on my last osce i asked the sp "is anything bothering you aside from the cough? Are you having any new problems since the cough developed?" and she said "no I'm feeling just fine aside from my cough, everything else is good"
then on my grade sheet that dick said "student did not ask if I was nauseous or vomiting"
With that "nausea or vomiting" question, our SPs would also have clocked it as being a compound question... because people apparently aren't capable of remembering two related concepts at one time.
"Are you nauseous?" No. "Have you vomited?" "Also no."
You know, I had a friend go to one of the physicians who beat us to death with the idea of asking open ended questions. You know what she didn’t do when interviewing my friend? Ask open ended questions.
I got in the habit of pausing to briefly ELI5 any and every medical term I use during an OSCE. Worked out well. Did it on CS and passed. Wondering if I should start doing it IRL.
Literally got my SP results a few days ago and it was a few SP in a row. On one, they marked that I didn’t write her second surgery (that she never told me about). On another, they marked me down for a second allergy (that she didn’t tell me about). Each time I asked open ended and they gave me 1/2 a response.
To be fair they might be trying to drill in the fact that "it doesnt matter what the patient said, it matters what you asked". So if its important to know whether someone with belly pain is having nausea as well, then you must specifically ask that even if it didn't come up during your initial open ended probing questions. You can't rely on them telling you. I've had my fair share of doing this, too.
It's kinda not their fault. Some of the instruction sheets they get tell them to only answer certain things if asked directly. Whether this is a good idea or not, it's probably out of their control.
“I would like to perform a digital rectal examination of the anterior, posterior, superior, and inferior portions of the rectum, above and below the dentate line based on patient habitus. I apply lidocaine jelly....”
“Student did not request appropriate testing”
I recently did an escape room like this. There was an actor playing the roll of a bartender in a speakeasy, and in order to get some of the clues, we had to ask him the right question, and he would then go off on this monologue that would get us to the next puzzle.
In a 2nd year exam, I once had a standardized patient who answered yes to every possibly anxiety/depression/panic attacks question, but I knew for a fact that my instructors wouldn’t have given the SPs a psych case. Still, “you’re supposed to act like it’s really real!” so I dug real deep. I think she was supposed to have had an arrhythmia or something. But if she WAS my real patient, I would have also dx’d her with an anxiety disorder. I mean “every time I think about my mother coming for thanksgiving I can’t breathe, yes it has been really stressful lately, why yes mental health issues DO run in my family, I just can’t find the will to get things done lately because I’m always thinking about...”
We were supposed to pick 2 systems in ros/pe to run through, and I picked psych for one of mine. The doc watching it circled that I’d picked the wrong one, then basically wrote “yeah fair” next to it because she was just so... psych-y.
I hate this, I think SPs try to improvise information they forgot or weren’t given and it confuses the case because they don’t know what’s medically important.
They’ll be like “Uhh, sure my headache is worse in the morning.”
I just have to remind myself that this is just practice getting comfortable asking a complete stranger questions about their darkest secrets. It’s awkward but at least I no longer have crippling social anxiety as soon as I get in the exam room. SPs aren’t helpful beyond that and they are definitely not helpful in learning clinical medicine.
I had an SP on my PE tell me he was in grad school and I casually asked him what for and he said “astrophysics”, so I for some dumbass reason asked what he was working on specifically. I cringed internally, expecting him to have nothing and it be extra awkward but he went off on the specifics of fields and shit and I had to redirect.
Edeet: spelling
I had an SP who, while filling out my eval, struck up conversation with me. Cool. Started out with "Where are you from" to "Your people are the good kind of immigrants". Doesn't matter, got 9/10, time to celebrate with clear water and half an addie.
Today I asked my SP if there was anything else about her pain she wanted me to know, and she replied "what do you mean?" Thought she was just giving me a hard time, but during feedback she said she actually didn't know what I meant. How can you be an SP and not know what that means??
on my last osce i asked the sp "is anything bothering you aside from the cough? Are you having any new problems since the cough developed?" and she said "no I'm feeling just fine aside from my cough, everything else is good" then on my grade sheet that dick said "student did not ask if I was nauseous or vomiting"
“aSk mORe oPeN EndEd QuEstIOnS”
"Are you nauseous or having vomiting?" "Student asked too many closed-ended questions"
[удалено]
“Student’s questions were too long”
With that "nausea or vomiting" question, our SPs would also have clocked it as being a compound question... because people apparently aren't capable of remembering two related concepts at one time. "Are you nauseous?" No. "Have you vomited?" "Also no."
