COMLEX-2 PE question.

[SLC]

Does anyone know whether the SP's are taught to "mimic" findings. Obviously they will feign pain during cases of sprains and strains etc, but will a SP try to fake an up going babinski or something?

I ask because one of my cases would have possibly had that as a finding (had the case been real) and when I checked the babinski was normal, but now I think I remember the sp cocking his toes up after they went down.

We were told to accept our findings as real, so I wrote normal babinski in the note, but maybe I was supposed to interpret his toe extension after the fact as an abnormal finding? (I honestly just figured he was ticklish)

I hate that I have to wait 7-9 more weeks to find out if I failed. I won't be surprised if I did. I didn't even have a manip to offer one of the patients that requested it. I should have just done some soft tissue kneading and stretching or something but I ran out of time trying to decide my own CS technique. I just wrote in my note that I would look up a maneuver for the follow up appointment if the pain hadn't resolved with RICE and NSAID's.

Horrible experience!

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[MLT2MT2DO]

I too won't be surprised if I failed as well. I did a few boneheaded things as well, everything felt awkward with the gown as well....I mean who uses gowns in outpatient care anyway? If those two things are your only blunder you're probably fine, they appear fairly minor,imo.

I take solace in the fact that most people feel like crap after this test and also that I know exactly where I went wrong so I know what to fix if I did fail.

 

[SLC]

I too won't be surprised if I failed as well. I did a few boneheaded things as well, everything felt awkward with the gown as well....I mean who uses gowns in outpatient care anyway? If those two things are your only blunder you're probably fine, they appear fairly minor,imo.

I take solace in the fact that most people feel like crap after this test and also that I know exactly where I went wrong so I know what to fix if I did fail.

Oh believe me, I had some other fairly major blunders. Like not checking an hcg before putting a teen on birth control. That was my first case though, that's the only excuse I can come up with.

More than anything I just felt awkward continually writing normal findings in my notes when a real case would not have them. Everyone was RRR no MRG with clear lungs, so that's what I wrote. But the cases, had they been real, would not have had normal findings.

Such an awkward test.

 

[MLT2MT2DO]

Agreed, you write what you find. I had a patient I flat out didn't finish (my first patient), had another I probably wasn't as "nice" as I should have been in pretend doctor land. I also had a complete brainfart on doing abdominal examines with patients having gowns. The other 8 cases I feel I pretty much rocked but these the one I didn't finish is definitely a screw up and the other 3 I feel could go either way.

At least being somewhat self aware, if I did crap the bed I'll know what to change next time.

 

[SLC]

Got my score in today (Aug 13th test). PASSED!!!

 

[MLT2MT2DO]

Got my score in today (Aug 13th test). PASSED!!!

Same.

I had some sizeable mistakes (that would go under humanistic booboos) too...people that fail this and feel they made no mistakes must lack self awareness.

 

[BigSib]

Does anyone know whether the SP's are taught to "mimic" findings.

Yes they can portray positive and negative exam findings. It is important to note that some of them may actually have real disease: heart murmurs, skin lesions, strabismus, etc. You should also accept these as real during your encounters and correlate clinically if it's related to the chief complaint.

I didn't even have a manip to offer one of the patients that requested it.

It is critical that you prepare for and perform at least a handful of OMM techniques the day of your exam. Many of the patients will outright ask you if 'something' can be done today during the appointment. When OMM is indicated it is fairly obvious. Soft tissue, myofascial release, sinus percussion, occipital release, etc. are all relatively easy techniques to have in your toolbox that day. Think of some common musculoskeletal, head/neck, and upper/lower extremity complaints that you would use OMT for.

 

[SLC]

Yes they can portray positive and negative exam findings. It is important to note that some of them may actually have real disease: heart murmurs, skin lesions, strabismus, etc. You should also accept these as real during your encounters and correlate clinically if it's related to the chief complaint.



It is critical that you prepare for and perform at least a handful of OMM techniques the day of your exam. Many of the patients will outright ask you if 'something' can be done today during the appointment. When OMM is indicated it is fairly obvious. Soft tissue, myofascial release, sinus percussion, occipital release, etc. are all relatively easy techniques to have in your toolbox that day. Think of some common musculoskeletal, head/neck, and upper/lower extremity complaints that you would use OMT for.

Well results are in and I passed, so I guess I did well enough. I guess I interpreted any faked findings more or less correctly.


I didn't have a manipulation for the complaint one patient had, but I did review my skills before the test, it was just something I didn't remember learning. In fact, it was something that wasn't even in my pocket manual when I went back to check what I should have done.