Format for CS progress note?

[vvv3]

I'm just curious b/c I can't figure things out. For those who took CS (and presumably passed ):

Did you write progress notes that were essentially one paragraph narratives with just the key history parts (relevant FMH, SH, etc. thrown in)?

or

Did you do it like First Aid CS has it where you always had separate sections for ROS, SH, FMH, etc.?

The first option seems to be the way of the example on the USMLE web site and the latter seems way too time-consuming, but I'm not sure if that means First Aid is overkill. . . .

 

[vegetables]

I'm just curious b/c I can't figure things out. For those who took CS (and presumably passed ):

Did you write progress notes that were essentially one paragraph narratives with just the key history parts (relevant FMH, SH, etc. thrown in)?

or

Did you do it like First Aid CS has it where you always had separate sections for ROS, SH, FMH, etc.?

The first option seems to be the way of the example on the USMLE web site and the latter seems way too time-consuming, but I'm not sure if that means First Aid is overkill. . . .

I did it the second way b/c I hate full paragraphs and separating it into sections allowed me to do bullet points, which to me was much faster. But try both ways for practice and go with what works for you.

Also with the paragraph method you might only writing the pertinent positives - having it in different categories and always filling out all of them (even if with a simple (-) sign) assures you that even when it is is negative, you write that, and you for sure get credit for asking that.

 

[deleted113029]

I'm just curious b/c I can't figure things out. For those who took CS (and presumably passed ):

Did you write progress notes that were essentially one paragraph narratives with just the key history parts (relevant FMH, SH, etc. thrown in)?

or

Did you do it like First Aid CS has it where you always had separate sections for ROS, SH, FMH, etc.?

The first option seems to be the way of the example on the USMLE web site and the latter seems way too time-consuming, but I'm not sure if that means First Aid is overkill. . . .

a person failed the documentation part of ICS by not breaking his write-up into separate sections. i passed by using the FA format. nuff said.

 

[IFNgamma]

follow the format exactly as they have it in First Aid and you will not go wrong.

 

[Pox in a box]

If you choose to type, about how many lines do you approximate that they allow?

 

[Samoa]

a person failed the documentation part of ICS by not breaking his write-up into separate sections. i passed by using the FA format. nuff said.

How do you know that's why they failed?

 

[deleted113029]

How do you know that's why they failed?

because their score report told them so and they remembered not following the FA format.

 

[Samoa]

So it could have been the note content and not the format. I find it hard to believe that someone would fail for using the same format as shown in the official example.

 

[deleted113029]

So it could have been the note content and not the format. I find it hard to believe that someone would fail for using the same format as shown in the official example.

did you read what the usmle said about those notes? they are NOT to represent a complete note...just the style. and again, i cannot help it if your skull is too thick to allow you to understand. he failed because of the FORMAT! sheeesh...short bus rider.

 

[JCserver3]

I did the history part in one paragraph and I passed. It is very important that you mention both positives and pertinent negatives. You should not forget to mention each part of the history. For example, you might say "Family history is negative. Pt does not smoke, drink, or use illicit drugs." I don't think the format matters. It's the content that is important. I chose to use paragraph style because it was faster to type, and made efficient use of space. (The computer limits how many lines you could type.)

For the physical exam, I broke it down like first aid.

Another tip I got before the test was to complete the differential diagnosis and plan first. Then do the history. Finally, the physical findings. This maximizes points gained in case you run out of time.

I was able to fit more tests I wanted to do by grouping similar tests into one line. This way, you don't leave out any tests that the graders might consider important.

In general, first aid goes into more detail in the writeup than you need to pass the exam. However, the more you can put into the writeup, the better.

 

[JCserver3]

If you choose to type, about how many lines do you approximate that they allow?

It is enough to convey the pertinent positives and negatives. I did occasionally run out of space and I solved that be using abbreviations and taking out things that are less pertinent than what I wanted to add. There is a page on the USMLE site that simulates this. Go to: http://www.usmle.org/orientation/2007/PatientNote/PNmain.htm

However, the software on the test is different than the simulation. The real test has a bar that increases as you type to let you know how much space you have left. Use accepted abbreviations whenever you can.

 

[Samoa]

did you read what the usmle said about those notes? they are NOT to represent a complete note...just the style. and again, i cannot help it if your skull is too thick to allow you to understand. he failed because of the FORMAT! sheeesh...short bus rider.

What I love most about this post is how you call me an idiot right after you make a statement supporting my argument rather than yours. That was actually kind of funny.

 

[deleted113029]

What I love most about this post is how you call me an idiot right after you make a statement supporting my argument rather than yours. That was actually kind of funny.

the person in question wrote the note very similar to example 1 but included PMH, FH, SH into his paragraph at various places. He did not place the info at the end of a typical HPI. thus, his format was very similar to the USMLE example 1 format yet he failed.

the content was there. the layout was poor. he failed. make what you want of this.

 

[Pox in a box]

the person in question wrote the note very similar to example 1 but included PMH, FH, SH into his paragraph at various places. He did not place the info at the end of a typical HPI. thus, his format was very similar to the USMLE example 1 format yet he failed.

the content was there. the layout was poor. he failed. make what you want of this.

I have a hard time believing that they would discount you for not "bulletizing" your note.

 

[Samoa]

My point is that he probably did neglect relevant information, and THAT was why he failed. I doubt it was a matter of format, as evidenced by the fact that other people passed who did the same thing.

Perhaps the data he gathered didn't adequately support his differential. How can you know what aspect of the note was deficient, unless it was your own note and you got specific feedback to that effect (which I thought they don't provide)?

 

[Tired]

My point is that he probably did neglect relevant information, and THAT was why he failed. I doubt it was a matter of format, as evidenced by the fact that other people passed who did the same thing.

Of course you're right about this. Obviously this "friend" was a ***** and just didn't include the relavent data in his/her note. Then, when asked why he/she failed, made up this lame-a$$ story about "my score report said I didn't use the right format." Kind of like, "I would have passed Step 1, but I was sick that day and the computer had a glitch."

I did not use the FA format, and passed just fine. I did one long paragraph, including the appropriate HPI/PMH/FH/SH etc.

The reason I did not use the bulleted format is that there is limited space in the note, and I tend to include a lot of pertinent negatives in my notes as well as positives. If I were to bullet it, or even use seperate lines for subheadings, I would not have had nearly enough space to include everything important.

 

[deleted113029]

My point is that he probably did neglect relevant information, and THAT was why he failed. I doubt it was a matter of format, as evidenced by the fact that other people passed who did the same thing.

Perhaps the data he gathered didn't adequately support his differential. How can you know what aspect of the note was deficient, unless it was your own note and you got specific feedback to that effect (which I thought they don't provide)?

Of course you're right about this. Obviously this "friend" was a ***** and just didn't include the relavent data in his/her note. Then, when asked why he/she failed, made up this lame-a$$ story about "my score report said I didn't use the right format." Kind of like, "I would have passed Step 1, but I was sick that day and the computer had a glitch."

I did not use the FA format, and passed just fine. I did one long paragraph, including the appropriate HPI/PMH/FH/SH etc.

The reason I did not use the bulleted format is that there is limited space in the note, and I tend to include a lot of pertinent negatives in my notes as well as positives. If I were to bullet it, or even use seperate lines for subheadings, I would not have had nearly enough space to include everything important.

you're both right. he must not have told me the whole story. btw, this person is not my 'friend.' just a disgruntled student at my school.

goes to show that people who fail don't truly reveal the reason why.