communications lab

I think the only thing worse than having to watch a recording of yourself in a clinical encounter with a standardized patient failing at life is when you have to watch said failures with a preceptor and two fellow students.

For the record, I especially hate watching videos of me where I’m talking or hearing recordings of myself because I think I sound like I’m 5. :[ Dr. Miller assured me that what I sound like to myself isn’t what I sound like to everyone else because of the way your own voice resonates in your skull and such, but…if that’s the case, does that mean I really do sound like a 5 year old child!? ;_;

At least it was very much an equal-opportunity process. We all got to watch each other perform our awkward patient exams.

On the plus side, as I did mention, we got Dr. Miller as our preceptor and she is by far my absolute favorite because she’s the bee’s knees (aka never makes you feel stupid when you make mistakes/forget things).

My feedback ranged from “Marginal/Needs Improvement” to “Very Effective.” I don’t think they’re allowed to give “Exemplary” to anyone because there’s always room for improvement, but that might just be me trying to make myself feel better. (Kidding. They claim that no one ever gets “exemplary.”) My “marginal” ones were mainly due to the fact that I spent way too much time talking to the patient and nowhere close to enough time for the actual exam, so my closing statements were pretty crappy (or just nonexistent, because anything you say after the timer runs out doesn’t count).

My two standardized patients’ specific comments were:

  • “Too timid”
  • “Very pleasant and easy to talk to”
  • “Ran out of time, will need to speed up”

We’re going to be the first class that gets to type our SOAP notes for our boards for Step 2 (PE). Luckily, I have a hell of a lot of experience with typing quickly due to the fact that I was responsible for typing up my brother’s homework assignments back in the day (elementary school).

(I’m not kidding. My dad would seriously tell me to do this to help my brother out when I could instead have been sleeping and growing a couple more inches. Firstborn sons. <_<)

At least it’s proved to be useful? My friend finds my typing ability amazing and says I’m “basically only limited by the speed of [your] thoughts.” His theory is that this is how I’m able to accomplish so many other things while still getting fairly decent grades (other than that last neuro test). I like to chalk it up to the fact that I’ve had so much practice with balancing a billion things in undergrad, but I’m sure it helps, especially in this case. We have 14 minutes for the patient interview/encounter and 9 minutes to write the SOAP note.

Currently, my biggest problem is getting to the assessment/plan, since there’s so much to talk through in just the subjective part, and I unfortunately blank out by the time I get to the assessment. I definitely need to work on streamlining that process so I have more time to do the actual exam, but…at least it’s unlikely that my patients will ever feel like I don’t care about them!?

Introduction:

  • Since we’re supposed to wash our hands in front of them and it’s pretty much been ingrained in us that it’s bad to ask them about their chief complaint while our back’s turned, talk about the weather! How was their drive there? Know anything about their life? Kids? Pets? Ask about that! Is it almost weekend? What are their plans? Is it the beginning of the week? How was their weekend?
  • Use the alcohol hand sanitizer from now on. It’s so much faster. D:

Subjective:

  • Maybe ask a little less in depth? :'( But what if I miss something crucial?!

Objective:

  • …Just work on everything to do with this. :/

Assessment:

  • Think faster. :[

Plan:

  • Make sure you summarize what you think it might be, the plan of action, and ask if they have any questions/other concerns.

Closing:

  • Hopefully, if I fix all of the above, this will actually count as “existent.”

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