PE major mistake ???

[tom bayer]

Took my PE last week, but I am worried about this mistake that I made. So in the examining room I sat at the table next to where the patient was sitting. I used the table to take notes so I was on the left side of the patient.

Should I have been sitting on a stool right in front of the patient? I am worried that they might think I was too far from them!!

I did this for mostly all the patients. I did make eye contact with them when they answered my questions.

Also, some for some of the cases I realized after I got home that I made the wrong diagnosis!!! I did this for about 3 0r 4 cases. Some of the cases were vague and it was hard to tell what their problem was.

Also my handwriting was really sloppy b/c I was writing soooo fast!!! How will they read my note?????


I am so worried I will have to retake this!!!!!!!!!!!!

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[shiftingmirage]

Wasn't your note on the computer?

It's hard to say what the outcome will be, because I don't think anyone truly knows how these things are graded except for the graders. Most people, especially AMGs, pass.

 

[tom bayer]

Also I realized when I was counseling a patient, I told them I think they have X diagnosis, then when I went to write my SOAP note, I realized that the X diagnosis was incorrect, so in mY soap note I wrote the right diagnosis as the first assessment. Am I gonna get points taken off for that????????

 

[rkaz]

I think he's referring to the COMLEX-PE.

Although I can't tell you if you passed or not, be assured that you can make several mistakes and still pass. On one of my cases I left out the #1 differential diagnoses (the other ones I listed were good, but not as clear cut/obvious as the one I left out). On two of my OMM cases, I remembered how to diagnose the condition with OMM technique, but I couldn't remember the OMM technique to treat. I was also quite worried about passing, but still managed to pass thankfully. My notes were very comprehensive, and I treated the patients very kindly (I think), so that may have surely helped me.

As far as your concern about being too far from the patient, I really wouldn't worry about it. After all, you had to come closer to do the physical exam, right? In some of my cases, I sat close to the patient, and in others I was probably 3-4 feet away.

I cannot give you an assessment of your handwriting, as I have no idea how badly illegible it really was or not.

At this point, there isn't much else you can do other than to do other things to keep your mind of the test. I know it's hugely nerve wracking, but stressing won't help. I hope you pass it (and most likely you will, as I thought the exam had around a 94% pass rate or greater). However in worse case scenario that you don't pass, we can go over strategies to help you pass the next time around. But otherwise, just enjoy your 4th year - as I'm trying to do also.

 

[WonderBoy]

Took my PE last week, but I am worried about this mistake that I made. So in the examining room I sat at the table next to where the patient was sitting. I used the table to take notes so I was on the left side of the patient.

Should I have been sitting on a stool right in front of the patient? I am worried that they might think I was too far from them!!

I did this for mostly all the patients. I did make eye contact with them when they answered my questions.

Also, some for some of the cases I realized after I got home that I made the wrong diagnosis!!! I did this for about 3 0r 4 cases. Some of the cases were vague and it was hard to tell what their problem was.

Also my handwriting was really sloppy b/c I was writing soooo fast!!! How will they read my note?????


I am so worried I will have to retake this!!!!!!!!!!!!

I did the same thing for few of my cases and so did a friend of mine. Later I realized maybe I should have sat in front of the pt. We did do that in OSCE. But honestly it was a lot easier to write on the desk and I maintained good eye contact.

I suffered a lot of the next few weeks because I thought I was gonna fail due to not sitting in front of the patient. But I passed.

I may have messed up one diagnosis as well, but I wrote possible other diagnosis as well. Handwriting I can't comment on, hopefully it will be fine.

But as far as the desk thing, that shouldn't affect you for PE grade.

 

[WonderBoy]

Also I realized when I was counseling a patient, I told them I think they have X diagnosis, then when I went to write my SOAP note, I realized that the X diagnosis was incorrect, so in mY soap note I wrote the right diagnosis as the first assessment. Am I gonna get points taken off for that????????

As long as the incorrect diagnosis was one of your three possible diagnosis on the note, I think it shouldn't be an issue. I know this sucks, but you will just have to wait and pray. Good luck

 

[BigSib]

If you want my honest opinion: you may fail the humanistic domain.

...in the examining room I sat at the table next to where the patient was sitting... I used the table to take notes...

There is a stool that you can sit on in every room. Are you saying you never sat in that stool? Logistically I don't understand how you would feel comfortable writing on the exam table with the patient sitting at the edge of that table. If you did this it is not common place and may result in markups by the patient actor.

Otherwise if it felt comfortable for you and the patient I wouldn't worry about this. If you're saying you sat at the table next to the sink/wall and the patient was on the exam table, and you wrote with the chart in your hands - I wouldn't worry about this.

I made the wrong diagnosis.

The major points of the assessment portion of the SOAP note are arriving to the correct diagnosis and ruling out other major, life-threatening conditions. They want you to write the #1 diagnosis and r/o XYZ in this area (and actually write "#1" and "r/o"). Other diagnoses such as nicotine dependence and alcohol abuse are viable options based upon this history, but likely will not be your #1.

Let's say the correct diagnosis was appendicitis. If you wrote 'acute abdomen' and never mentioned the appendix I'm sure this would be in the realm of correct. You would never fail the encounter because you didn't get the #1 diagnosis correct. In my opinion it's more of a 'at least you're in the ballpark' sort of diagnosis than a perfect diagnosis.

...my handwriting was really sloppy.

This is actually pretty important and goes hand-in-hand with your English speaking capabilities. If the examiner can't read your note, you'll be docked on some points. However, you must realize that someone grading the SOAP notes reads a countless number in a given year, and that many notes are sloppy and they're used to reading sloppy writing. At the end of the day my hand was dead too, and I'm sure the writing was sloppy - but I still passed.

They're transitioning over to electronic keyboard entry soon, so if you were to retake the exam this would be a mute point (unless you can't type efficiently).