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  #1  
Old 06-05-2013
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Clock Clocks in CS exam room

are there clocks in the room. and also do we look at it or not or use the anouncement. also is there clocks outside. or use the announcement.???
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Old 06-05-2013
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yes there are clocks in the room but it is better not to look at them and to focus on the patient
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There are clocks inside on the wall and you can use them to manage your time. I tried to look at it a couple of times but then relied on the 10 minute announcement. If you are slow in history taking, then it might be of real use
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It also seems like those clocks run faster than normal clocks!

As suggested by other posters, when they say 5 minutes remaining, you should already have begun your physical exam or at the very least, gotten up and begun washing your hands (i utilized this awkward silence part to quickly summarize the HPI). SPs are spot on with the HPI and almost always give quick yes/no answers. So you should be good with 8-9 minutes on the history.

Ofcourse the golden rule is -
Summarize+Counsel+Do you have any questions for me? >>>> Lengthy physical exam.

Goodluck!
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Quote:
Originally Posted by Doc13586 View Post
It also seems like those clocks run faster than normal clocks!

As suggested by other posters, when they say 5 minutes remaining, you should already have begun your physical exam or at the very least, gotten up and begun washing your hands (i utilized this awkward silence part to quickly summarize the HPI). SPs are spot on with the HPI and almost always give quick yes/no answers. So you should be good with 8-9 minutes on the history.

Ofcourse the golden rule is -
Summarize+Counsel+Do you have any questions for me? >>>> Lengthy physical exam.

Goodluck!

summerizing, is different for everyone correct, I mean everyone does it differently.

for instance,

can I say
" I think your {condition} could be due to this and this and than explain this and this, and say I will order this and this to look for this and this", and than COunsel and ask if any questions.


Because this summerizing thing take a lot of time. I keep hearing do it, and not do it. I am getting confused.

aslo what are we summerizing, all the positives, and negatives, or just the reason the person came in today. so is it more like paraphrasing.
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ooh just saw Sabio old post.

it indicates the ending in FA is a summary and counsel.

I understand now, I been doing it correct the whole time.
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Originally Posted by shima View Post
ooh just saw Sabio old post.

it indicates the ending in FA is a summary and counsel.

I understand now, I been doing it correct the whole time.
I think you answered your own question. But yes, summarizing is basically talking about what the person came in for and an opportunity to make sure you aren't missing anything in terms of their complaints.

Counselling is also equally important. Personally, I ran out of time on a few encounters but asked "Do you have any questions for me?" anyway. Not sure if i'll be given points for that, but i wanted to indicated that if time had allowed, i would've ask that question.
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Summarizing, Counseling & Closure are three different things but all can be done at the end of your encounter. I prefer to counsel during the history taking & summarize at the end of history taking leaving closure for last so that if I run out of time I only miss points for closure.
You don't get any points for doing anything after the announcement "this encounter is now over".
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Originally Posted by Novobiocin View Post
Summarizing, Counseling & Closure are three different things but all can be done at the end of your encounter. I prefer to counsel during the history taking & summarize at the end of history taking leaving closure for last so that if I run out of time I only miss points for closure.
You don't get any points for doing anything after the announcement "this encounter is now over".
This is exactly the approach I did.

Remember.. "5 MINUTE MARK" you stop everything you are doing and start the PE (if you are in the middle of it thats fine).

NEVER EVER sacrifice summarizing, Counseling and closure.

The "expendable" part of CS is the PE for sure
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Quote:
Originally Posted by XpaezX View Post
This is exactly the approach I did.

Remember.. "5 MINUTE MARK" you stop everything you are doing and start the PE (if you are in the middle of it thats fine).

NEVER EVER sacrifice summarizing, Counseling and closure.

The "expendable" part of CS is the PE for sure

please give me an example of summarizing
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Based on the history I took, I would like to summarize first. You have been having pain in left side of the chest for the last 2 hours which has been radiating to the left arm. Along with this, you can feel your heart racing and have been sweating profusely. You have never had these symptoms before. There is no history of heart diseases in the family. And you quit smoking last year after smoking for 20 years. Is there anything you would like to add to it which I might have missed out on?



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please give me an example of summarizing
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Originally Posted by gagan View Post
Based on the history I took, I would like to summarize first. You have been having pain in left side of the chest for the last 2 hours which has been radiating to the left arm. Along with this, you can feel your heart racing and have been sweating profusely. You have never had these symptoms before. There is no history of heart diseases in the family. And you quit smoking last year after smoking for 20 years. Is there anything you would like to add to it which I might have missed out on?
This is perfect, with practice it takes less than a minute, remember to move your hands and change your voice tone, do whatever it takes so that you dont sound like a robot
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This is perfect, with practice it takes less than a minute, remember to move your hands and change your voice tone, do whatever it takes so that you dont sound like a robot
what if i do not summarize. I am finding hard to summarize.

see my husband did not summarize this is his score sheet.

please tell me , many people say different things.
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If I'm not wrong, this is an old scoresheet as you don't get a detailed report now. N with the changes that have come about from Januarythis year, you should not take a risk. You might pass without summarizing, but it would be better to play it safe. I did summarize for all the cases and then also finished 11 out of 12 cases in 13-14 minutes. You just need to practice


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what if i do not summarize. I am finding hard to summarize.

see my husband did not summarize this is his score sheet.

please tell me , many people say different things.
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Not only the summarizing gives you extra points (for CIS & ICE) but it also helps you to organize your HPI for PNs.
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