PsychDr2B
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Topics: 35
Posts: 197
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In two words: HIGHLY RECOMMENDED!
Greetings Doctors! I just returned from the Step2 CS free seminar that Kaplan offers to anyone interested. It's like a two hour info-commercial about not only Step2CS, but what their 5 day course has to offer. I won't get into details about their course because you can get that from their web-site. However, the free seminar itself is full of valuable information. here's how it went down:
First, I was given a sheet that looks this:
1. Opening Scenario
Johnny Anderson, a 28-year-old Male, comes to the emergency Room complaining of severe headache and stiff neck.
2. Vital Signs
BP: 130/80
Temp: 101F (38.3C)
RR: 22/minute
HR: 88/minute
3. Examinee Tasks
1. Obtain a focused and relevant history.
2. Perform a relevant physical examination (do not perform rectal, pelvic/genital, or female breast examinations).
3. Discuss your initial diagnostic impression and work-up plan with the patient.
4. After leaving the room, complete your patient note on teh given form.
Then, they played a video. Start timer for 15 minute countdown: It showed the doctor approach the door with a provided blank piece of notepaper on his clipboard to copy the info I just descirbed above (The same paper appears inside the room). The doctor knocked and entered the room. He acknowledged the patient as Mr. Anderson and introduced himself as Doctor P. He began with chief complaint and focused/ relevant history. The patient responded with having severe headache and pain in the neck, and admitted to having a cold a week before. After washing his hands with soap and water, the doctor's physical exam focused on neurological signs and Kernig's sign was positive. A voice off screen calls out: "You have 5 minutes remaining for this encounter." The doctor completes his physical exam and conlcudes by telling the patient his diagnostic impression and work-up plan and cordially leaves the room.
After the video, I was given a Patient Note chart to fill out that looked like this: (What I filled in is in italics). Start timer for 10 minute countdown:
Patient: J. Anderson
History
A 28 year-old male with no significant past medical history presents to emergency room with headache and neck stiffness. (I then listed relevant history information.)
Physical Examination
VS: Temp 101F(38.3C), RR 22/minute, HR 88/minute, BP 130/80
General appearance: patient is lying flat on his back, shielding eyes from the light. He is in obvious discomfort due to headaches.
HEENT Exam: Atraumatic, normocephalic, PERRLA, Tympanic membranes are clear bilaterally.
Kernig's Sign: +
Differential Diagnosis: and Diagnostic Work-Up:
1. Meningitis 1. CBC w/ differential, electrolytes, glucose, blood culture, ESR
2. Subarachnoid hemmorhage 2. CT scan of head
3. Encephalitis 3. If CT scan negative, lumbar puncture.
4. Brain abcess 4. CSF for culture, cell count, gram stain.
On the actual exam, you can submit this info on a computer screen in a cubicle outside the patient rooms. I was also given an example of the checklist the patient is given once the doctor leaves the room. It is part of your overall score on that case. I was showed that scoring occurs the following way: Step2 CS (Pass/Fail) = (ICE + CIS + SEP)*#cases
70 points/case = ICE (Integrated Clinical Encounter) = History (~20points) + Physical (~10points) + Patient Note (~40 points)
20 points/case = CIS (Communication and Interpersonal Skills)
10 points/ case = SEP (Spoken English Proficiency)
You have to gain at least 60% of these total points per case for 11 to 12 cases in order to PASS.
Two major themes Kaplan says to remember in order to PASS:
1. Treat patient like he/she is a real patient in your clinic.
2. Go for the points! Meaning, make sure you maximize on what the examiners are looking for during your history, physical and patient note write-up. Sharpen your communication and English speaking skills (i.e. fight accents).
I do recommend this free seminar to anyone, if it is offered in your area. I'm not affiliated with Kaplan in any way; and I don't know if I will ultimately take their Step2CS course. However, I will be taking some course for it eventually. I just wanted to post this information to you all; because I want to give back to you all who have helped me with my motivation to keep studying and stay focused. I am still waiting my Step1 results (any day now). I pray for us all. Best of luck and keep on truckin'!
Now back to Step2CK prep...
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