is there any chance they could be pregnant if they're a woman? Um I've also put here, it's important to find out whether their partner is male or female, don't assume, um, because this can just make it awkward. Um And if they're in a same sex relationship, there's less chance that they're gonna be pregnant. Um So, yeah, make sure you ask about that. Um And it's also important to ask about any pain um, during sex. Again, this can be a symptom of endometriosis. Um And then, like I said, asking if they're on contraception also finding out what contraception they're on. So, is it hormonal, is it barrier as this can lead you, um, if they're on hormonal, then they're not protected from S TI S. So you wanna know if they're using any barrier protection at all? Um, and then you wanna ask about HRT, if you, if you've got an older, um, woman, um, and find out what HRT they're on again with the HRT. It's important to ask about, um, surgical history if they've had any hysterectomies, um, at all. Um, and then it's really important to ask about their cervical smear history, um, if they've had that done and then just your general history, medications, medical history, family history, it's really important, family history and the Gyne history to find out about any Gyne cancers that run in the family, um, as well. And then, yeah, the social history as well. If they've got any stress, um, at all as this can impact your periods, um, and like exercise and diet as well. And then finally, um, the ice again, if you wanna bring that, bring this in a bit earlier on, it can be good to find it out what their, their ideas, concerns and expectations are a bit earlier. Um Sorry, Ruth, can I sorry to keep you off your flow? Just wanted to say something that helped me. Um I'm quite proud of it myself. I II thought of it myself. So um the way to remember one that I used to think of stuff is like one said and, and like you said as well, you always need to mention obstetrics G stuff. They kind of cross over if you're doing obstetrics. A ask about G stuff. If you're doing Gynae, ask for obstetric stuff. The way I used to remember it was think of the four Bs. So for if you're doing the Gyne history, so blood brush babies and bond. So blood refers to periods. So ask about periods, ask about menopause. Are they still having periods? Are they, have they gone through menopause, blah, blah, blah, that's blood brush. It's a little bit uh I don't know a bit of a stretch, but I had to try and get it to start with a B. So brush refers to smear tests. So um uh I expect um maybe some of you guys have seen a smear test being done, but it's a, it's a they brush the cervix essentially to send off. So brush refers to smears. So ask about smears babies. Obviously, that's your obstetrics history. Ask about how many babies any complications and then bond. Is your sexual history. So ask if they are sexually active, um, any STIs or whatever also never assume someone's sexuality as well. I that I wouldn't put it past card, maybe put something like that in. Um So that's blood brush babies and bond. So blood for periods, brush for smears babies for obstetrics and bond for your sexual history as well. Sorry, I'll um I'll, I'll be quiet now. So, thanks Kath. That's really useful. Um So, yeah, I think that's all of the Gyne history. So we'll just move on to some common gyne presentations now. Um I've already mentioned some of them. Um So, like I said, endometriosis, we want to be thinking about abdominal pain, um pain during um sexual intercourse, um heavy periods, very painful periods and often um they're subfertile. So having problems conceiving. Um and then moving on, there's also P ID. I think this came up last year. Um So important to ask about um any discharge, if they're sexually active, any chance of any S ti s um as this can um can cause P ID. Um Also it could be an ovarian cyst or torsion, I think probably less likely but could definitely come up with severe pain um on the ovarian torsion um and then endometrial cancer. So this is your postmenopausal bleeding. Um This is like a key feature of it. So, if they've got postmenopausal bleeding, you're gonna be referring them straight away. Um Just to rule it out um it also be fibroids and ectropion causing um the bleeding um in at any age, but um often fibroids a bit more common as you get older, I think. Um And then PC OSI think this is something that could definitely come up as well. Um So this is um characterized by like um either dark hair growth or like acne and, you know, you would also have like irregular or absent periods. Um And then the last thing you can do is get ultrasound scan to show like cysts on ovaries. Um So it's like if you have two out of three of these um sort of, so the dark hair and a hair growth and acne um comes under like one category