Step 2 CS- 15 minutes once you enter room or when you view patient info outside?

[DrTacoElf]

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Does anyone know for step 2 CS if the 15 minute timer starts when you get the patient information outside of the room or once you enter the room?

Thanks!

 

[jmcappleby]

It starts the second you are allowed to access information, i.e. when you start reading the patient information, vitals and chief complaint. Most people from what I've seen take 30-60 seconds outside processing the information, creating a template for interview on their blank sheet, etc. I usually liked to come up with a 3-item differential as well, esp. if I thought it might be abuse or depression or some information that may need a little coaxing to unveil. Sure, you lose that time from your interview but that way you can make sure you don't forget to ask anything and that you have some sense of direction going in. You don't want to conduct the whole interview and then walk out of there only to realize you forgot to ask about Family History or allergies... it may be irrelevant to your diagnosis but it still needs to be asked for completeness' sake.

 

[RaraBovis]

It starts the second you are allowed to access information, i.e. when you start reading the patient information, vitals and chief complaint. Most people from what I've seen take 30-60 seconds outside processing the information, creating a template for interview on their blank sheet, etc. I usually liked to come up with a 3-item differential as well, esp. if I thought it might be abuse or depression or some information that may need a little coaxing to unveil. Sure, you lose that time from your interview but that way you can make sure you don't forget to ask anything and that you have some sense of direction going in. You don't want to conduct the whole interview and then walk out of there only to realize you forgot to ask about Family History or allergies... it may be irrelevant to your diagnosis but it still needs to be asked for completeness' sake.

👍

 

[blahwhatever]

They announce that you can start the clinical encounter, and then before you enter the room, you pick up the patient information chart and read it. Before I entered each room, I wrote on my scrap paper OPQRST(onset/palliative/precipitating factors/quality/radiation/severity/time associations) and SMASH FM(surgeries/medical hx/allergies/social hx/Health care maint./family hx/meds) in big letters on the side. Even though it took about 30 seconds or so of my time before I entered the room, I actually saved more time overall and didn't miss those questions in any of my encounters. Because I would be able to check off what I asked, and take a glance at my paper which instantly gave me any questions I left out without having to think about it at all.