After a year of getting a good score for your USMLE Step 1, you would face the next level of USMLE – Step 2 CS or Step 2 CK. With the written examinations of the USMLE boards, you can more or less predict your USMLE scores. But it is quite different with Step two CS. You will be showing your clinical skills, particularly in assessment and physical examination of a simulated clinical situation.

After gathering the necessary data from your patient to create your clinical picture of the patient's illness, you will be expected to provide feedback to your patient. This will come in the form of health teaching, prescription and other related information that the given illness requires. It is expected that you provide effective feedback that is:

• Focus on behavior rather than on the person. It is important that you refer to what the patient does than to what you think or imagine he is. Thus, you might say that a person "talked more than anyone else in this meaning" rather than "he is a loudmouth." The former allows for the possibility of change while latter implies a fixed personality trait.

• It takes into account the needs of the patient for the feedback. What you say can be destructive when it serves only your needs and fails to consider the needs of the person you are talking to. Effective feedback is given to help, not to hurt

• Directed toward behavior which the patient can do something about. Frustration is only increased when the patient is reminded of some shortcomings over which he has no control or a physical characteristic which he can do nothing about

• Involves sharing of information rather than giving advice. By sharing information, you leave the patient free to decide for himself. By telling him what to do, to some degree, you take away the patient's right to autonomy.

• Involve the amount of information the patient can use rather than the amount you would like to give. To overload a patient with feedback is to reduce the possibility that he may be able to use what he receives effectively. When we give more than what the patient can use, you are more often than not satisfying some need of your own rather than helping the patient.

There is no doubt that you will be given points on your knowledge of medical concepts and principles and how you apply it to the given situation. But when you are in a situation where you are conscious of a group of people hanging to your every word, you can't help but feel nervous. And the more you do, the more it will be difficult for you to think clearly and use words to elicit necessary information from your patient, as well as provide useful information for your patient.