Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
any recent csa takers around here? -
#1
ngk

did anybody give csa recently? if so, please give the list of cases u encountered in the exam and as well some exam tips - do's and dont's....
Reply
#2
tta

I also passed . I bought OSCE and NMS clinical skills assessment exam. The latter book was relegated to curing the wobble on my table very quickly. The OSCE book I did find very useful as it gave an idea of structure and helped me focus on what was relevant within the USA. I spent a month going over their cases every other day with friends. No more than one hour each day. Then the exam
I worried loads about this the night before and then until I got my result. I am lucky as have English as my first language and this helped me. No matter how hard they try to make it lifelike these are artificial situations. The cases are everyday occurrences however there was one with an atypical presentation-my first case. I had asked this guy every question relating to his presenting complaint and every review of system question I could think of and got negative responses to them all. So I am standing there thinking sh.. what is going on with you. After a 30sec pause decided to move onto PMH as had no other questions left and as soon as he told me this I knew what was going on with him. So do not worry if find yourself in that situation.
To be honest in the fifteen minutes you cannot take a full history, will forget to ask questions (everyone does!!) and cannot do a full examination either. My examination was shit on the day, I would have failed my finals here with it. RESP exam only percussed and listened to back if not respy complaint, otherwise if it was did front and back per, aus and vocal resonance. It was with one of these respy cases that I had my only positive signs of the day simulated by the patient. CVS exam only auscultated in four quadrants all day! No rolling, breathing in or out or any of that nonsense. Admittedly only had one true CVS case that day. ABDO exam quick inpsection, light palpation, deep palpation, look for organomegaly, bowel sounds. Nothing else, said PR in work up if appropriate. NEURO exam, had a system so was slick not thorough! Looks good to a non-medic i.e. the SP!

Other things I did was stand for all the cases ( except one, pure discussion and reassurance case ) and not use the seat provided. This kept me near the patient and at their eye level, hardly used my note paper at all to help maintain eye contact with them. Made sure I spent a good two minutes addressing their concerns at the end. A lot of what I did here was picked up from the OSCE book.

Remember to be sensible, if they have had a headache for three months and look well ( as most SP's do, some act ill and then it is obvious ) do not waste time doing kernig's etc as when was the last time you saw a healthy looking patient with a three month history of meningitis!

Also I did no health counselling if it was not relevant. I left the rooms usually with about two minutes to spare.

The amount of space to write up the history was not enough for me and whilst I tried to keep it ordered did struggle with presentation a bit. This was an area I could have improved upon.

On the day try to be relaxed and FOCUSED. Be nice, speak clearly and listen to the SP. Answer all their questions before you leave the room. I also cracked a couple of jokes from time to time to help develop a rapport and it seemed to work.

Good luck to everyone as you will pass this exam.
Reply
#3
ngk

thank u so much tta
Reply
#4
Karen - Seda622@cs.com

I am going to take SCA can somebody explain me how to do physical exam for a 5 min. For example if you have a SP with abdominal complain should you check HEENT, CN, MUSCK-SCEL , BECAUSE in NMS REVIEW WHEN YOU LOOK AT NOTES FOR PATIENTS WITH DIFFERENT PROBLEMS YOU SEE THAT ALL SYSTEMS ARE CHECKED
Reply
#5
NYfmg


Karen,

Do a focused physical exam. Examine other systems if relevant. If you try to do all systems, you will not be able to do a good job.
Reply
#6
HJI

I failed once and passed this time....
all I can say is do not be fooled into thinking that this is a test of your english. I am a native speaker but failed. I also have excellent step 1& 2 scores, so I guess i am not that dumb.
But I failed because I believed in the "focused exam" thing too much. Not having actually practiced medicine, I was too eager to get down to the diagnosis, and once I did so, I forgot to ask any other questions.
E.g. the patient that came in because her arm hurt. I was able to get out of her that she played tennis often. So after that, my focus was all on her arm.....but what I learned after I failed the exam was that she might have had a different problem that was causing the pain, such as a neurological problem. That meant that I should have asked at least a few simple neuro questions. OR she could have been having this elbow paing because of depression or even domestic violence.

My point is that your really need to try to do a full physical on every patient....even if it is not a complete one, at least try to start at the head and end at the toe. Who knows, maybe this patient had pain in other joints too.....

and for me, the Kaplan Workshop Courses(2 days, only courses, the ones done by Dr. Swartz) were extremely helpful and finally made me understand what the test is really about.

Good luck to you all!
Reply
#7
stm

I am sorry but I disagree with you HJI about doing a full physical. You do not have time for that plus it is not necessary. It sounds to me that because you have not practised medicine you have a weakness in your history taking in so much that you get caught up with the presenting complaint, and are maybe not used to broadening your questions, especially as it is not a singular diagnosis they are after, but differential diagnoses. This is key, so when you see someone with a sore arm you have to think of causes and focus your questions on those possible causes. That way you can focus your examination so it is relevant to your history. As when you start practising you will not do a neuro exam on all patients with sore abdomens! So why do it in the exam.
You are right though about needing more than good English
Reply
« Next Oldest | Next Newest »


Forum Jump: