The USMLE website has recently posted an expanded description
of the Communication and Interpersonal Skills (CIS) Subcomponent
of the Step 2 CS examination. Previously, few details were
provided on precisely what aspects of the standardized patient
encounters were used in scoring.
It is worthwhile to note that from their inception, Kaplan's
CS preparation courses have addressed ALL of
these scored aspects. The specific scoring information provided
in the recent USMLE announcement is summarized below:
Standardized patients provide a global rating of physician
skills using a series of generic rating scales which are based
upon national consensus about essential communication skills and
review of other commonly-used rating forms.
Questioning skills are evidenced by the use
of open-ended questions, transitional statements, facilitating
remarks; and by accurately summarizing information from the
patient. Raters also evaluate avoiding the use of leading or
multiple questions, repeated questions (unless for
clarification), use of medical terms/jargon unless the terms are
immediately defined, and interrupting when the patient is
talking.
Information-sharing skills are evidenced by
acknowledging patient issues/concerns and clearly responding with
information, clearly providing counseling when appropriate, and
by providing closure to the encounter, including statements about
what happens next. Raters also evaluate avoiding the use of
medical terms/jargon unless such terms are immediately defined
for the patient.
Professional manner and rapport are evidenced
by asking about the patient's expectations, feelings, and
concerns, support systems, and impact of illness, with attempts
to explore these areas; by showing consideration for patient
comfort during the physical examination; by attending to
cleanliness through hand washing or use of gloves, by providing
an opportunity for the patient to express feelings/concerns;
encouraging additional questions or discussion; by making
empathetic remarks concerning the patient's concerns, by making
the patient feel comfortable and by showing respect during the
encounter.