hopefulDOcter4321

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Hey guys, just wanted to know how you combat nervousness and filler words during SP encounters. I know many people say that you should just practice as much as possible but my school only has around 2-3 opportunities with SPs per semester. Personally, my go to filler word is "um" or "ugh". I'm still a 1st year student and have only had 2 encounters so far. But I want to begin early on as this could negatively impact rotations and Step CS if it becomes a bad habit. Additionally, do you have any advice for the note typing part? I'm not the fastest of typers and I've found I cannot finish parts of the note due to time constraints. Thanks!
 

sanfran256

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I struggled with this as well, am quite shy and have a soft voice so I don't appear as confident as I could! I think it honestly hurt me third year so if you can find a way to combat this now you will have a much easier time during rotations!

Tips:

-Record yourself at home - this will be quite hard to watch but helps A LOT in recognizing what you are doing well and what you need improvement on
-Instead of using filler words - just pause, seems awkward in your head but isn't. Using filler words comes across a lot worse
-During your A/P do not pose you plan as a question - many people do this and it comes across as not confident
-Set up a meeting with an "expert educator" - most schools have docs who can help students like us practice presentations - the sessions are so helpful! They can help you organize your presentations/critique you
-If you have time, join a toastmasters club- I didn't do this but heard from friends they are helpful
 
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TakotsuboOkazaki

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Three tips:

1.) It takes time, you will get better at encounters in general
2.) Echoing the above poster, don't be afraid to just pause and prepare your next statement. Just be sure not to take too long!
3.) Be as prepared as possible so you don't find yourself searching for what question to ask next. This was a big one for me.
 
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Matthew9Thirtyfive

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One time I was really hungry and completely lost my train of thought. Rather than just fill the silence, I just apologized told the SP that I lost the thread and would come back to it if I remembered. I remembered a couple minutes later and circled around. She said she appreciated the honesty rather than me trying to fumble through it or BS it.

If you’re thinking, don’t be afraid to pause for a few seconds. I also ask the SPs if they are okay with me jotting down a few notes as we talk. They never mind, and the few seconds lets me think of my next thing while not being just awkward silence.
 
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hallowmann

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You can use other fillers, like sure, OK, etc. As long as it is not a huge part of the encounter, you'll be fine. Its something that you easily learn and manage over time.

One time I was really hungry and completely lost my train of thought. Rather than just fill the silence, I just apologized told the SP that I lost the thread and would come back to it if I remembered. I remembered a couple minutes later and circled around. She said she appreciated the honesty rather than me trying to fumble through it or BS it.

If you’re thinking, don’t be afraid to pause for a few seconds. I also ask the SPs if they are okay with me jotting down a few notes as we talk. They never mind, and the few seconds lets me think of my next thing while not being just awkward silence.

This. You're human. I actually still use this all the time when I see patients (mostly when I'm trying to do something on the EMR simultaneously). Often, they laugh it off. It humanizes you and helps to build rapport in the outpatient setting. Its less ideal in the inpatient setting, as people are more acutely ill and confidence, honesty, and reassurance are usually what patients look for in their physicians.
 
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CyrilFiggis

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The majority of your encounters are the same every time - HPI, PMH, PSH, meds, allergies,FH, SH, etc.

Especially as a first year, just focus on nailing those. Every encounter on the wards becomes a variant of this which frees you up to focus on the specific HPI questions for a given presentation.

You are nervous either because you don’t feel comfortable with the above or because you view SPs as a test/grade.
 
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NickNaylor

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I was someone who was always anxious about "patient" encounters (real or simulated) when I was being directly observed by someone. It really wasn't until I was a PGY-3 that I finally got over it. I think it's normal to be anxious when doing interviews when you know you're being observed. It's something that will get better as you do more and more encounters and you become able to do them in your sleep.
 
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mistafab

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Listen to good public speakers - they do not use filler words. You don’t notice how large of an effect these filler words have on your ability to persuade and instill confidence. It goes a long way in the clinic.

My advice is to separate your SP practice and filler word problem into two distinct goals. Go practice with friends your H&P, and also start an “um“ jar or something to cut those fillers out of your life.

Best of luck.
 
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deleted915325

I can get anxious when being observed or graded but am really good when on my own or with other students. It’s harder (at least for me) to get over those kinds of nerves but the nerves that come from just taking a history and physical will go away once you start to nail down your skills, which you’ll develop slowly but surely with practice
 
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