Student Preparatory Instructions Ppt. - 2014 M3 Clinical Skills Exam - Finalized

8/12/2019 Student Preparatory Instructions Ppt. - 2014 M3 Clinical Skills Exam - Finalized

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Goal of th is Exam

To assess your abilities in:

History-taking

Physical Examination

Interpersonal Communication Skills

Clinical Decision Making

Note Writing

This exam is also similar to the USMLE Step 2

CS as a way to help you prepare for that exam.


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Locat ion o f Exam

The exam will be held in the

Education and Evaluation Center.

Garden Level of the

Health Sciences Building.

Upon arrival, sign in and have a seat in theStudent Orientation Room.


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Your Exam Date

Lori Wasion in Undergraduate Studies will assign you to a

specific exam date and time.

If you foresee a conflict with your assigned date and/ortime, contact Lori Wasion in Undergraduate Studies as

soon as possible at [email protected]

or at 847-578-3215.
mailto:[email protected]:[email protected]


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Arr ive on Time for your Exam

Students are expected to arrive on time.

If you arrive after the exam has started, you

will not be allowed to take the exam.

You will have to reschedule for a different date.

There are a limited number of exam slots

rescheduling is not encouraged and may not be

possible.


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Proper A tt ire / What to B ring

PROPER ATTIRE:

Clean white lab coat.

Dress professionally yet comfortablyno jeans, t-shirts, etc. Scrubs are acceptable.

Wear professional yet comfortable shoes as you will be on your feet for 2 hours.

If you have long hair, wear it pulled back.

Do not wear any perfumes, colognes or lotions with fragrances.

Wear a watch, but do not wear a lot of other jewelry.

WHAT TO BRING WITH YOU: Bring a pen or pencil to use for taking notes

Bring your stethoscope


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About the pat ien t cases -

All 5 patient cases will require you to:

Take a focused history (including relevant parts of the historybeyond the HPI)based upon the chief complaint stated on thepatient chart.

Perform a physical exam based upon the chief complaint andinformation gathered during the history

Some cases may also require you to interpret and deliver lab,imaging and/or test results to the patient.

Some case may also require you to do patient education and/orcounseling.


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THE HONOR CODE

You will then see the HONOR CODE on the screen.

The HONOR CODEis an agreement between you andthe university stating you understand the cases you are

seeing today are confidential testing material and youwill not discuss the cases with your fellow students.

Click ACCEPT - do not touch the keyboard again

DO NOT read the PATIENT CHART until you areinstructed to do so by the Exam Proctor.


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The Patient Chart

When instructed to do so by the Exam Proctor, pull

the Patient Chart and begin reading.

Timing of the 15 minute encounter immediatelybegins at that moment.

Once you have read the entire chart, knock on the exam

room door, enter and begin the encounter.

Always take the chart into the room with you for further

reference.


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More abou t the Patien t Chart

Read all of the information on the Patient Chartvery carefully.

Some charts may also have lab and/or imagingresults that you need to read, interpret anddiscuss with the patient.

Read the STUDENT TASKSclearly stated oneach chart and make sure you accomplish allthese tasks by the end of the encounter.


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Example o f a Patien t Chart

Patients Name: John Watson

Patients Age: 40

Chief Complaint: Low Back Pain

Setting: Outpatient Clinic

Vital Signs: Blood Pressure: 120/70

Pulse Rate: 70

Resp. Rate: 12Temp: 98

STUDENT TASKS: You have 15 minutes to:

1. Obtain an appropriate history based upon the chief complaint.

2. Perform a pertinent focused physical examination.

3. Discuss your diagnostic impressions (DDx) with the patient.

4. Discuss what steps you will take next regarding the patients care.

5. Answer any questions the patient may have to the best of your ability.

IMPORTANT NOTE: You are the health care provider for this encounter. You may not defer anything

to another health care provider (i.e., the attending, the chief resident, consult service.) You must make

all the decisions regarding this patients care.


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Do Not Take Vital Signs

Since the patients vital signs will be on

every Patient Chart, you do not need to

take any vitals at all.

Assume the vitals on the chart are current

and accurate.


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Do Not Perfo rm a Breast/Pelvic/Gen ital o r

Rectal Examinat ion

None of the cases require you to actuallyperform any of the above stated exams.

However, if you think it would have beenpertinent to the case to perform such an

exam, notate it in the post-encounterexercise under Diagnostic Studies.


