Feeling overwhelmed with clinical skills and what to read

[Yozer34]

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So I've recently started my clinical rotations (here in Ireland we start 3rd year, second semester) And I'm having a lot of difficulties with history taking. I have sound basic science knowledge and I know most of the diseases in terms of pathology but when it comes to asking the right questions and extrapolating certain aspects of the patient's presenting complaint I just can't think of the differential.
Our school recommends Talley and O'connor - and I've read a few sections of it before - but the info evaporated from my memory. Other than the fact that the book is incredibly detailed and at this point it's simply a memorization exercise for me to remember the specific things to inquire about for a certain presenting complaint.
Having said that, I did buy Oxford Handbook of Clinical Examination and Practical Skills and I liked it a lot, but it seems it's not good or detailed enough for my school. For example, we've been taught in class the assessment of tracheal tug and the book doesn't even mention it.

Would it make sense for me to repeatedly read Talley and O'connor until I can at least remember half the details or should I just opt for the basics, such as those in the Oxford book?
Any suggestions ?- this is extremely frustrating! Add to it that every resource differs slightly in the organization of the history and exam, so there's no chance of remembering the next question to ask when you're consulting 2 or more resources simultaneously.

 

[Psai]

It's a gradual process. Eventually you figure out what's important for each disease process and tailor your history eventually.

For example, in heart failure a student may forget to ask whether a patient uses extra pillows when they sleep or their exercise tolerance. This information gives you an idea of their baseline symptomatology and the nyha classification but you wouldn't really be thinking about that as a clerkship student when you're busy trying to remember to wash your hands or ask about smoking history or whatever you're taught to do.

Basically just try to see as many patients as you can and get detailed feedback. Also look back at the attending notes or consultant notes and see what they thought were important so you can remember to get that information next time.

 

[sliceofbread136]

I find it helps to think through their problem list and looking up differentials for each of those problems so you at least have some structure to your thinking and questions when you are first starting out.