and then like irregular absent periods is another category. And then the cysts on the ovaries is the third category. And if you have two out of three of these things, then you can be diagnosed with PCOS. Um So it can be a clinical diagnosis. Um And yeah, last year we had P ID and um the urinary incontinence which um we did for some of you at the Mochis ski at the weekend. Um So hopefully that's giving you a bit of an idea of the sort of things that you need to ask. Um And yeah, I think the really important thing here is definitely the ice, like a big thing in the urinary incontinence. One was the impact it was having on their life. Um And that's what they really wanted you to get out of it as well as obviously getting the diagnosis and knowing how to manage it. Um So yeah, that's the end of um this week's um teaching next week we've got explaining um contraception and H RT that me and Kath are doing. Um we've put a few videos here um on the menstrual cycle if you wanna have a watch of those before. Totally optional might just give you a bit more of a, of a help when we're going through it next week. Um But yeah, if you have any questions, pop them in the chart now or if you want to put in the chart, if you wanna ask any questions, we can um put you on the speaker. Yeah, hopefully that was helpful for you. Any questions can be on anything if, if not all Peds and Gyne as well, I'll put the um Yeah, thank you for putting up. Do you have anything to add? Sorry, I was gonna say thank you for putting those, those links up and I'll ask, I might send them over to send in the email as well. Yeah, yeah, but just to let you guys know, um it's absolutely not um compulsory this, these you're doing this in your own time. So it is literally just um a few background information just to help with the contraceptive. So you can understand it a little bit better. Um But yeah, if you want to watch them, great. If you don't, that's also fine. They're not like you don't have to watch them. Um Cool. Thanks, Ruth. Any problems? Thanks, Ruth. I was gonna say no, it was really good, really kind of succinct. And uh um yeah. No, it is very good. And I think they all all find that very useful. Great. Well, yeah, if you've got any questions, we'll hang around for a little bit. Um And before you go, if you could fill in the feedback, that would be really great, everyone. Thank you. Thanks for coming. Um So the question in the chat about um the written feedback from the mocks, um I think you do get some written feedback. Um It depends on your examiner, but there was a section for examiners to write, to give written feedback, but there was also mark schemes which involved um kind of marking in terms of, did you ask certain um aspects of the history that we'd want you to be asking? So, um I'll say that you will get your feedback form and it might, they'll definitely have filled out kind of where you ask certain things where you didn't, but they might have just given you the verbal feedback and that's what they've got for like the written feedback. But then it might, it depends on your examiner. Yeah, it definitely depends. I also, I mean, I seem to remember them not being very chaotic when I did it. And like some examiners just didn't give any feedback and then some people didn't get their feedback. Um But yeah, I think you'll know from it yourself, kind of what you did well, and what you you missed and like you go around in pairs. So I think like the your like partner also gives you feedback so that can be really useful. Um But yeah, you should definitely get some feedback that is written. Hopefully. Will there be other online mocks from us? Yes. So there is going to be one more mock isn't there at the end of our teaching series? Um Yes. Yeah. Um So that one, I, you know, I'd say the teacher sessions we've got going on will be covering a lot of stuff which um will really think is just pertinent to the, but that one will be uh it will try to be as accurate a reflection of the kind of stations that you'll get on the day. Um So yeah, that'll be in um April, I think. Yeah, I think it's April time. Yeah, I'll have to check my calendar but I believe it's April, I think. Ok. Well, I think that's it. So if there's any further people can email us, if there's any further questions that they have in general or about the teaching, you will have our email address. So you can always drop us an email and we'll get back to you as soon as we can. Um, but yeah, that was really good, Ruth and, um, hopefully we'll see some of you all next week as well for the next session, which, um, is s teaching one. and I think that one would be a really good one as well. So definitely it will lead on from this one really nicely. So, yeah. All right. That's fine. Right. We'll end it there. Thanks everyone. Bye bye bye.