Apr 25, 2009. The Step 3 Computer-based Case Simulations (Step 3 CCS) are an integral part of the exam and are designed to evaluate your ability to diagnose, treat, and monitor simulated patients in an interactive setting. A familiarity with the interface is crucial to help you. This interactive online USMLE Step 3 CCS workshop aims at strengthening your concepts and understanding of USMLE Step 3 Clinical Case Simulations (CCS). CCS - the computer-based simulations on USMLE step 3 constitute about 25% of the total score and doing well on this component is extremely crucial to pass the exam. The USMLE Step 3 CCS simulator contains 100 cases with a realistic real-time simulator which provides feedback and grading for each case based on your answers.
Overview
Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. It is the final examination in the USMLE sequence leading to a license to practice medicine without supervision. The examination material is prepared by examination committees broadly representing the medical profession. The committees comprise recognized experts in their fields, including both academic and non-academic practitioners, as well as members of state medical licensing boards. Step 3 content reflects a>Three stages of clinical encountersINITIAL WORKUP CONTINUING CAREURGENT INTERVENTIONPatient encounters characterized by initial assessment and management of clinical problems among patients seen principally in ambulatory settings for the first time. These encounters may also include new problems arising in patients for whom a history is available.Patient encounters characterized by continuing management of previously diagnosed clinical problems among patients known to the physician and seen principally in ambulatory settings. Encounters focused on health maintenance are located in this frame.
Also included are patient encounters characterized by acute exacerbations or complications, principally of chronic, progressive conditions among patients known to the physician. These encounters may occur in inpatient settings. Patient encounters characterized by prompt assessment and management of life-threatening and organ-threatening emergencies, usually occurring in emergency department settings. Occasionally, these encounters may occur in the context of a hospitalized patient. Clinical problems include ill-defined signs and symptoms; behavioral-emotional; acute limited; initial manifestation and presentation of chronic illness.Clinical problems include frequently-occurring chronic diseases and behavioral-emotional problems. Periodic health evaluations of established patients are included here.Clinical problems include severe life-threatening and organ-threatening conditions and exacerbations of chronic illness.Physician tasks emphasized include data gathering and initial clinical intervention. Assessment of patients may lead to urgent intervention.Physician tasks emphasized include recognition of new problems in an existing condition, assessment of severity, establishing prognosis, monitoring therapy, and long-term management.Physician tasks emphasized include rapid assessment of complex presentations, assessment of patients' deteriorating condition, and prompt decision making. Content Outline and SpecificationsContent Description
The content description that follows is not intended as a curriculum development or study guide, but rather models the range of challenges that will be met in the actual practice of medicine. It provides a flexible structure for test construction that can readily accommodate new topics, emerging content domains, and shifts in emphasis. The categorizations and content coverage are subject to change. Successful completion of at least one year of postgraduate training in a program accredited by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association should be helpful preparation for Step 3.
Content Outline
All USMLE examinations are constructed from an integrated content outline, which organizes content according to general principles and individual organ systems. Test questions are classified in one of 18 major areas, depending on whether they focus on concepts and principles that are important across organ systems or within individual organ systems. Sections focusing on individual organ systems are subdivided according to normal and abnormal processes, including principles of therapy.
Table 1: Step 3 MCQ Test Content Specifications*
* Percentages are subject to change at any time. ** The general principles category for the Step 3 MCQ examination includes test items concerning normal processes not limited to specific organ systems. These test items are typically related to normal development. Categories for individual organ systems include test items concerning those normal and abnormal processes that are system-specific.
Table 2: Step 3 CCS Test Content Specifications
Categories in bold are covered in CCS cases; categories not in bold are not covered.
Physician Tasks/CompetenciesStep 3 Ccs Format
An additional organizing construct for Step 3 design is physician tasks and competencies. More information about the physician task and competencies outline is available. Items are constructed to focus on assessing one of the following competencies:
Table 3: Step 3 MCQ Physician Tasks/Competencies Specifications Gravura font free download mac.
Table 4: Step 3 CCS Physician Tasks/Competencies Specifications
Categories in bold are covered in CCS cases; categories not in bold are not covered.
Strategies
Patient Scenario Formats
Patient scenarios for any Single Item or Sequential Item Set may be provided in either Vignette (paragraph) format, or in Chart/Tabular format. Test items using the chart/tabular format are designed to resemble patient charts but are not intended to be an exact representation of a patient chart. Questions written in chart/tabular format will contain relevant patient information in list form, organized in clearly marked sections for ease of review. Familiar medical abbreviations may be used within chart/tabular format questions.
