쉐도잉 연습: Urinary Incontinence History | Lower Urinary Tract Symptoms | OSCE Guide | UKMLA | CPSA | PLAB 2 - 영상으로 영어 말하기 배우기
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180 문장
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1
Hello my name is Jade, I'm one of the doctors.
2
Can I just check your name and date of birth please?
3
Yeah it's Samantha Harris and it's the 7th of April 1960.
4
Okay lovely and what brings you in today?
5
Um, yeah, it's been embarrassing.
6
Um, I've been having small accidents.
7
Okay.
8
Could you tell me a bit more about what you mean by that?
9
Um, well, it's just like, I have to wear, you know, pads everywhere I go.
10
And I really need to know, you know, where the nearest Lou is just in case.
11
Okay, yeah.
12
And these accidents, does it tend to be urine or bowels?
13
Yeah, just like going for a wee, yeah.
14
Okay, and how long has this been going on for?
15
So, I'd say two months now.
16
Okay, yeah.
17
Did it seem to come on all of a sudden or is this something that's been gradually getting worse?
18
Yeah, it has gradually been getting worse.
19
It would happen maybe once every other day, but now it's like two to three times every day.
20
Okay, yeah, seems like quite difficult to manage.
21
Very distressing, yeah.
22
Could you tell me a bit more about how it feels when you have these accidents?
23
Okay, so I'll just like have a sudden urge, you know, to go for a wee and stuff.
24
And when I get that urge, it's then when I know there's like a small amount of leakage onto the pad.
25
So the accidents tended to be kind of small amounts as well.
26
and do you have any trouble passing urine when you're trying to go to the toilet?
27
No no that's that's all fine thanks yeah
28
and does it feel like you're emptying your bladder fully when you do pass urine?
29
Yeah yeah yeah yeah and these accidents do they seem to be random or have you noticed any triggers?
30
Just sort of like it'll just come out of nowhere like
31
that sudden edge yeah yeah so sometimes people might notice their accents
32
when they're sneezing or laughing is
33
that something that's ever happened to you yeah actually now you mentioned it's sort of like occasionally you know
34
if I laugh or like yeah I have a virus
35
and a cough or something and yeah particularly
36
if my blood is full at
37
that time I will definitely have yeah okay some leakage yeah okay fine
38
and have you noticed any pain or stinging
39
when you're passing you no no okay um or any blood no no
40
or any change in the color of your urine
41
no not at all okay and then can i just ask a bit about your gynecological history as well
42
Have you ever had any previous gynae surgery?
43
No, I mean, I've given birth, but nothing complicated at all, no. Yeah, okay.
44
So how many times have you given birth?
45
So I have four children.
46
And when was the last time you were pregnant?
47
So, yeah, my youngest, so it's 32 years ago.
48
In terms of your previous deliveries, were they vaginal deliveries?
49
Yeah, no complications.
50
Did you need any instruments at all?
51
No, I was very lucky.
52
No, good and no tears or anything like that?
53
No, not at all.
54
And when was the last time you had a period?
55
Okay, so yeah, so that would have been 12 years ago.
56
Okay, yeah.
57
So went through the menopause about 12 years ago.
58
Having any menopausal symptoms since then?
59
No, I mean, I've had nothing recently and you know, I might have previously had some hot flushes, but it's all been very, very simple.
60
Okay, very lucky again.
61
Yeah, good.
62
And have you noticed any further vaginal bleeding since you went through the menopause?
63
Not at all, just 12 years ago was the last kind of bleed really.
64
Okay great and then just thinking on a day -to -day basis how much fluid would you tend to drink?
65
I've always been you know really good at drinking water
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so I'll drink about two litres each day yeah I always have done.
67
Okay so that's not changed compared to normal.
68
No, fine.
69
And do you drink much caffeine at all?
70
Well, I did have a look on the internet and it did say that caffeine could irritate the bladder.
71
So I would have a morning coffee, but I've stopped that.