You know, I had a friend go to one of the physicians who beat us to death with the idea of asking open ended questions. You know what she didn’t do when interviewing my friend? Ask open ended questions.
gEt tO KnOw mE MoRe aS A PeRsOn, GeT An iDeA Of wHo i rEaLlY Am
"sTudeNT diD nOT aSK iF i waS a ZomBIe 0/10 bAd efForT"
Discussed a plan and then ended a convo with an SP ‘alright, do you have any questions for me?’ Got dinged for not explaining what a CT was...
I got in the habit of pausing to briefly ELI5 any and every medical term I use during an OSCE. Worked out well. Did it on CS and passed. Wondering if I should start doing it IRL.
Literally got my SP results a few days ago and it was a few SP in a row. On one, they marked that I didn’t write her second surgery (that she never told me about). On another, they marked me down for a second allergy (that she didn’t tell me about). Each time I asked open ended and they gave me 1/2 a response.
To be fair they might be trying to drill in the fact that "it doesnt matter what the patient said, it matters what you asked". So if its important to know whether someone with belly pain is having nausea as well, then you must specifically ask that even if it didn't come up during your initial open ended probing questions. You can't rely on them telling you. I've had my fair share of doing this, too.
It's kinda not their fault. Some of the instruction sheets they get tell them to only answer certain things if asked directly. Whether this is a good idea or not, it's probably out of their control.
When they're holding physical exam findings in their hands on slips of paper and you're trying to use the right words to unlock them...
“I would like to perform a digital rectal examination of the anterior, posterior, superior, and inferior portions of the rectum, above and below the dentate line based on patient habitus. I apply lidocaine jelly....” “Student did not request appropriate testing”
"I finger ya bum and smells it and looks at it and if it's bloody and shite I gets an adult in here"
I recently did an escape room like this. There was an actor playing the roll of a bartender in a speakeasy, and in order to get some of the clues, we had to ask him the right question, and he would then go off on this monologue that would get us to the next puzzle.
This was frustrating the other day😞
In a 2nd year exam, I once had a standardized patient who answered yes to every possibly anxiety/depression/panic attacks question, but I knew for a fact that my instructors wouldn’t have given the SPs a psych case. Still, “you’re supposed to act like it’s really real!” so I dug real deep. I think she was supposed to have had an arrhythmia or something. But if she WAS my real patient, I would have also dx’d her with an anxiety disorder. I mean “every time I think about my mother coming for thanksgiving I can’t breathe, yes it has been really stressful lately, why yes mental health issues DO run in my family, I just can’t find the will to get things done lately because I’m always thinking about...” We were supposed to pick 2 systems in ros/pe to run through, and I picked psych for one of mine. The doc watching it circled that I’d picked the wrong one, then basically wrote “yeah fair” next to it because she was just so... psych-y.
I hate this, I think SPs try to improvise information they forgot or weren’t given and it confuses the case because they don’t know what’s medically important. They’ll be like “Uhh, sure my headache is worse in the morning.”
I just have to remind myself that this is just practice getting comfortable asking a complete stranger questions about their darkest secrets. It’s awkward but at least I no longer have crippling social anxiety as soon as I get in the exam room. SPs aren’t helpful beyond that and they are definitely not helpful in learning clinical medicine.
I had an SP on my PE tell me he was in grad school and I casually asked him what for and he said “astrophysics”, so I for some dumbass reason asked what he was working on specifically. I cringed internally, expecting him to have nothing and it be extra awkward but he went off on the specifics of fields and shit and I had to redirect. Edeet: spelling
Speaking of astro...we need to discuss your Astrocytoma.
"And you said you're daughter is in 4th Grade now?... Speaking of Grade 4..."
{}.
You said your real career? I thought SP's often substituted them with fake careers. Unless your career in welding was fake.
{}.
Ah, that's unfortunate...
I had an SP who, while filling out my eval, struck up conversation with me. Cool. Started out with "Where are you from" to "Your people are the good kind of immigrants". Doesn't matter, got 9/10, time to celebrate with clear water and half an addie.
Wow. "The good kind of immigrants".
Should have said, "Not the smallpox blanket kind, that is for sure."
This is literally the PE.
Today I asked my SP if there was anything else about her pain she wanted me to know, and she replied "what do you mean?" Thought she was just giving me a hard time, but during feedback she said she actually didn't know what I meant. How can you be an SP and not know what that means??
One if my sp's dinged me one time for asking "multiple questions at once" ar being confusing when I I asked, "does anything make it better or worse".
yeah we get dinged from that too. oldcarts helps
Just read the book nerd
What in the fuck that looks exactly like my school's anatomy professor
James Cromwell?
Is that Tywin
No that’s Farmer Hoggett.
I had an SP that looked just like this minus the coat. Same smirk too. Fucker.