Single-Item Questions
Free nero dvd burner software for mac download. A single patient-centered vignette is associated with one question followed by four or more response options. The response options are lettered (ie, A, B, C, D, E). A portion of the questions involves interpretation of graphic or pictorial materials. You are required to select the best answer to the question. Other options may be partially correct, but there is only ONE BEST answer. This is the traditional, most frequently used multiple-choice question format on the examination.
Example Question 1
1. A 30-year-old man comes to the emergency department because of an acute episode of renal colic. Medical history is remarkable for episodes of painful urination and passing of what he calls 'gravel in my urine.' Urinalysis demonstrates microscopic hematuria with some crystalluria and no casts. Supine x-ray of the abdomen shows no abnormalities. A 4-mm renal calculus is detected in the distal right ureter on ultrasonography. There is no evidence of dilation of the collecting system. The patient's pain is responsive to narcotic medication. In addition to administering intravenous fluids, which of the following is the most appropriate next step?
(Answer: E)
Example Question 2 Proshow producer crack + keygen.
Patient Information
Age: 62 years Gender: M, self-identified Ethnicity: unspecified Site of Care: office
History
Reason for Visit/Chief Concern: 'My legs hurt when I walk, and it's getting worse.'
History of Present Illness:
• 3-month history of worsening leg pain • pain exacerbated by walking; peak intensity after 1 block • pain resolves completely with rest • pain rated 4/10 at worst Past Medical History: • hypertension • mild angina • type 2 diabetes mellitus
Medications:
• lisinopril • metoprolol • furosemide • glyburide • lovastatin
Allergies:
• no known drug allergies Psychosocial History: • has smoked one-half pack of cigarettes daily for 44 years
Physical Examination
• Appearance: no acute distress • HEENT: funduscopic shows grade 2/4 arteriovenous nicking • Neck: no jugular venous distention • Pulmonary: clear to auscultation; mildly diminished lung sounds • Cardiac: no bruits; distant heart sounds • Abdominal: obese; no tenderness, guarding, masses, bruits, or hepatosplenomegaly • Extremities: no joint erythema, edema, or warmth; no hair on toes; no femoral bruits; dorsalis pedis, radial, and femoral pulses intact • Neurologic: sensation to vibration intact
Question: Which of the following is the most appropriate diagnostic study?
(Answer: A)
Multiple Item Sets
A single patient-centered vignette may be associated with two or three consecutive questions about the information presented. Each question within these sets is associated with the patient vignette and is independent of the other question(s) in the set. The items within this type of format are designed to be answered in any order. You are required to select the ONE BEST answer to each question.
Example Questions 3 to 4
A 52-year-old man returns to the office for reevaluation of an ulcer on his right great toe. The patient has a 15-year history of diabetes mellitus and takes glipizide and rosiglitazone. He first noticed the ulcer 2 months ago. One month ago, a 14-day course of oral amoxicillin-clavulanate therapy was prescribed. He has smoked one pack of cigarettes daily for the past 37 years. He is 178 cm (5 ft 10 in) tall and weighs 102 kg (225 lb); BMI is 32 kg/m2. Today, vital signs are temperature 38.8°C (101.8°F), pulse 96/min, respirations 12/min, and blood pressure 130/85 mm Hg. Physical examination of the right great toe discloses a 1.5-cm nontender ulcer with a depth of 0.5 cm, a moist base, yellow exudate, and surrounding erythema to the level of the malleoli. Vibration sense and sensation to monofilament examination are absent. Pulses are diminished in both feet. Capillary refill time is 2 seconds in the right great toe. Urinalysis discloses 3+ protein.
3. Which of the following historical factors or physical examination findings is most strongly associated with development of this patient's foot ulcer?
(Answer: B) Apple store app download for laptop.
Vray for c4d download mac installer. 4. Which of the following is the most appropriate action at this time?
(Answer: B)
Sequential Item Sets
A single patient-centered vignette may be associated with two or three consecutive questions about the information presented. Each question is associated with the initial patient vignette but is testing a different point. You are required to select the ONE BEST answer to each question. Questions are designed to be answered in sequential order. You must click 'Proceed to Next Item' to view the next item in the set; once you click on this button, you will not be able to add or change an answer to the displayed (previous) item.
