"What do you say next" type questions (Step1)

[grandeelmd]

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anyone have any suggestions on how to handle these questions? I keep getting punished by Q bank and there doesn't seem to be any good info in the review books...

 

[SuitsYou]

Never get a court order
Never ask a superior

 

[Stinger86]

anyone have any suggestions on how to handle these questions? I keep getting punished by Q bank and there doesn't seem to be any good info in the review books...

BRS Behavioral Science gives you 95% of the guidelines you need to correctly answer the questions. QBank behavioral questions are too in depth, and worthless to boot.

General ideas:
1) If a patient is competent, they make the final decisions about their medical care, not you or anyone else
2) Always tell the truth
3) Always take care of patients yourself (never refer tough patients)
4) Never make other people do your job for you (nurses, students, etc)
5) Respect patient privacy and, except for a few situations, always maintain it even from family and other doctors who aren't treating the patient, unless given permission to do so by the patient first
6) Always be friendly, direct, and honest with the patient. Unless you can't help it, tell them things in person, face to face, not over the phone, and not from across a giant desk in your office.
7) Remember that minors get the benefit of privacy in certain situations (drug use, std's, etc), and not in others

 

[joshua_msu]

Durable power of attourney overrides any documents such as living wills.

 

[Pox in a box]

Durable power of attourney overrides any documents such as living wills.

I'm a bit perplexed on that topic. I think Dr. Fadem has it confused too.

POA is not the same thing as a Durable POA of healthcare.

 

[Doc Ivy]

I hear you--- I feel like THE most unethical person on the planet-- I'm batting 40% on these... it's like all my instincts are wrong

HELP, first aid sucks in terms of preparing you for what to say/do next

 

[smgilles]

I hear you--- I feel like THE most unethical person on the planet-- I'm batting 40% on these... it's like all my instincts are wrong

HELP, first aid sucks in terms of preparing you for what to say/do next

I had around 10-12 of these type of questions on my exam. How I approached them was think about what I would say to the patient, then pick something else 😀 Kaplan BH did a decent job of laying out the laws and how to approach these questions....otherwise I think it's just hoping your logic matches the question writer's.

 

[samyjay]

My friend told me to respond as WWJD "what would jesus do?"

 

[Discobolus]

I just don't know what to think about these questions. My behavioral science was of the chart (in the bad direction) on the Comprehensive Basic Science Examination, but then a month later I take the Behavioral Science shelf and get the best grade of any shelf exam I've taken the first two years. Both tests had a lot of these types of questions.

My set of rules would be something like this:
1. Never pass the patient off to someone else
2. Never make absolute statements
3. Be touchy feely and never confrontational

 

[Doc Ivy]

My set of rules would be something like this:
1. Never pass the patient off to someone else
2. Never make absolute statements
3. Be touchy feely and never confrontational

Yeah, I've read all of the Kaplan "rules" and I still don't know what to say next a lot of the time--- do you ask the family to leave the room, or do you let the patient do it? Stuff like that... It's so hard to know what to answer because honestly you could justify it either way-- it's like trying to read the test writer's mind. Grrrr. Ijust hope Qbank covers all the possible scenarios so that I don't have to actually "think" about my answers on the real thing

 

[LukeWhite]

My friend told me to respond as WWJD "what would jesus do?"

SPEAKING of which, one of these response choices was something along the lines of, "God works in mysterious ways," and the explanation said that this was an example of "Catholic theology." Woah! Kaplan has some religious-accuracy quality control to do on those questions.

 

[Doc Ivy]

SPEAKING of which, one of these response choices was something along the lines of, "God works in mysterious ways," and the explanation said that this was an example of "Catholic theology." Woah! Kaplan has some religious-accuracy quality control to do on those questions.

I know, I did that question yesterday and I was like--- so only Catholics know about God? 😕

 

[viper]

Yeah, I've read all of the Kaplan "rules" and I still don't know what to say next a lot of the time--- do you ask the family to leave the room, or do you let the patient do it? Stuff like that... It's so hard to know what to answer because honestly you could justify it either way-- it's like trying to read the test writer's mind. Grrrr. Ijust hope Qbank covers all the possible scenarios so that I don't have to actually "think" about my answers on the real thing

I think if you do enough of those questions and read the rules in Kaplan and FA, you should be fine. For the family one - ask the family to leave and let the patient stop you IF he wants them there. Very logical - patient would have difficult time telling family to get out of the room so he can have privacy. I agree these scenarios are ridiculous, but I think you probably have 95% of them covered by q-bank questions and the rules. After that, when you get thew weird question, you think about what you would immediately do, and then realize that that's probably wrong - then figure out why and take a shot in the dark with another choice. 🙂

 

[Doc Ivy]

I think if you do enough of those questions and read the rules in Kaplan and FA, you should be fine. For the family one - ask the family to leave and let the patient stop you IF he wants them there. Very logical - patient would have difficult time telling family to get out of the room so he can have privacy. I agree these scenarios are ridiculous, but I think you probably have 95% of them covered by q-bank questions and the rules.

True. It is logical, but then I started thinking well what if the patient has trouble disagreeing with what the "almighty doctor" says and feels pressured to have the family leave the room... I know what the USMLE thinks is right, but I still feel like its so murky.

 

[omarsaleh66]

Isnt the best thing to say, "I need to speak with you in private?"

So u arent directly telling the family to leave, and the patient can easily tell his family to leave the room or ask them to stay.

Maybe we are talking about the same question?

 

[Doc Ivy]

Isnt the best thing to say, "I need to speak with you in private?"

So u arent directly telling the family to leave, and the patient can easily tell his family to leave the room or ask them to stay.

Maybe we are talking about the same question?

Nope. Sorry. Wrong. Apparently just saying you need to speak to them in private puts the patient in the position of having to say they want the family to leave or stay and in USMLEland that's not the right answer.

Silly, I know.