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USMLE Step 2 CS SP Challenges Challenging situations presented by the Standardized Patient (SP) during the the USMLE Step 2 CS Encounter.

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Old 07-05-2012
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Question Non-compliant SP!

Hi all:

as titled, if SPs refuse to answer questions or physical exams, how to document it on the patient note?

Thank you!
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Old 07-05-2012
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The first thing, is "Ask why?". You have to know why the SP is refusing the history taking and/or physical exam. Accordingly you have to give assurance.

For example the SP is afraid because his/her problem is very personal, So, you have to try your best to comfort the SP and assure him/her that everything is confidential and that his medical illness information won't be released without his/her approval.

Another example, the SP is not happy because you were late. You have to say "sorry, it took me long to be here, I know that your time is extremely precious and I apologize, now that I am here, let's make the most of our time and get on your problems one by one.

When SPs are non-compliant, they usually want to see if you will handle the situation appropriately and they'll then open up to you and let you take history and do physical but you have to appropriate action first (pinpoint the problem and provide a solution).

If by the end of the encounter you still did not take history or do physical then pretty much means you have failed that case "often fatally" and it does not matter what you write in the patient note then.

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The above post was thanked by:
BBNF-82 (10-07-2012), daaas1287 (06-30-2013), docwedsengr27 (01-07-2013), drgokult (07-05-2012), drsrb (12-20-2013), nepb (11-10-2012), tharani sundarraj (03-19-2014), tyagee (07-27-2012)



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