Scoring of the Step 2 CS Subcomponents

Examinees are scored in three separate subcomponents:

1. Integrated Clinical Encounter (ICE),
2. Communication and Interpersonal Skills (CIS), and
3. Spoken English Proficiency (SEP).

The ICE subcomponent includes assessment of:

1. Data gathering – patient information collected by history taking and physical examination
2. Documentation – completion of a patient note summarizing the findings of the patient encounter, diagnostic impression, and initial patient work-up

Data gathering is scored by checklists completed by the SP. The checklists are developed

by committees of clinicians and medical school clinical faculty and comprise the essential history and physical examination elements for specific clinical encounters. The patient note is scored by trained physician raters. .

The CIS subcomponent includes assessment of:

1. Questioning skills – examples include:

• use of

- open-ended questions, transitional statements, facilitating remarks

• avoidance of

- leading or multiple questions, repeat questions unless for clarification, medical terms/jargon unless immediately defined, interruptions when the patient is talking

• accurately summarizing information from the patient

2. Information-sharing skills – examples include:

• acknowledging patient issues/concerns and clearly responding with information

• avoidance of medical terms/jargon unless immediately defined

• clearly providing

- counseling when appropriate

- closure, including statements about what happens next

3. Professional manner and rapport –

examples include:

• asking about

- expectations, feelings, and concerns of the patient

- support systems and impact of illness, with attempts to explore these areas

• showing

- consideration for patient comfort during the physical examination

- attention to cleanliness through hand washing or use of gloves

• providing opportunity for the patient to express feelings/concerns

• encouraging additional questions or discussion

• making

- empathetic remarks concerning patient issues/concerns

- patient feel comfortable and respected during the encounter

The SEP subcomponent includes assessment of:

1.Clarity of spoken English communication within the context of the doctor-patient encounter (eg, pronunciation, word choice, and minimizing the need to repeat questions or statements)

SEP performance is assessed by the standardized patients using rating scales and is based upon the frequency of pronunciation or word choice errors that affect comprehension, and the amount of listener effort required to understand the examinee's questions and responses.

** both scoring card are of unfortunate students who failed in exam.

this post's information is taken from www.usmle.org 2010