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Step 2 Clinical Skills Exam. How to pass with flying colors. Overview of Exam. Ten to twelve cases 10 are scored Adults only P ediatric cases will be parents 15 minutes per clinical encounter 10 minutes per progress note. Overview of Exam. Grading Integrated Clinical Encounter - PowerPoint PPT Presentation
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Step 2 Clinical Skills
ExamHow to pass with flying colors
Overview of ExamO Ten to twelve cases
O 10 are scoredO Adults only
O Pediatric cases will be parentsO 15 minutes per clinical encounterO 10 minutes per progress note
Overview of ExamO Grading
O Integrated Clinical EncounterO Data-gatheringO Progress Note
O Communication/Interpersonal SkillsO Spoken English Proficiency
Clinical EncounterO 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 EncounterO Doorway NoteO IntroductionO HistoryO PhysicalO Differential DiagnosisO WorkupO Answer questionsO Provide counseling
Progress NoteO History
O Bullet or narrativeO Abbreviations are acceptable
O Physical ExamO Be honest
O Differential DiagnosisO Up to 3 items prioritized with H&P findings
supporting each diagnosisO Work-Up
O 3-5 itemsO 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 ErrorsO Failure to introduce yourself to patient
O Use patient’s name, state name, handshake, explain role
O Failure to perform a patient-centered interview/examO Repeat back what you hear, reflect back
emotion, summarizeO Ask permission to perform touch patient,
introduce maneuvers, explain findingsO Use of jargon
Common ErrorsO Failure to show compassion
O Acknowledge patient’s painO Acknowledge patient’s emotion
(sadness, anger, etc)O Touch the patient appropriatelyO Keep the patient comfortable (help
them sit up, lie down, draping)O Failure to Summarize
O Must be done at least once
Common ErrorsO Lack of clarity of differential/plan
O Verbalize your differential diagnosisO Outline a clear plan
O Failure to ask for questionsO After answering them, ask again
O Missed opportunities to counselO Most encounters require some counseling
O Failure to empower/collaborate w/ patient
Common ErrorsO 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 reassuringlyO Repeat the opportunity for them to
ask further questions
Final TipsO You don’t have to be perfect!O SPs are easier than real patientsO There is a reason for everything you
see