Step 2 CS PowerPoint Presentation

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Step 2
Clinical Skills Exam
How to pass with flying colors
Overview of Exam
O Ten to twelve cases
O 10 are scored
O Adults only
O Pediatric cases will be parents
O 15 minutes per clinical encounter
O 10 minutes per progress note
Overview of Exam
O Grading
O Integrated Clinical Encounter
O Data-gathering
O Progress Note
O Communication/Interpersonal Skills
O Spoken English Proficiency
Clinical Encounter
O Doorway Note (20 seconds)
O History (7 minutes)
O Physical (4 minutes)
O Closure (4 minutes)
O Tip: Don’t shortchange the closure, this is
the primary means of evaluating
communication skills
Clinical Encounter
O Doorway Note
O Introduction
O History
O Physical
O Differential Diagnosis
O Workup
O Answer questions
O Provide counseling
Progress Note
O History
O Bullet or narrative
O Abbreviations are acceptable
O Physical Exam
O Be honest
O Differential Diagnosis
O Up to 3 items prioritized with H&P findings
supporting each diagnosis
O Work-Up
O 3-5 items
O Tip: if you are running out of time, start at
bottom of the page
Why do folks fail?
O Vanderbilt students do not fail because they
lack knowledge.
O Vanderbilt students do not fail because they
lack communication skills.
O Vanderbilt students DO fail because they fail
to meet the checklist requirements that the
SP is looking for during the encounter.
Common Errors
O Failure to introduce yourself to patient
O Use patient’s name, state name, handshake,
explain role
O Failure to perform a patient-centered
interview/exam
O Repeat back what you hear, reflect back
emotion, summarize
O Ask permission to perform touch patient,
introduce maneuvers, explain findings
O Use of jargon
Common Errors
O Failure to show compassion
O Acknowledge patient’s pain
O Acknowledge patient’s emotion (sadness,
anger, etc)
O Touch the patient appropriately
O Keep the patient comfortable (help them sit
up, lie down, draping)
O Failure to Summarize
O Must be done at least once
Common Errors
O Lack of clarity of differential/plan
O Verbalize your differential diagnosis
O Outline a clear plan
O Failure to ask for questions
O After answering them, ask again
O Missed opportunities to counsel
O Most encounters require some counseling
O Failure to empower/collaborate w/ patient
Common Errors
O Missing or rushing through the “embedded
concern”
O Look for this in each patient (open ended
question at the end)
O Acknowledge the patient’s emotion
(empathize with them!)
O Answer honestly but reassuringly
O Repeat the opportunity for them to ask
further questions
Final Tips
O You don’t have to be perfect!
O SPs are easier than real patients
O There is a reason for everything you see

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