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benpu: 我也说两句经验:CS BSO and some real stuff
作者:USMedEdu
发表时间:2008-06-19
更新时间:2008-06-19
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发信人: benpu (麦地大奔), 信区: MedicalCareer
标 题: 随大流,CS BSO and some real stuff
发信站: BBS 未名空间站 (Thu Jun 19 14:03:18 2008)

看大家讨论的这么热闹,我就也说两句经验:

1。态度第一。对病人的热情、细心再怎么强调也不过分。这和CS的评分标准是一致的
。所以大家练习的时候不要本末倒置,为了问全问题而忽略病人感受。CS中反而专业是
相对最不重要的,不要为了少问几个细节或是少了几个体检担心。

2。英语口语很重要。说话要大声,保证SP可以听清楚,也显得有信心。

复习资料:
1。FA practice case 为主。
2。UW case作为检漏。
3。FA minicase熟悉诊断(名称)、鉴别诊断及相应检查。

前段时间一位版友总结的3P很重要“practice,prioritize, protocol”。

这里简单写一下我的protocol:

1. before start, get your pen in hand and make sure it's in writable
position by pressing the knob. you will get messed up if you forget to do so.

2. when hearing "examinee..." you can start without waiting for the whole
announcement to finish.

3. before entering, draw couple lines to divide the scratch blue note paper
into 3 areas. write down the Abnormal VS, last name in the top area. leave
the middle big block for notes with Mnemonics as the title, and leave the
bottom one for reminding (important dd, counsellings for smoking, family
support or so on)

4. knock the door, count to 3 then walk in.

5. "hello, Mr. XYZ, I am Dr. Benpu, nice to meet you!" (I say hello in order
to avoid confusing about morning or afternoon...) then shake hands.
remember smiling.

6. grab the drape, when opening that, say "how's the room?".after the SP
answers, gently cover him

7. say "I am gonna ask you couple questions and do a brief physical on you,
at the same time, I need to take some notes, is that Ok?"

8. start history collecting by " How may I help you today"

9. first open-end Q "could you please tell me more about..?" mostly SP will
bring up extra stuff

10. go by your mnemonics "OCDFP LIQRAAA, PAMHUGSFOSS" you will get most of
the points for sure even you miss couple, don't worry

11. when done, ask "do you have anything else you want to tell me about?"

12. "next I gonna do a physical on you, please excuse me couple seconds when
I wash my hand"--->really wash your hand please

13. "thanks for waiting, shall I start?" get "yes" then proceed

14. always asking for permission before exposing body parts. always tell SP
which exam you gonna do (no need to be specific). I will say "I gonna listen
to your heart, may I lower you drape a little bit?"

15. I got many female SP. I told them "could you please hold your breast
aside a little bit for me? thanks" when listen to the heart.

16. remember tie back. remember to help them lying down or getting up.

17. PE done. grab your note (I do so to take a peep coz mostly I forgot
their name already ) say "thanks a lot for your cooperation, Mr. XYZ. Let me
summarize here. If you have any questions, please feel free to bring it up.
You told me ........during physical examination, I found...so my impression
is.......I need to do ...... then we can sit down discuss the diagnosis and
figure out what is the best treatment option for you. Do you have any
questions?" Here is when the SP brings up the challenging questions.
finally, do not forget to look at the bottom area of your note for any
necessary counsellings.

18. Done. say "It's very nice talking to you. Once I get all the results, I
will call you ASAP. take care" shaking hands

19. for PN, just practice with FA (UW is no good on this one)

20. couple tips:
a. in history taking, generally ask all the systems from top to bottom in
order not to lose important hints, 1-2 Qs for each system is enough

b. if you feel not enough time for closure, you might do it first, if any
time left, then do some PE. I did so.

c. don't panic if you made some mistake. I called one SP name backwards,
when she corrected me, I said "please accept my apology for bad
pronunciation" , then we all laughed, no big deal.


OK. time for BSO. like I said, spoken English is important. I finished most
of my patient encounter with 1-3 mins left (messed up the very first one, no
time for closure), and even one before the 5 min-remaining announcement.
and for most of PN I had 1-2 mins left because I made my notes based on the
mnemonics.


good luck everybody, see you guys on dok's party!


--
※ 修改:·benpu 於 Jun 19 14:08:29 2008 修改本文·[FROM: 216.170.]

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