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I must say i have so much to share.
I practiced with a partner for about a month, with my husband who is a practicing physician, a friend on skype with neigborhood kids and a little more. Read FA, UW and some additioinal cases. The cases were not a suprise but i can't believe the mistakes i made during the exam.
Things i did right;
Knocked, addressed the patient by his last name, washed hands in all encounters, draped in all except 2 where i had forgotten but after a minute i realized i had not draped so did that, completed in less then 15 minutes, which was not difficut becasue of the practice, typed the note and was able to completed within 10 mintuest, fluency in english was not a problem, talking to the patient while washing hands (aksing about weather, occupation, just simple smiles) once or twice during the encounter and shaking hands while leaving, asking if they had questions, and also counselled them with some important things in which they needed counselling.
THINGS I GOOFED UP ON:
As soon as i asked them what was going on, i could not think of any pertinent questions. My mind could not think of the important questions, a guy came in for fatigue, i elimiated the possibility of depression, hypothyroidism, PTSD, infections, pain, CCf and then wanted to know more malignancy but was not able to find any cause. While examination i noticed real purpura i was not sure, what that was, inquired if everything was okay at home which he said was, could'nt figure out the cause. My DD's were also mixed up.
I guy with stomach upset, no vomitting, diarrhea just bloating could'dnt think of the pertinent quesitons again. In the last 15 mintues i asked if any thing makes it worse, he goes ic-cream. Just a simple case, i goofed up there as well.
I diagnosed Occupational lung disease in one, told the patient but forgot to writed down in the DD column.
A patient who had trouble balancing the checkbook. Guess what could that be and i saw real edematous feet and just got off-tracked.
Forgot to write about fundoscopy on one PN and vibrations sense on a diabetic patients, thats besides the other findings that i forgot. God knows how many.
Challenge questions were not different, in fact those in FA are more then enough and simple diplomacy can help quite a bit.
I think with all the practice, my history taking was not that great. PAMHUGSFOSS helped though.
I just thought i will share if this helps. Will let you know of the result if i pass.
congrats ...i want to practice some cs cases via skype...can u email me at
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