End of Second Year Assessment

In February/March all second year BUSM students complete the End of Second Year Assessment (EOSYA). The purpose is to assess students’ ability to communicate with and examine patients at the end of the second year.

End of Second Year Assessment Student Schedules (BU Login Required)

Assessment Objectives

The assessment objectives are to:

evaluate the students’ ability to interview and communicate with patients
assess the students’ physical examination skills
gauge the students’ ability to synthesize data and present it in written format
provide feedback to students on their clinical skills
measure the skills of the class as a whole such that individual and curricular deficiencies can be addressed
create the opportunity to experience a timed clinical skills examination that is similar to the End of Third Year Assessment (EOTYA) and the USMLE step 2CS exam

Overview

The exam takes place at the Clinical Skills & Simulation Center on a series of dates in February/March. It starts after the completion of the Doctoring-2 course, and draws on materials learned in ICM-1/Doctoring-1 and Doctoring-2. There are three cases played by highly trained standardized patients. Students rotate through the cases in a round-robin format so that every student interacts with every case. Student receive feedback from the standardized patients and an Academy of Medical Educator.

There is a sample case included under the Sample Case section of this page. It includes the script that only the standardized patient sees, as well as the materials the student would see in interacting with the case. STUDENTS ARE STRONGLY ADVISED TO REVIEW THE SAMPLE CASE.

Grading

Students taking the EOSYA will be graded on their performance in each of four skill areas:

Interview
Communication
Physical Examination
Write-up

Second year students are required to take the End of Second Year Assessment and is part of the grade for the Doctoring 2 Course. Students who perform well will receive a congratulatory letter with their scores. Those who marginally pass will be required to review their scorings, tapes, and write-ups with a faculty member and will be offered a retake of the exam. Those who do not pass will be required to review their scorings, tapes, and write-ups with a faculty member. They will also be required to retake the exam.

What to Bring

What you will need to bring:

White lab coat with name tag
BU ID
Stethoscope

Reference materials are not allowed during the exam.

Directions

The Clinical Skills and Simulation Center (CSSC) is located in the basement of the Evans Building. Take the elevator or stairs down one flight and follow the signs to the CSSC.

Expectations of Students

For the EOSYA cases, students are expected to:

Introduce themselves to the patient and use the patient’s name
Use appropriate interview and communication techniques (For example: start with a series of open-ended questions and gradually move to more targeted ones, or the “cone” approach. Avoid jargon, use summarization effectively, show empathy where appropriate, etc.)
Conduct a patient-centered interview (What are the patient’s concerns? What does s/he think might be causing the symptoms? What questions does s/he have?)
Elucidate the History of Present Illness
Ask pertinent ROS questions (based on the presenting problem) to help to refine the differential diagnosis
Find out about the Past History, Medications, Allergies, Habits, Family History, and Psychosocial situation, etc.
Wash hands (or use sanitizer) before and after conducting the physical examination
Perform a targeted physical examination pertinent to the presenting problem (in those cases that involve a physical exam)
Attend to patient comfort throughout the examination
BRIEFLY summarize for the patient what they think might be going on
BRIEFLY counsel the patient when appropriate (on how the problem might be handled, on what health promotion techniques the patient might employ, etc.)
End the encounter
Type a Write-up on a laptop computer based on the interaction
Create a differential diagnosis for the patient’s presenting problems
Participate in the feedback starting with self-assessment

Ethics Form

Please review the EOSYA Ethical Attestation Form before attending your EOSYA Session.

Sample Case

The EOSYA Sample Case can be viewed here.

Student Comments

What past students say they learned from the evaluation:

This is a learning opportunity, not just an evaluation (though I would not have believe it if you had told me that before hand).
The more open-ended questions I use the more information I obtain.
If an open-ended question yields some information, then you should follow it with another open-ended question.
Multiple questions should be avoided.
Summarization is useful.
Using transitional statements is useful.
It is useful to ask a patient about his or her concerns.
I know more medicine then I thought I did.
I should think about differential diagnoses while I am interviewing and examining the patient.
I was worrying more about the science but the patient was commenting on my way of communicating.
There is a tension between “connecting with the patient” and gathering data efficiently.
I do not come across the way that I think I do.
There is a natural tension between “following the thread” and conducting the interview in an orderly fashion.
I should always ask about family history and medications.
I found the feedback from the standardized patients to be constructive. In addition, they reinforced things that I do well.