Case closure timing

Case Closure Timing - The Final Countdown

• The "2-minute warning" is a critical, non-negotiable stop signal.
  • Cease all new questions or examination maneuvers immediately.
  • Pivot from data gathering to presenting your synthesized conclusions.
• Your final task: Deliver a structured, confident closure.
  • This demonstrates respect for time and clinical decisiveness.

⭐ In CCS cases, failing to provide a clear closure (summary, diagnosis, plan) is a major reason for losing marks, even with excellent data gathering.

Pre-Closure Checklist - Don't Rush The Exit

Before the 2-minute warning, systematically confirm all tasks are complete. Don't leave points on the table by ending prematurely. A structured final check ensures comprehensive care and scoring.

• Review Orders: Scan all ordered tests & treatments.
• Finalize Diagnosis: Confirm your primary/differential list.
• Counsel Patient: Explain diagnosis, plan, and red flags.
• Check Vitals: One last look at patient stability.
• Advance Clock: Move time to see final results before the case ends.

⭐ A frequent error in CCS is inadequate patient counseling. Always advise on prognosis, follow-up appointments, and specific warning signs that warrant an immediate return to care.

Common Timing Traps - Clock-Watching Blunders

• Obsessive clock-watching breeds panic and forces errors. It's a symptom of poor time allocation, not a solution. Avoid these common blunders:
  • Analysis Paralysis: Freezing for >30-60 seconds while just staring at the clock. This kills your momentum.
  • Front-Loading Panic: Rushing the initial history/exam, missing key data, only to have awkward time left at the end.
  • Ignoring the 2-Minute Bell: Starting new, complex actions after the final warning. Focus only on concluding tasks.
  • Task Fixation: Getting stuck on one action (e.g., a tricky order) while ignoring other pending, high-scoring actions.

⭐ A pre-planned "endgame" for the final 2 minutes is crucial. Most points are lost here due to panicked, illogical changes or failing to formally end the case.

• The 2-minute warning is the critical cue to begin case closure.
• Ensure all essential investigations and treatments are ordered before this point.
• Use the final 2 minutes for checking results, patient counseling, and confirming the final diagnosis.
• Avoid initiating new, complex diagnostic pathways after the warning.
• A structured, confident closure is crucial for scoring well.
• Conclude with a clear final diagnosis and patient disposition (e.g., admit, discharge).