about counceling - najmeh

[ArchivalUser]

is that okay if we councel with sp after we asked about social history ?

[ArchivalUser]

What do you mean to counsel on the spot as needed during the social history? I have the same question!

[ArchivalUser]

i mean after we asked about smoking or alcohol or useing candom if they need counceling ,talk to them immediatly about that ,i think if we do this, were not gonna forget counceling,i just wanna make sure ,,,,

[ArchivalUser]

Only once I read that we can and should do this from an exam taker. I wish we can do that. But as far as I know, we should not do that because it may sound kind of judgmental and prevent the SP from telling you about other issues. Like, if you ask about smoking and counsel him immediately and then ask about alcohol s/he may deny any consumption, you know what I mean!

Please, any input is appreciated

Thanks

[ArchivalUser]

okayy thanx,then its better do counceling at the end,,any more suugestion?

[ArchivalUser]

ideally, you do counseling at the end during closure. if you have confidence on yourself to not forget about the problems such as smoking, drink, unprotected sex, overweight/diet-exercise etc. that pt mentioned during history taking, closure would be best/ideal time to counsel.

however, for practical reasons, some examinees (i heard from several examinees who passed the cs) did it immediately after they had learned about it during taking social history, and they passed.

i think it is up to the individual examinee, how (s)he is confident and comfortable to remember the risky behaviors and do the counseling at the end/closure which is ideal/best. it can go either way, i guess.

it might be helpful to do it briefly right away (immediately) in some cases where you anticipate extended physical exam (e.g., gen phy + neuro exam such as in confusion/forgetfulness cases). In such cases, you may not have time at the end even for closure.

overall, it is a dilemma between ideal vs reality, and up to individual preference.

i hope some of us who already passed the exam would tell us their experience on this issue.