CS: percentage of checklist on FA to pass

[Solarium]

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Practicing over the cases in FA, I notice myself keep missing about 10-20% of the checklist for the questions to ask in the history taking. Approximately how much % is required for us to pass?

Also, anyone has a breakdown on the data collecting portion of the exam? How much is the PE vs history taking vs PN, and in the PN how much are DD's vs workup vs the rest, etc.

 

[TMP-SMX]

Sounds like you are worrying about it way too much. Just be empathetic to the patient, drape properly, explain the next steps and workup, and finish everything in time.

 

[Depakote]

don't over-think the test.

They are really just trying to find out if you can:
-speak proficient English
-ask the appropriate questions and perform the appropriate physical exam for a chief complaint
-take a background history on a patient
-develop a differential and order tests given the above
-provide some advice
-do the above while seeming somewhat human


If you've completed your 3rd year of medical school, you've been doing this... FA is good in that it offers some structure and reminds you to ask about social history, allergies, etc. (I'm glad it told me to auscultate the heart/lungs of every patient... don't know if I would have done that to everyone). But don't feel like you have to do everything it says the way it says. And you can afford to miss some things on CS and still pass by a wide margin.

I got cut off on a few rooms and didn't get to close, thought of a number of historical items I forgot to ask and still did fine.

 

[coffeebythelake]

don't over-think the test.

They are really just trying to find out if you can:
-speak proficient English
-ask the appropriate questions and perform the appropriate physical exam for a chief complaint
-take a background history on a patient
-develop a differential and order tests given the above
-provide some advice
-do the above while seeming somewhat human


If you've completed your 3rd year of medical school, you've been doing this... FA is good in that it offers some structure and reminds you to ask about social history, allergies, etc. (I'm glad it told me to auscultate the heart/lungs of every patient... don't know if I would have done that to everyone). But don't feel like you have to do everything it says the way it says. And you can afford to miss some things on CS and still pass by a wide margin.

I got cut off on a few rooms and didn't get to close, thought of a number of historical items I forgot to ask and still did fine.

This makes me feel better.

 

[coffeebythelake]

here's my situation from CS... tell me what you think about my chances...
who scores us for our SP encounters? is it the SP themselves? or is there someone watching from behind a one-way-mirror?

1. I consistently felt pressed for time, but managed to finish all the patient encounters. Did a CAGE questionnaire on everyone who drinks even if 1-2 drinks/week (are we supposed to?) In most cases, I started my PE when the 5-minute warning was called. Did not have time to complete a full neurological exam. There were several patients who smoked, but I really only had the opportunity to counsel one of them on cessation.

2. Forgot to ask a few historic things from 2-3 of my patients.

3. Forgot to write a few things on my H&P, including pt with hx of subjective weight loss whose DDx include cancer.

4. i think my ddx and work up plan were okay. not great, but okay.

5. Completely blanked out on my last pt encounter, ended up rambling my way through it. Totally missed what was going on and didn't ask any of the right questions. Felt like a total fool. I think I must have been very tired or something.

6. Occasional difficulty with the challenge questions. For most of them, I basically said... "based on what you've told me so far, i think it might be [insert diagnosis -- proceed to talk about what it is], however, I'll need to continue the H&P to figure out what it is and rule out whatever else it could be".

7. Overall, formulaic in my questions and routine. Transition statements were all the same: e.g., "hi Mr/Ms ____, my name is studentdoctor ____, i'm here to perform a history and physical exam" ; "i'm going to ask you a few questions about lifestyle and personal habits..." ; "okay, i'm going to sit down and give you a clinical impression of what i think is going on..."