Verbalising the clinical exam in CS? - USMLE Forums
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USMLE Step 2 CS Communication Skills Step 2 CS Communication, Spoken English Proficiency, Language and Interpersonal Skills Discussion forum. CIS and SEP components of the USMLE Step 2 CS Exam.


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Old 03-04-2011
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Hammer and Otoscope Verbalising the clinical exam in CS?

Hi,

does anyone know if it is recommended that we verbalize what we do on the physical exam in the step 2 CS exam and our finding at each step for example do we say: I am looking at the eyes to see if there is Jaundice and pallor, at your skin for rash, listening to bowel sounds and bruits .. etc..

Thanks
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Old 03-04-2011
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Arrow Just say it in general

You don't need to mention the specifics such as:
you are looking for jaundice
examining the appendix
looking for bulging tympanic membrane
listening for wheazes and crackles
....

You just need to give a general idea to the patient, like:
I now will examine your eyes with the light,
I now will palpate your abdomen,
I will use the autoscope to look into your ears
I will listen to your lungs with a stethoscope
....

You need to deal with the CS exam just as you do in real life. In real life we don't explain each and every step we take.

Of course, if the patient asks you why you are doing this, then at that point you can explain in details.

Also, if you keep running commentaries while doing the physical, there is higher chance that you will commit errors as it is difficult to focus on both tasks (doing the exam and commenting on it).

The SPs will assess your performance in this way:
the student examined the eyes with a light
the student palpated all four quadrants of the abdomen
the student examined for rebound tenderness
the student examined auscultated the lungs front and back
.....etc

They will give you points for each thing that you do, they will not negatively assess you if you don't explain to them the procedure in details.
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Old 03-04-2011
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Thanks that was very useful. In Canada you need to verbalize everything otherwise you do not take the mark.
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Old 05-26-2011
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I was thinking, we need to say whatever normal or abnormal findings during PE in order to get score.
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