72
And I just have maybe two or three cups of tea a day, so not much at all.
73
And cutting out the coffee, has that helped your symptoms at all?
74
No, because they're just happening more regularly.
75
Okay, enough.
76
And then just to double check, how often do you open your bowels typically?
77
Just like every day, I've never had, yeah, still the same, never had a problem.
78
Yeah, and have you noticed any changes to your weight at all?
79
No. Or any bloating in your abdomen?
80
No. No?
81
Okay, any fevers or anything?
82
No. No. Okay, lovely.
83
And I guess probably one of the most important things is how has this been affecting you sort of day to day?
84
I mean it is getting me down a bit.
85
I've just found it very, very distressing.
86
It's like it's really not my confidence and self -esteem.
87
So I just find it so embarrassing
88
so I mean I'm going out far less I mean I will go to work but
89
yeah and I find it work very stressful you know just really scared I'll have like a major accident
90
so yeah it's really affecting yeah
91
it seems like it's sort of dictating what you do with your day it is yeah yeah yeah and
92
so you mentioned you've sort of had a read on the internet is there anything in particular
93
you thought might be going on?
94
I mean I have no idea
95
if I'm absolutely honest what's causing it I was just guessing it might have something to do with having had children.
96
Yeah and is there anything about it that's been really worrying you?
97
I'm really worried um you know the accidents are becoming more regular
98
and more I'm worried
99
that it's going to continue to get worse I mean
100
it's a struggle at the moment to leave the house you just think people can smell you
101
so goodness if it just gets worse I dread to think I'll not go out
102
and is there anything in particular you were hoping
103
that we'd be able to do to help you today yeah just hoping
104
you could help reduce the number of accidents I don't a tablet or something.
105
Okay next I'll be asking a little bit more about your background history
106
but just before we move on I'll just kind of summarise back to you what we've talked about
107
so far so that you can correct me or add anything in if it's okay.
108
So you've come in today
109
because over the past couple of months you've been having some accidents where you're incontinent of urine
110
and these have been gradually getting worse
111
so now you're needing to wear pads all the time
112
and are experiencing these accidents two to three times a day
113
which is obviously very distressing for you and
114
when it happens you tend to feel a sudden urge to need to pass urine
115
and that's when the accidents occur they've also been occasionally triggered by things like coughing
116
if you've got a bit of a bug or
117
when you're laughing as well
118
but you've not had any problems in passing urine emptying your bladder you've not noticed any pain
119
or stinging in blood in the urine either
120
and you've had four children previously all by vaginal delivery
121
and there weren't any complications and you've not had any significant gynecological problems in the past
122
You've been drinking the same amount of fluid as you've usually done, but you have cut back on caffeine to see if that would help.
123
But it's not made much difference so far.
124
Does that all sound about right?
125
That's perfectly right, thank you.
126
Do you have any other medical problems at all?
127
Yeah, I've got high blood pressure and high cholesterol.
128
OK.
129
And ever been admitted to hospital before?
130
No. Or any surgeries?
131
No. Lovely.
132
And so do you take regular medications?
133
Yeah, for a long time now.
134
So like Simvastatin, Ramipril and Lodipine.
135
Yes, I'm on those.
136
Okay, those are the main things.
137
And anything over the counter?
138
No, no. Lovely.
139
And are you allergic to any medications?
140
No, not at all.
141
No. Great.
142
And is there anything that runs in the family? or?
143
Yeah so my mum, she died of breast cancer, I mean she was 82.
144
Actually my dad, he died of prostate cancer.
145
Yeah, but I mean he was 90 so.
146
I'm sorry.
147
Thank you.
148
And just a bit about your lifestyle as well.
149
So do you live with anyone at home?
150
I live with my partner.
151
And you mentioned you're working.
152
Yeah, so I'm a receptionist at the local primary school.
153
Okay, lovely.
154
And then just a few questions we ask everyone.
155
So do you smoke at all?
156
Never, never smoked, no. Any alcohol?
