← Full lesson and references Paired practice cardsSt Emlyn’s · MLA

Candidate brief Examiner checklist

One learner performs. One learner checks the key steps and gives feedback. Then swap roles. This is a practice aid, not an official mark scheme.

Candidate

Thyroid examination

MLA · Paired examination practice

Your task

You are a medical student. Examine the thyroid and relevant peripheral signs. Present your findings and discuss appropriate next steps with the responsible clinician.

Starting information

Practise with a consenting partner, using the equipment and scope agreed before starting.

Suggested practice time: 8–10 minutes for a focused run, followed by feedback. Allow longer to practise the full sequence. This is not an official examination timing.

St Emlyn’s · MLA · Practice aid, not an official mark schemeCandidate card

Show examiner checklist

Examiner / observer

Thyroid examination

Tick the actions you observe. Discuss any step that was not needed for this examination; unchecked boxes are not a score.

Examiner / observer · 1 of 2

Thyroid examination

Preparation · History and peripheral examination

Agree supervision and any communication or chaperone support before starting. Provide a chair, couch, pen torch, stethoscope and reflex hammer. Water is optional and only offered when safe to swallow. Practise comfortable techniques on a consenting partner.

Preparation

Introduces themself by name and as a medical student.

Confirms the patient’s identity.

Explains the purpose and extent of the examination.

Obtains consent before starting. Key step

Asks about pain and any urgent symptoms. Key step

Performs hand hygiene.

Uses appropriate protective equipment.

Provides suitable exposure and privacy, keeping other areas covered.

Positions the patient comfortably.

Explains that the patient can ask them to stop. Key step

History and peripheral examination

Asks about symptoms of altered thyroid function and any neck swelling.

Inspects body habitus, flushing, tremor, eye signs, eyebrows and neck scars or swelling.

Assesses hand warmth, clamminess, tremor, nails, palmar erythema and skin texture.

Measures the pulse rate.

Assesses pulse rhythm and quality.

Reviews blood pressure, respiratory rate, saturation and temperature; glucose only if indicated.

Checks lid retraction, lid lag, proptosis and eye movements, asking about diplopia.

St Emlyn’s · MLA · Practice aid, not an official mark schemeObserver 1 of 2

Examiner / observer · 2 of 2

Thyroid examination

Neck and legs · Close

Neck and legs

Inspects the neck from the front and side; palpates tracheal position and any swelling.

Describes size, shape, nodularity and diffuse enlargement.

Assesses movement on swallowing, offering water only when swallowing is safe. Key step

Assesses movement with tongue protrusion when relevant and palpates lymph nodes.

If using sternal percussion, does not treat dullness as proof or exclusion of retrosternal extension.

Listens over the thyroid for a bruit.

Inspects the shins and assesses lower-limb reflexes.

Close

Restores comfort and privacy, offers help with dressing and thanks the patient.

Ask the candidate

How would you present your findings and their significance? Separate structural findings from clinical signs suggesting altered thyroid function. Describe swelling, movement, nodules, tenderness and nodes; explain the purpose of thyroid tests, imaging or referral.

What would you do next, and why? Explain the important uncertainty, a relevant next assessment and when help is needed. State what you could not assess.

Feedback

What went well:

One thing to improve:

Try again focusing on:

St Emlyn’s · MLA · Practice aid, not an official mark schemeObserver 2 of 2

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