Re: CNS exam in 4-5 minutes
InSitu - 06-13-08 18:52

Hi there,

The CNS Exam should not take much time since it is only for you to perform for testing purposes. That means you do not need to spend much time performing one test and the SP will understand it. For example, when performing the ocular exam tell the patient to follow your fingers and do it as fast as you can and the actor will give you credit for that part. The actor wants to know if you actually remembered that part of the exam but will not grade you on how much time you spent and how accurately was it done. Anyone please correct me if I am wrong. :)

Re: CNS exam in 4-5 minutes
radhamesramos - 06-14-08 14:39

the cranial pairs, should be done quickly, but most of the time you can defer it! So, the only thing I recommend you is to do ocular, extremities strenght testing, sensitivity, and Romberg if necessary, this would take you between 2-3 minutes if the patient is cooperating. Actors will grade for your intentions, not for doing it all thoroughly

Re: CNS exam in 4-5 minutes
sackatdoc - 06-17-08 18:12

i am thinking CS exam is some kind of play or what in which patients are fake.We shouldnt forget we are true medicos.we should not act in front of them.my view is hypothetically we should assume these sp's are not faking any illness.we should look at them as true people,then our true potential will get tapped spontaneously.coz we are generally polite,empathetic&sincere to true patient.of course it doesnt amount to not respecting the time that we have to spend with them.kindly guide me if thinking that way can be of any help.

Re: CNS exam in 4-5 minutes
TheOne - 06-17-08 21:12



Yes you're right.. I would simply say "You're a Doctor and CS is formated to make sure that you are a Doctor".

Re: CNS exam in 4-5 minutes
InSitu - 06-17-08 21:23

I agree guys but the CS is not reality with you being TIMED to see the patient so you must find ways of how to get things done and that still counts. Yes you should treat the actor as a real patient except for the timing which you may play with.

Thanks

Re: CNS exam in 4-5 minutes
sackatdoc - 06-18-08 03:51

I want to stress here is we shouldnt be too much carried away by the fact that actors are the ones we are interacting with.coz such a feeling may make this whole history taking &examination thing a fake &madeup affair.so your genuine skills take a back seat&you landup in confused state of mind that is whether to practice medicine or be at a social meet with Sp.hope i convey what iam thinking.

Re: CNS exam in 4-5 minutes
InSitu - 06-18-08 11:45

Sackatdoc...I agree with you 100% but what I am trying to convey here is that you are timed and you must find ways to cut down on time on the physical part and still counts. If you are treating the SP 100% on the physical without looking at the time then you will not be able to complete the encounter. For example a real cranial exam will take a good ~10 minutes (maybe more). Can you afford taking 10 minutes on the CS exam to do one thing?

With you stressing that you must treat the SP as real I agree 100%, except for the time spent on the physical exam. With skills you can do it faster without the SP noticing it.

When I took my exam I did fly through the physical but I spent more time on the history and I allowed the last minutes to sit with the patient telling them what I think and what are my plans and allows them to ask their questions. It shows your confidence.

Re: CNS exam in 4-5 minutes
sackatdoc - 06-18-08 13:57

OF COURSE sir,i never said do an exhaustive exam.thats just not feasible at any rate.but yes talking part is what i'm saying shouldnt be a pretence.Any way we got eachothers point loud &clear thats what matters.i have absolutely no intention to do something undesired& uncalled for just for the heck of it.Thanks for reinforcing.

Re: CNS exam in 4-5 minutes
InSitu - 06-18-08 14:42

I guess the summary of this thread is treat the PS as a patient and be smart how to manage your time wisely. Up to the point history and good enough physical. Thank you sackadoc, you are great.

Re: CNS exam in 4-5 minutes
sackatdoc - 06-18-08 15:31

thanks i think replies are just our way know&communicate with eachother ¬ try to offend.seriously if i offended you or irritated you,i'm ready to apologise.It is indeed fun to have a healthy arguments.May be we can come up with something productive&new.Take care

Re: CNS exam in 4-5 minutes
InSitu - 06-18-08 16:06



???No not at all, I am not offended why are you saying that? This conversation was productive in my opinion. I am sorry but you are confusing me doc. I really appreciate your participationin this thread which is indeed helpful to all.

Re: CNS exam in 4-5 minutes
sackatdoc - 06-21-08 13:58

where are you insitu,we're missing you.if you'll be absconding for so long ,how we'l interact.then how will i do moonshining-all of my meaningless stuff.

Re: CNS exam in 4-5 minutes
InSitu - 06-21-08 19:43



I am in chicago today :) visiting some family and will be back to Ohio (Cleveland) and to interact with all of you more often soon. Thank you sackadoc...I like your attitude and its a pleasure having you here.

Re: CNS exam in 4-5 minutes
sowmyanmanju - 06-26-08 03:54

if u can watch the videos of usmleworld on how they efficiently examine all the required tests of CNS ..........
it is very helpful
personal experience ............

Re: CNS exam in 4-5 minutes
doctor1 - 06-29-08 12:52

ok jjusst as u mentioned spend a minute each on sensory and motor , 2 minuteas on cranial nerves examination , and do the minimal for cerebellar