Step 3 Ccs Mac Download Version
Example Questions 5 to 6
A 2-year-old girl is brought to the office by her mother for evaluation of fever. You have been the girl's physician since birth. While in the office, the girl stiffens and then has bilateral, symmetrical shaking of her upper and lower extremities; she becomes mildly cyanotic. The episode lasts for approximately 45 seconds, after which she becomes relaxed and appears to fall asleep. Vital signs at this time are temperature 40.0°C (104.0°F), pulse 120/min, and respirations 40/min. On physical examination she has a generally pink complexion and flushed cheeks. She is limp and somnolent and responds with a cry to noxious stimulus. Tympanic membranes are inflamed bilaterally, nose has a scant, clear discharge, and throat is mildly erythematous. Lungs are clear to auscultation except for transmitted upper airway sounds. Heart has rapid rate with a grade 1/6 systolic murmur at the left sternal border. Complete blood count, blood culture, lumbar puncture, and catheterized urine specimen are obtained and sent for stat analysis. Acetaminophen is administered by rectal suppository. Thirty minutes later the patient awakens and is smiling. She is afebrile. Additional history discloses that she was born at term, she had an uneventful neonatal course, she has normal growth and development, and vaccinations are up-to-date. She has never had an episode similar to this. Initial laboratory results are shown:
10,400/mm3
Neutrophils, segmented
Neutrophils, bands
Lymphocytes
Monocytes
Cerebrospinal fluid
Normal
Usmle Step 3 Ccs Cases
Other laboratory studies are pending.
5. In addition to ampicillin for otitis media and acetaminophen, this child also should receive which of the following?
(Answer: E) Content barrier for mac os x.
Download toon boom harmony macbook. 6. Two weeks later the patient is brought to the office for a follow-up visit. Her mother says that she is doing well and she has had no recurrence of her symptoms. Examination of the ears shows resolution of the otitis media. Which of the following is the most important diagnostic step at this time?
(Answer: E)
Pharmaceutical Advertisement (Drug Ad) Format
Bakugan battle brawlers episode. The drug ad item format includes a rich stimulus presented in a manner commonly encountered by a physician, eg, as a printed advertisement in a medical journal. Examinees must interpret the presented material in order to answer questions on various topics, including
Step 3 Ccs Software MacAbstract Format
The abstract item format includes a summary of an experiment or clinical investigation presented in a manner commonly encountered by a physician, eg, as an abstract that accompanies a research report in a medical journal. Examinees must interpret the abstract in order to answer questions on various topics, including
Primum Computer-based Case Simulations (CCS)
You will manage one case at a time. Free-text entry of patient orders is the primary means for interacting with the format. Buttons and check boxes are used for ordering a physical examination, advancing the clock, changing the patient's location, reviewing previously displayed information, and obtaining updates on the patient. At the beginning of each case, you will see the clinical setting, simulated case time, and introductory patient information. Photographs and sounds will not be provided. Normal or reference laboratory values will be provided with each report; some tests will be accompanied by a clinical interpretation. To manage patients using the Primum CCS software, it is essential that you complete the Primum tutorial and sample cases provided. A brief description of the interface is provided in the Primum Tutorial.
![]()
We at ccscases.com do think that Crush Step 3 CCS is a good resource. It has good information on workups for chief complaints. However, no matter how much you study a book, you will not perform well unless you get comfortable and familiar with how the USMLE Step 3 CCS software works. We do not think that doing the 5 practice cases offered on the USMLE website is sufficient preparation to be prepared enough to do well on the test, even if your medical knowledge is solid. There is high anxiety on the test, so if you are not adequately familiar with the software, this could cause serious problems in your performance. Some cases are very short, and some people have complained of the software having lagging times between orders. You do not want to waste time saying “Oh…shoot, what’s that order called again…” Or “Umm…how do I order something?” Or “How do I get the time to go forward?” These are things that a book may explain to you, but like learning a skill, you don’t really understand it until you do it.
Book information such as is found in Crush Step 3 CCS is helpful, but if you really want to crush it, you will need to actually do cases in real software that mimics the real test. At CCSCases.com, we have over a 100 cases that will effectively teach you how to do well on test day. CCSCases.com includes real software that closely mimics the real test; it includes 20,000 orders just like in the real test; it includes grading and feedback.
We feel that there is no substitute to adequately prepare for the USMLE Step 3 CCS portion of the test other than doing cases on real software. We recommend that you give us a shot by going to our download page and downloading a free trial of our CCS Software. You can download it here.
Comments are closed.
|
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
December 2020
Categories |