CS: do you speak out loud what you are doing when examining?

[RaraBovis]

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Are you supposed to be saying, apart from 'now I would like to examine your chest etc. ', things like- the breadth sounds seem normal..I hear no added sounds etc.
I mean, do they expect you to speak out loud your findings or individual steps of the examination?
On the one hand, it seems like this would help you remember things and retain focus, on the other it's not so cool to have to actually say everything.

Thanks.

 

[jtlc2345]

You are interacting with the patient, not an examiner therefore I would advise against saying you findings out aloud during your examination.

Jonathan

 

[sirscrubsalot]

I agree - no positive/negative finding discussions regarding the physical exam... you should definitely ask them permission (i.e. asking is it okay) to begin the PE, and tell them that you are now going to perform this exam now... i.e. listen to your hear, lungs or going to perform an abdominal exam.

You can say that you're going to be listening to their stomach or see how their reflexes are, but hold off on giving any positive/negative findings to the SP when doing the PE; during and after.

The only findings/thoughts I would be giving is a set of possible differentials based from their CC/HPI and round off at the end by saying something like, based on our discussion and from the physical exam... it may be x, y or z... and we'll need to do a, b, c... to find out more...etc etc.

That's my opinion - I've already taken the exam and am done with it... others can comment their thoughts too.

 

[kryptik]

^ agree totally with above

 

[RaraBovis]

thanks. yes, I totally agree with you guys too. just that I watched these silly videos on youtube and thought maybe things are done differently for the exam.

 

[PokerDoc]

thanks. yes, I totally agree with you guys too. just that I watched these silly videos on youtube and thought maybe things are done differently for the exam.

can you point me to these silly videos on youtube? id like to see them

 

[OveractiveBrain]

Are you supposed to be saying, apart from 'now I would like to examine your chest etc. ', things like- the breadth sounds seem normal..I hear no added sounds etc.
I mean, do they expect you to speak out loud your findings or individual steps of the examination?
On the one hand, it seems like this would help you remember things and retain focus, on the other it's not so cool to have to actually say everything.

Thanks.

Im pretty sure is was a mandatory part of OSCE, and SHOULD be done in CS. Check First Aid for their recommendations, but the whole CS experience is not even close to what you'll do in real life.

 

[RaraBovis]

can you point me to these silly videos on youtube? id like to see them

Just type whatever exam you would like to see (Neuro/cranial nerves/ CVS or what have you) into their search. These aren't specifically for the CS. A lot of them are either imprecise/casual or funny. I'm not recommending them- I'm sure most people have better resources. I just wasn't one of those people.

 

[MrBigLips]

Im pretty sure is was a mandatory part of OSCE, and SHOULD be done in CS. Check First Aid for their recommendations, but the whole CS experience is not even close to what you'll do in real life.

It was pretty mandatory to do when there were examiners during actual med school tests, but not in the CS. Telling the patient "S4 gallop heard in the right 4th ICS" is pretty useless. I know I didn't do anything like that and I managed to pass.

Best thing to do is just explain what your going to do to the patient, and be as gentle as possible when doing it.

I totally agree with the whole CS experience not being what you do in real life part though. That's a fact.