Cases ending too fast...

[tyman123]

I'm reading the UWORLD CCS Readout case management material. For example, the DKA case requires you to do all the ER management (fluids, insulin drip etc...), then under "Review orders" it asks you to admit pt to ICU, routine vitals, BMP q4hours.

Do I even get this far in the case? In the CCS cases, my cases end in 2 mins, I enter a dignosis and I'm DONE. Are you supposed to put these admission orders in? Or are you done once the "review orders and enter final diagnosis" pops up?

Furthermore, it goes further and asks you to enter Discharge Orders such as D/C iv lines, d/c insulin, Diabetic teaching etc....

WTF

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[Nice2MeetU]

The case ending so quickly is not always a good thing. If you advance the clock too much, then your patient may have a bad outcome, which will end the case. You should be putting in the orders on each patient as if it were a real patient, so in the ER, stabilize and resuscitate, then admit to floor, ICU, d/c home, whatever. You definitely should be writing a full set of admission orders, just like a real patient.

For the sick patients, I would typically just advance the clock to your next lab results; if they're following up as outpatient, then advance the clock every 48 hours or so. Remember, the final diagnosis means nothing - it is not counted into your score, so don't rush once you think you know the diagnosis. Also it seems like there are few cases where they try to trick you by presenting what seems like a straightforward diagnosis, that is actually something else. That's why every patient needs a full physical and reasonable work-up. I wouldn't worry too much about the d/c stuff. For my actual cases, once the patient had improved enough in the hospital, then the case ended. But I always counseled before advancing the clock.

 

[thetubes]

even ending the case early when you have a good outcome (ie you reached the diagnosis) doesn't necessarily mean you nailed it. it just means you probably nailed the diagnosis and did enough stuff to show the computer that. all of my cases ended early on the real exam...ie in like 3-10 minutes but i did considerably worse on the cases than the MC. luckily for me the MC was 75% of the exam

 

[Instatewaiter]

I'm reading the UWORLD CCS Readout case management material. For example, the DKA case requires you to do all the ER management (fluids, insulin drip etc...), then under "Review orders" it asks you to admit pt to ICU, routine vitals, BMP q4hours.

Do I even get this far in the case? In the CCS cases, my cases end in 2 mins, I enter a dignosis and I'm DONE. Are you supposed to put these admission orders in? Or are you done once the "review orders and enter final diagnosis" pops up?

Furthermore, it goes further and asks you to enter Discharge Orders such as D/C iv lines, d/c insulin, Diabetic teaching etc....

WTF

If you've done the appropriate management and it ends quickly, you're doing something right. Unless you have killed the patient, it will keep giving you opportunities to try again and won't end. So you probably are doing something right.

My real thing, I finished at 1 pm and all of my cases ended early. I even had one where i totally screwed up, pressed the wrong button and didn't treat a child with lead paint for 50 days... whoops. I still scored a 250. The CCS cases ending early is usually a good thing