CS - type or handwrite?

[Pollicis]

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Hi, I have terrible handwriting and will most likely type my answer.

Can someone with experience please post what this was like -- is there a character or word count limit and if so, what are they? Is it just a free-form box or are there discrete areas for history vs physical exam vs differential vs investigations?

Also, are there basic functions like copy and paste for editing?

Thank you! 🙂

 

[Medical123]

I started out writing my notes, but since I write kind of big and slow, I changed to typing after the first case. Plus, I was nervous and I think that contributed to my note being less legible than it would have otherwise been. I think that I type much faster than I write and this just seemed to be a better option for me. Get a copy of First Aid for CS. The format of the note is virtually identical to what is in there.

Yes, there are discrete boxes for History, Physical Exam, Differential, etc. There is a character count if you type your note. I am not sure what it is, but I did not feel that it was sufficient enough to type out a good history on some of my patients with multiple complaints. I just tried to be very concise and made sure that I hit the big points I obtained from the history---like drug allergies, pertinent family history, duration of symptoms, etc. If you decide to write your note, you only have a certain amount of space in which you can write. Anything you write outside the box will not be graded.

I didn't try to cut and paste, so I can't help you there! Sorry! Good luck!

 

[Pollicis]

Cool thanks for the quick reply. I ordered my FA a week ago but I'm still waiting for the book to arrive in the mail!

So I guess it's ok to switch back and forth from paper to computer as the need arises? I'm curious how you would set up tables in the typed version, for example recording power/tone/co-ord/sens/reflex for RUL/LUL/LLL/RLL?

Does anyone know if there is a sample program out there that emulates the real thing?

Thanks 🙂

 

[wakemewhenit'so]

...

So I guess it's ok to switch back and forth from paper to computer as the need arises? I'm curious how you would set up tables in the typed version, for example recording power/tone/co-ord/sens/reflex for RUL/LUL/LLL/RLL?

you can switch back and forth from paper to computer, as long as it's not on the same patient.

as for the tables for recording all that stuff you said, I am not sure you'll have time to do most of those maneuvers, let alone the space or time to record them in your note. and if you do, it will likely be at the expense of other stuff that may or may not be important. It seems like you think that you're going to be able to be perfect on this test, and you're sweating the details aiming for 100% gold stars and smiley faces, when it's all one big foggy, unclear mess of a test that is very restricted on time, especially because these aren't real patients, and you may find yourself more nervous than you expected, at least I did.
I think you probably don't need to sweat it so much... I mean, I found the test miserable to take, but I passed it and I don't think I got to base one on my neuro exam because time was up shortly after I was done washing my hands and asking the irrelevant history questions and listening to the heart, which I probably didn''t need to be listening to in the first place? or maybe I shoud have listened more to the heart?...do you get the idea? the test is a big mess, at least for some of us who still manage to pass, and not some perfect exercise in table making. but it blows over in the end, kinda like a fart.

 

[step2csblows]

I failed Step 2 CS once before I passed it. My user name reflects my feelings about the "exam." (I was never good at OSCEs, and never liked them, so that's part of it. Most of you should pass no problem. Remember, it has an 80-90% first time pass rate.)

This is an unnecessary test. But that fact is irrelevant. It's currently there. It has to be passed.

Here are some things that I changed:
Typed notes!
More thorough physical (heart/lungs/abd + pertinent)
Better memorization of symptom complexes and minicases in First Aid CS
Experience of one try helped with the second try
Better closure! (Counseling patient on 2 likely dx and tests you plan to run; essentially letting the patient know what you plan to do. However, NO assurances or telling patient they definitely have a certain thing.)
Draped better and adherence to mnemonics: i.e. systematic!
Different testing center...have no idea if that affected anything since it is supposedly standardized

Things I did wrong but still passed:
Blew the dx on one case completely
Missed the dx on one case by a good bit
Confusing phone case

Two of the cases are test ones, so it's possible that two of my cases that I did poorly on were test cases. But I don't believe so (one of them is my guess).

Tips:
Get a partner, practice First Aid cases, memorize all questions to ask depending on CC, use same mnemonic for all cases (LIQORAAA PAMHUGSFOSS). Unless you are a slow typist, typing is better. It's important to note that perfection is not needed. Strive to grab as many points as possible by being systematic.

I hate this test with a passion. Obviously I can't answer case-specific questions because, aside from it being unethical, the NBME will track me down and excommunicate me from the medical field. I would be happy to answer general questions in order to help you guys get through this nonsense (hopefully with only $1000 blown instead of $2000 like me). Remember, this test is mostly BS and a hoop that has to be jumped through.

Take heart, my medical brethren! 👍

 

[sga430]

whatever u r more comfortable with. practice writing a PN with both typing and writing.

 

[mikedc813]

I typed. I liked the ability to rephrase or change what I wrote which is more of a hastle when writing. I also type MUCH faster than writing.

 

[LaurieB]

you can go to the usmle and do a practice note that is almost exactly like the real deal:

http://www.usmle.org/Orientation/2007/PatientNote/PNmain.htm

 

[JulianCrane]

I wrote all of my patient notes and just made sure that my handwriting was adequate. Typing is fine, but I stress out about typing under pressure. If you write your patient note, just make sure that you look over your note at the end and make sure it is legible and if u need to insert anything, use adequate signals to tell the reader what you mean and/or cross out things.

 

[Pollicis]

Actually I'm quite surprised that at this day and age people still opt to handwrite. I also type about 3x faster than I can write, and typing is automatically legible. Having said that, I saw lots of people turning in handwritten sheets on my test day. Strange.