milee99
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hello friends,
I have my exam in two weeks .. and i am very scared..
i have done first aid cases once,
but i am running out of time.. like exceeding by about 3-4 minutes in cns case
what should i do??
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| arlete
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cns is the most challenging in terms of time management. Just keep practicing, two weeks help a lot improving it. Try and be calm, you don't have to be perfect, and there are many other chief complaints you will be able to manage time beautifully. 
Edited by arlete on 05/24/08 - 05:15 AM
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| hitesh
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Well, keep practising and try to stay as focussed in your H and P as possible.
Try not to look at any watch when you practise and let your study partner keep the time. I'm saying this, 'cos on the real exam you wont have a watch. There will be a wall clock, but you wont be able to look at it too often ( I dunno if you'll lose any points on the check list, but i think it can bring down your CIS score if you keep looking at the clock)
Also, during the exam, make sure to make a mental note of the time when you entered the room.. I remember, on my exam, in a few cases, I looked at the clock but I had no idea how much time had elapsed cos i didnt know at what time i had entered the room!! 
Good Luck!
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| roentgenindia
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milee99
CNS cases obviously require precise time management.Try to practice it again and again to manage it accordingly.However,also prepare yourself for an emergency closure-because proper counseling and closure is MUST and you may sacrifice part of PE instead of closure.(Closure alone counts 6 marks out of 20 CIS component).
How to do an emergency closure is well describedin my notes uploaded on this forum.
http://www.prep4usmle.com/forum/thread/70916/
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| angel23
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hey roentgenindia!!
how do u know closure counts 6 marks out of 20
is it written somewhere?
i mean do u know distribution of marks?
can u plz tell us
n does closure marks also include counselling marks?
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| roentgenindia
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A few people attended Kaplan and posted their tips on some other forum (usmleXXXxm).If you read my notes it is given at page 6 of my notes.
as far as I know there are about 23 points of CIS nad you need to score 20
1)examinee knocked before entering
2)apeared professional in dress/hygiene
3)introduced self by name
4)comfortable eye contact
5)used patient name
6)Focused attention on patient
7)expressed empathy( reflected pt feeling)
8)conveyed nonjudgmental attitude ( avoid words like good, great,excellent)instead say allright, okay, thank you
9)used appropriate draping techniqe
10)used few open ended questions
11)used non leading quaestions
12)asked one question at a time
13)answered without interrupting the patient
14)paraphrased
15)used lay language ( imaging studies instead of CT MRI, Electrical study instead of ecg
16)used transitional phrases
17)gave explantion during physical
18)appropriate reassurence
19)summerized significant hx
20)diagnostic impression in lay term
21)discussed diagnostic test
22)asked if pt had any questions or concerns
23)paient educations/suggestion
If you see point 18-23 are generally discussed in counseling.
So it means just by doing proper wrap up you secure 6 points out of 20 which you need to pass CIS-The most dreaded component for IMG's!
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| angel23
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thanks roentgenindia!!
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| roentgenindia
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UR welcome!
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| milee99
Forum Guru
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thanks all of you!!
i did not expect so many prompt replies!!
thank you so much !
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