157
Rarely, I mean maybe a special occasion I'll have a glass of wine but very very.
158
So on a weekly basis?
159
No, no, no. Okay and then have you ever tried any recreational drugs?
160
No, never.
161
Okay I think that's all the questions I've got to ask.
162
Thank you very much for speaking to me today, Saman.
163
Thank you.
164
Today I spoke with Samantha Harris, a 64 year old lady presenting with urinary incontinence.
165
Samantha describes progressively worsening urinary incontinence over the past two months.
166
She experiences a sudden urge to go to the toilet two to three times a day
167
which often results in a small amount of leakage before she's able to reach the toilet.
168
She also occasionally experiences leakage when coughing or laughing.
169
This has been very distressing for Samantha and has significantly affected her confidence.
170
Samantha has a past medical history of hypertension and high cholesterol for which she takes simvastatin, ramipril and amlodipine.
171
She has four children all born via vaginal deliveries with no complications.
172
She has no known allergies.
173
Samantha works as a receptionist at the local primary school.
174
She does not smoke and rarely drinks alcohol.
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Samantha is concerned that her symptoms will continue to worsen and this will affect her quality of life further.
176
The most likely diagnosis is mixed urinary incontinence with predominant urge incontinence and occasional stress incontinence.
177
To complete my assessment I would perform an abdominal and pelvic examination in addition to urinalysis.
178
I would refer Samantha to the continence service for further evaluation and bladder training.
179
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180
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이 레슨의 어휘와 말하기 포인트
이 말하기 레슨은 영상 “Urinary Incontinence History”을(를) 바탕으로 합니다. 가장 자주 반복되는 단어는 다음과 같습니다: accident, Samantha, urine. 이 영상에는 섀도잉할 문장 180개와 단어 1804개가 있습니다. 말하는 구간의 길이는 12:23입니다. 화자는 분당 약 146단어의 일정한 속도로 말해서 섀도잉하기에 편한 속도입니다. 단어의 83%가 영어에서 가장 많이 쓰이는 3,000단어에 속합니다. 나머지는 연습 전에 미리 확인해 두세요. 전체 180문장 중 44문장이 질문이어서 의문문 억양과 짧은 대답을 연습하기에 좋습니다.
이 영상의 핵심 어휘
영상에 나오는 익혀 둘 만한 단어 15개를 발음, 뜻과 함께 정리했습니다.
| 단어 | 발음 | 뜻 |
|---|---|---|
| urine 명사 | /ˈjʊɹɪn/ | 오줌, 소변 |
| sudden 형용사 | /ˈsʌd.ən/ | 급격한 |
| bladder 명사 | /ˈblædɚ/ | 부레 |
| occasionally 부사 | /əˈkeɪʒənəli/ | 가끔 |
| gradually 부사 | /ˈɡɹæd͡ʒuəli/ | 점점, 점차 |
| caffeine 명사 | /ˈkæfiːn/ | 카페인 |
| symptom 명사 | /ˈsɪm(p)təm/ | 증상, 증후 |
| trigger 명사 | /ˈtɹɪɡɚ/ | 방아쇠 |
| fluid 명사 | /ˈflu.ɪd/ | 유체, 유동체 |
| sting 동사 | /ˈstɪŋ/ | 물다, 찌르다 |
| bleed 동사 | /ˈbliːd/ | 피를 흘리다 |
| cholesterol 명사 | /kəˈlɛstəɹɒl/ | 콜레스테롤, 콜레스테린 |
| bowel 명사 | /ˈbaʊ.əl/ | 대장, 큰창자 |
| complicated 형용사 | /ˈkɑm.plɪˌkeɪ.tɪd/ | 복잡하다 |
| occur 동사 | /əˈkɜː/ | 일어나다, 발생하다 |
영상에 나오는 구동사
| 단어 | 뜻 |
|---|---|
| go out 동사 | 나가다 |
따라 말해 볼 만한 문장
영상에 나오는 짧고 완결된 문장으로, 일상 대화에서 그대로 쓸 수 있습니다:
- Can I just check your name and date of birth please?