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The Patien t Encounter

15 m inu tesUpon entering the patients room:

Greet the patient by the FIRST AND LAST NAME printedon the chart as a way to confirm you have the correct chartin hand.

Ask patient how he/she prefers to be addressed.

Introduce yourself by your first and last name.

Begin taking the patients history.

Dont forget to wash your handsjust before you begin thephysical exam!!


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During every encounter

Treat the patient as if he/she were a real

patient in a real health care setting.

Act professionally and respectfully at all times.


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Bringing the encounter to a pro fessional

clo se -

When you have accomplished all tasks listed on the Patient Chart:

Report to the patient your diagnostic impressions.

Explain what steps you will take next regarding the patients care.

Answer/address any questions/concerns the patient may have.

Exit Patients Room.

Click STOP ENCOUNTERon the laptop and immediately begin thePost-encounter exercise.


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What i f I f in ish the encounter

early? Summarize the history with the patient for accuracy.

You may think of more questions to ask when doing so.

Check the Patient Chart to make sure you have done

everything listed under Student Tasks.

Then you may exit the room. NOTE: Once you exit theroom, you may not re-enter again. So make sure youhave completed all the tasks listed on the chart.

Click STOP ENCOUNTERon the laptop andimmediately begin the Post-encounter Exercise for

that case.


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Your Ro le in Each Encounter:

The Buck Stops w ith YOU

Unlike past SP exams, for this exam YOU are

the sole person in charge for each patient case.

You are not to defer any responsibility ordecision-making to the attending or the chief

resident, or the consult service etc.

All final decisions for the care of each patient are

YOURS.


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The Post Encoun ter Exerc ise

10 m inu tes

Each post-encounter will be based on the

matching patient encounter.

The post-encounter for each case will be a

note that is similar to the USMLE Step 2

CS note.


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USMLE Step 2CS Style Note

Document pertinent H&P Findings

List your top 3 DDx in rank order.

Link key H&P findings to each DDx

Order appropriate further diagnostic tests.

An example of the Step 2 CS note can be found at:

http://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdf
http://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdfhttp://www.usmle.org/pdfs/practice-materials/patient-note/example-note-1.pdf


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SP Verbal Feedback

You will receive verbal feedback only after your 1st,3rd,and 5thpatient encounters.

Feedback will be self-reflective with SPs asking you what

you feel your strengths were and what are areas forimprovement when it comes to your communication skillsand professionalism.

They will not discuss any actual details of the cases oryour physical examination skills.


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Digi tal reco rding of al l encounters

Your encounters will be digitally recorded.

Students are not allowed to view the

recordings, unless authorized to do so by theadministration.

Only CMS faculty and EEC staff may reviewthe recordings because these encounters

contain confidential test materials.


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EEC Rules and Regu lat ions

Consulting medical references of any kind is strictly prohibited during anyexam in the EEC.

Use of smartphones, tablets or any other electronic computer device isstrictly prohibited during any exam in the EEC.

Do not bring any prepared personal notes. They may not be used during theexam.

Absolutely no talking is to take place in the hallway outside of the patientsrooms during the exam.

Any one who does not abide by these rules, will be asked to leave the examimmediately and report to the Director of Standardized Patient Education.

Your behavior will then be reported to the appropriate faculty and deans.


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Grading Po l icy

You must pass this exam in order to graduate.

Students who fail, or demonstrate clinical

deficiencies, will be asked to meet with a facultymember to review their performance.

Students who do not pass the exam will be

required to re-take the exam by October 1,2014and must successfully pass the re-takeexam.


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Grading Domains

You will be graded on two categories across all 5 patient

cases:

1) Clinical Reasoning, which consists of History and

Physical Exam (Data gathering), Decision-Making, and

Note Writing (documentation). The Note includes DDx

and ordering of appropriate diagnostic studies.

2) Interpersonal Communication and Professionalism

You must pass each category across all 5 cases to pass

the exam.


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Exam Score Resu l ts

The Office for Undergraduate Studies will send

you the final results of your exam. This will

occur in late June/ early July.

If you have any questions regarding the results,

you should contact Laurie Broutman, MD directly

at: [email protected]


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EEC Con tact Person:

On the day of your exam, if you are running late, orare unable to attend due to illness or anemergency, please call or email:

Barbara Eulenberg

Director of Standardized Patient Education

Phone: 847-578-8462

Email: [email protected]
mailto:[email protected]:[email protected]

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Student Preparatory Instructions Ppt. - 2014 M3 Clinical Skills Exam - Finalized