跟讀練習: How to Present a Patient: Inpatient Bedside Teaching Rounds (Group 12) - 通過影片學習英語口語
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61 句
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Jonathan, this is Dr. Jones and our internal medicine service team.
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Hi.
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Hi Jonathan.
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We're going to be, I'm going to be presenting your case to them.
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Is that alright if I do that in the presence of your girlfriend and co-worker here?
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Yes, this way.
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Thanks Jonathan.
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So this is the first UMC visit for Jonathan, who is a 24-year-old African-American
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with a history of sickle cell disease who presented to the emergency department with a two-day history of bilateral knee pain.
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He's ectomorphic and is in moderate distress.
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The pain began Tuesday at approximately 4 a.m while he was working a night shift at Walmart.
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He had difficulty sleeping because of the pain that night, that night and the pain gradually continued to increase due to a severity of 8 out of 10 today.
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The pain was exacerbated with walking and standing and was not significantly relieved with Percocet,
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which he received from another physician that we aren't sure who it was.
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Jonathan has never experienced knee pain to this extent before, but he did say that he's had a few episodes in the distant past of knee pain.
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He reports some chills and a mild shortness of breath, but he denied fever, nausea,
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vomiting, cough, chest pain, abdominal pain, or recent trauma to the knees.
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He has no other known medical illness and isn't on any chronic medication for sickle cell disease either.
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In the ED, he was given an IV bolus and received two doses of morphine at 6 mg and 8 mg doses.
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For past medical history, he was diagnosed with sickle cell disease at age six
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and has had six to eight previous hospitalizations for that.
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He has a history of lower extremity ulcers as well, but he has never had a pneumococcal vaccine which is interesting.
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His social history includes, he lives with his mother and four siblings.
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He works at Walmart as a stalker but denies any IV drug use or tobacco use.
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He does consume alcohol occasionally, and last time was this last weekend.
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He has two siblings that also have sickle cell disease.
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In the review of systems, it was negative except for lower extremity ulcers and intermittent left hand pain.
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In his vitals, he had a temperature of 36.3 degrees Celsius, heart rate of 96, a respiratory rate of 16,
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blood pressure of 108 over 70, and his O2 saturation was 89% on room air.
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For Hent, he's normocephalic, atraumatic, perle, and extraocular movements are intact.
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With lungs, they're clear to auscultation and percussion with no wheezes, rails, or bronchi.
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CV, his S1, S2 were normal.
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He is tachycardic with a soft flow murmur heard at the base.
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There was no S4, but he does have decreased pedal pulses.
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For abdominal exam, bowel sounds are normal the spleen tip was not palpable.
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GU, he didn't have any urethral discharge either.
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For skin, he had a silver scaly rash on the flexor surface of the right elbow,
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and there are non-healing bilateral ulcers of one centimeter diameter on both medial malleoli.
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For musculoskeletal, he has mild swelling of the right knee and small effusion.
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There's no erythema, and it's not tender to palpation, but there was pain on full extension his left knee didn't have any significant swelling or tenderness.
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He did have full range of motion bilaterally with his knees.
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Now in the lab work we have a CBC, BMP and liver function test pending.
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And so in conclusion or in summary, Jonathan, he's a 24-year-old African-American man with a history of sickle cell disease and hypoxia.
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He presented the emergency department with bilateral knee pain and minor right knee effusion.
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On the differential diagnosis, we have vaso-occlusive disease, periarticular infarct, septic arthritis, and gout.
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Vaso-occlusive disease is most likely due to the afebrile presentation of the patient.
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And the pending CBC results will likely rule out septic arthritis due to a gram-negative Neisseria, Staph, or Salmonella.
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Potential plans of treatment include knee pain.
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Well, for knee pain, we would consider NSAID treatment with morphine for breakthrough pain.
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For sickle cell disease, we should monitor closely for acute chest syndrome, splenic sequestration, and aplastic crisis,
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and consult a hemonch for a sickle cell referral after he is released from the hospital.
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And then we should also obtain a chest X-ray to rule out new infiltrates and consider oxygen therapy
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if he becomes symptomatic in his lungs again.
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All right, any questions?
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Would I also recommend adding two liters of oxygen via nasal cannula?
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I think that'd be a great idea.
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And great job, Bryce, you really were very thorough.
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Thank you for letting us present in front of you.
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That was really great.
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Thank you.
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Thank you.
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本節課你將練習什麼？
這節課通過一段醫院查房的真實對話，幫助你提升英語口語表達能力，尤其是醫療場景下的描述技巧。你可以學習如何清晰陳述病情、彙報檢查結果，同時鍛鍊“shadow speak”（影子跟讀法），跟著影片中的語速和語調模仿，讓口語更流暢自然。無論是備考雅思口語練習，還是日常英語口語練習，這樣的真實場景都能讓你更快適應英語交流。
核心詞彙與短語
- sickle cell disease：鐮狀細胞病（醫療術語，需準確發音）
- exacerbated：加重（描述病情變化的常用詞）
- vaso-occlusive disease：血管閉塞性疾病（診斷相關表達）
- afebrile：無發熱的（體檢彙報中的關鍵形容詞）
- acute chest syndrome：急性胸部綜合徵（併發症描述）
影子跟讀法練習技巧
影片中的對話語速適中，語氣專業且親切，非常適合“shadowspeak”練習。建議你先完整聽一遍，熟悉內容後，逐句暫停模仿：注意醫生詢問患者時的溫和語氣，以及彙報病情時的清晰邏輯。模仿時不僅要跟緊語速，還要關注重音（如“8 out of 10”中的數字強調）和停頓（如列舉症狀時的自然斷句）。每天堅持10分鐘，既能提升口語流暢度，也能積累醫療場景詞彙，讓“看影片學英語”不再停留在表面。記住，犯錯是進步的開始，勇敢開口，你會越說越好！
影片中的語法
說話人最常用的結構，並附上影片中的原話：
| 結構 | 影片中的用法 |
|---|---|
| 現在完成時 have/has + 過去分詞 — 過去發生但與現在仍有關聯的事 | has never experienced · has had · has never had |
| 被動語態 be + 過去分詞 — 強調發生了什麼，而不是誰做的 | was exacerbated · was given · was diagnosed |
什麼是跟讀法？
跟讀法 (Shadowing) 是一種有科學依據的語言學習技巧，最初開發用於專業口譯員的培訓，並由多語言者Alexander Arguelles博士普及。這個方法簡單而強大：您在聽英語母語原聲的同時立即大聲重複——就像是一個延遲1-2秒緊跟說話者的影子。與被動聽力或語法練習不同，跟讀法強迫您的大腦和口腔肌肉同時處理並模模擬實的講話模式。研究表明它能顯著提高發音準確性，語調，節奏，連讀，聽力理解和口語流利度——使其成為雅思口語備考和真實英語交流最有效的方法之一。