Last minute COMLEX PE Prep! Please Help!

[jacksparrow82]

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I am scheduled to retake my PE exam this coming wed. march 5. I feel like this time around I am a lot more prepared for this exam than the last time, but I want to make sure I am not missing anything big or obvious.
I failed the "data gathering" section which includes the basic history taking and physical exam. I did "proficient" on omm and "needs improvement" on my note and humanistic sections.
I think I really need to focus on doing a much more thorough, detailed history. I think thats what got me the first time, I rushed through it and missed a lot of questions.
I've been going through First Aid for the CS daily. Basically, I quiz myself on each case and make sure I've asked all the appropriate questions and get at least 3 good differentials and diagnostic exams.
Here's my plan, please give me your feed back on it.
My plan is to ask COPMAP questions of everyone. Any complaints of pain get the LIQORAAA questions. Any mention of alcohol will get CAGE questions. Any woman of childbearing age will get OB/Gyn history. Everyone will be asked about the following: PMH, PSH, SocH(including tob, etoh, drugs, occupation, living situation), FH, Allergies, Meds, Sexual Hx.
Most complaints will get asked about constitutional symptoms, (nightsweats, weight/appetite, blood in stool/sputum), sick contacts, recent travel, last ppd test. Any complaint of fatigue or depression gets the SIG EM CAPS questions.
I'm going to summarize everything before starting the physical exam. I'm going to offer a diagnosis and plan after the physical exam along with counseling on quitting smoking, safe sex practices, and help with drinking and ask "Is there anything else I can do for you today? Do you have any questions?"

For the physical exam I'm going to make sure to do Neuro exams on patients with complaints of headache, diabetes, depression, or neurological complaints.
OMM I'm not too concerned with. Those cases were obvious and pretty easy.
For the humanistic portion, everyone will be addressed strictly as mr. or mrs., get hand shakes, smiles, eye contact, proper draping before starting the history, hand washing, asking permission to start the physical exam, re-tying the gown when finished, showing empathy by saying: "I'm so sorry to hear you're not feeling well, I hope I can help you feel better as quickly as possible" All coughing ask "Can I get you a glass of water or a tissue?"

I think this will cover all of my bases. I don't want to give them any opportunity to fail me again!
Please let me know if there are any other things I should make sure to do/not miss! I need all the help I can get. I can not afford to fail this time!

 

[AlternateSome1]

Remember to relax. You are going to rock this thing.

 

[jacksparrow82]

Thanks! That's definitely an important one. I probably will be anything but relaxed until I get in there and actually start the test! I just can't wait to get this over with so I can put it behind me and enjoy the remaining two months of my 4th year!

 

[kristing]

I just took it for the second time, too. I think that if you do your plan as listed, you may not get through everything. Seriously. I only found I needed to ask the CAGE questions once, and is it really necessary when someone says they only have 2 beers on the weekend?

i did ask sexual history on EVERYONE. I lumped it in with social history. I didn't ask occupational hx of everyone, nor did I last time.
I did well on that section the first time and I didn't follow too much of a plan before (I failed only on the humanistic section). I was much more organized this time and would ask a question and then STOP. (That was an issue last time - I would ask - do you have any chronic medical problems like diabetes, asthma, heart disease, and these folks are trained to only answer the last thing.) So to make it go faster, ask things like: What diseases run in your family? What chronic medical problems do you have?

Remember to go over the plan at the end and to also summarize at some point in the encounter, also (usually after the history is good). (You mentioned that, but I KNOW this is what killed me initially. That and the last name thing, not shaking hands, and not draping. Damn the drapes. Damn them! I ended up not draping 2 old guys who were wearing gowns that LITERALLY went to their ankles who sat for the whole time, because what the hell is there to drape?)

I don't want to freak you out, I really don't. I just want you to get done in the mere 14 minutes you have!

I ended a little early on some, at time on 2.

Good luck, man! Good luck!

 

[jacksparrow82]

Thanks for that helpful insight. I will keep your points in mind

 

[jacksparrow82]

Well, my plane leaves tomorrow for philly and I'll have just tonight and tomorrow night to do any last minute preparation. I must say I am quite nervous about this exam. I have so much riding on the results. If I fail, I don't graduate on time, don't start residency on time who knows what else!
If I pass...life is good.
I guess I just need to stay positive and focused.
Any last minute PE advice from people who have already passed it?

 

[futuredo32]

I haven't had the "joy" of experiencing the PE exam, but from reading about all of your preparation, I think you are going to do awesome on the exam🙂. Good Luck!🙂