First of all...

In CSU examinations, there are several things that you MUST/should do, in every P.E. station.

those are;

• GIEP - Greet, Introduce, Explain, Permission.
  you always always have to do this for professionalism, and is almost always a part of a marking criteria.
  Greeting and Introduction is self explanatory,
  Explanation should not include medical jargons, e.g. palpate, and should provide what will happen to the patient. e.g."this will involve you removing your gown..."
  Permission - always ask for permission. or get sued.
  

  Hello/good morning/good whatever , my name is ________, i am a _ year medical student. i am instructed to do a _____ examination on you, which involves you removing your ______, and me touching around your _____ area. do I have your permission?

• Washing hands
  Before and AFTER the P.E.
  Just make sure you don't waste too much time on this. however, also make sure your hands are not WET. you will be deducted marks for having wet hands when palpating, and NEVER wipe your hands on your coat.
  if you ran out of time at the end of P.E, tell the examiner that you intend to wash your hands after the P.E as you run out. (no, don't actually run)
  
  
• positioning of patient
  CVS, Respi, PVD - 45deg. (why? if patient flat, he may have difficulty breathing due to orthopnea)
  GI - flat. - Make sure arms and legs NOT crossed!
  students always forget to check the patient's position.
  no, really. also, check if the patient is not crossing his arms or legs.
  
  
• exposure of patient
  make sure the patient is properly exposed.
  one point of special mention is that when palpating for the femoral pulse (yes our seniors had to do that during exam) we have to expose the area so that we're not feeling for something else. no joke.
  
  
• *If the examiner happens to be Dr.FIA*
  Pass the exam slip to him, using your right hand. he is very touchy about cultural professionalism.
  
  
• Follow the general steps
  unless stated, always go from Inspection, Palpation, Percussion, and Auscultation.
  
  
• Before Palpation...
  4 things;

1. warn the patient,
2. ask if there's any pain in the area you're going to touch,
3. warm your hands,
4. touch the patient's arms "is this warm enough for you?"

• During auscultation...
  do not talk. report either before or after you auscultate.
  
  
• when reporting...1
  prioritize your report.
  i.e. say things that are important first.
  e.g. upon general inspection, the patient is alert, conscious and communicative, appears to be in no repsiratory distress nor obvious pain, he is of average build and height, no gross deformaties, no obvious mass nor discolouration. he does not have any gadgets attached.
  do not report "no gadgets attached" etc.
  to quote Dr.FIA, "DON'T TELL ME ABOUT WHETHER THE PATIENT HAS A PACEMAKER FIRST, IS HE DEAD OR ALIVE!?"
  
  
• when reporting...2
  some things are expected of us to know, and some things are not. make sure you know what you're talking about, and do not crap.
  e.g. *try not to do this*
  -student- "S1 and S2 are heard, there were no added sounds, there were no splitting of the sounds."
  -examiner- "what are the causes of splitting of the heart sounds?"
  -student- "errrm."
  
  
• Be nice to patients, and SPs.
  sometimes being nice to patients will give you marks for professionalism, and if your patients express pain (say ouch) you will be deducted marks for it. be gentle, and think what does the patients feel.
  did you know that when you measure JVP, the rulers have sharp edges and they really hurt when you press against the sternal angle? I do, so i filed my ruler to have round edges.
  little things like that shows that you care, and i feel its a good practice.
  also, the people you're going to see in your real exam will be your SPs. they're also humans - they are LESS likely to give you problems during exam if you're nice to them all the time. greet them, smile, shake their hand and ask if they're comfortable dan tanya sudah makan kah belum kah... (it means "ask if they've eaten, in our local language where our university is, for people coming from other continents ;) )

• always thank the patient when you're done
  the SP's are paid, but we should thank them nevertheless. its general courtesy.
  
  
• Don't lie.
  Don't try and make the examiner think that you know what you're doing. they aren't that stupid. it's very common for us students to not be able to palpate an apex beat. most will say they cannot find it, some will keep trying (for the whole 5 mins) and some will say it's there when they actually don't.
  the examiner will either ask you to carry on, or if the marking scheme requires you to actually locate the apex, they will point it out for you.
  the examiner will have examined the patient before you did, so s/he will know exactly where the apex is. don't lie.

• 
  

that's all i can think of now.

will add when i recall.