- Have you ever had any previous gynae surgery?
- In terms of your previous deliveries, were they vaginal deliveries?
- Did you need any instruments at all?
- Do you have any other medical problems at all?
이 영상의 문법
화자가 가장 많이 쓰는 문형을 영상 속 실제 표현과 함께 정리했습니다.
| 문형 | 영상 속 표현 |
|---|---|
| 현재완료진행 have/has been + -ing — 전에 시작해 지금도 계속되는 동작 | I've been having · has gradually been getting · you've been having |
| 현재완료 have/has + 과거분사 — 과거의 일이 지금도 관련이 있을 때 | that's been · have you noticed · Have you ever had |
| 수동태 be + 과거분사 — 누가 하는지보다 무슨 일이 일어나는지에 초점 | been occasionally triggered · been admitted |
주의할 발음
화자는 you've, I've, I'm 같은 축약형과 약화된 형태를 50번 사용합니다. 들리는 대로 짧게 발음하세요.
- “sh”와 “zh” 소리: occasionally /əˈkeɪʒənəli/, medication /mɛdɪˈkeɪʃən/, occasion /əˈkeɪ̯ʒən/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, evaluation /ɪˌvæljuˈeɪʃn̩/
- 긴 단어 — 강세 위치에 주의: occasionally /əˈkeɪʒənəli/, medication /mɛdɪˈkeɪʃən/, cholesterol /kəˈlɛstəɹɒl/, complicated /ˈkɑm.plɪˌkeɪ.tɪd/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/
한국어 화자가 어려워하는 소리:
- /f/ — ㅍ(/p/)으로 바꾸지 말고 윗니를 아랫입술에 대기: cough /kɔf/, caffeine /ˈkæfiːn/, fluid /ˈflu.ɪd/, refer /ɹɪˈfɜː/, lifestyle /ˈlaɪfˌstaɪl/
- /v/ — ㅂ(/b/)과 구별하기: virus /ˈvaɪ.ɹəs/, virtual /ˈvɜɹt͡ʃuəl/, fever /ˈfivɚ/, evaluation /ɪˌvæljuˈeɪʃn̩/, vaginal /ˈvæd͡ʒ.ən.əl/
- /z/ — ㅈ이 아니라 성대를 울리는 /s/: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, menopause /ˈmɛnəpɔːz/, sneeze /sniːz/, summarize /ˈsʌməˌɹaɪz/
이 영상으로 연습하는 방법
- 먼저 말하지 않고 영상을 끝까지 듣고 모르는 단어를 적어 둡니다.
- 보통 속도로 한 문장씩 섀도잉하고, 화자의 리듬과 맞을 때까지 반복합니다.
- 자신의 목소리를 녹음해 원본과 비교하고, urine, sudden, bladder 같은 단어에 특히 주의합니다.
쉐도잉이란? 영어 실력을 빠르게 키우는 과학적 방법
쉐도잉(Shadowing)은 원래 전문 통역사 훈련을 위해 개발된 언어 학습 기법으로, 다언어 학자인 Dr. Alexander Arguelles에 의해 대중화된 방법입니다. 핵심 원리는 간단하지만 매우 강력합니다: 원어민의 영어를 들으면서 1~2초의 짧은 지연으로 즉시 소리 내어 따라 말하는 것——마치 '그림자(shadow)'처럼 화자를 따라가는 것입니다. 문법 공부나 수동적인 청취와 달리, 쉐도잉은 뇌와 입 근육이 동시에 실시간으로 영어를 처리하고 재현하도록 훈련합니다. 연구에 따르면 이 방법은 발음 정확도, 억양, 리듬, 연음, 청취력, 말하기 유창성을 크게 향상시킵니다. IELTS 스피킹 준비와 자연스러운 영어 소통을 원하는 분들에게 특히 효과적입니다.