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The USMLE Step 2 Clinical Skills (CS) exam consists of a series of learner-patient encounters in which the medical students are expected to

  • investigate the simulated patient's chief complaint,
  • obtain a thorough assessment of their medical history (medications, allergies, social history) and family history,
  • complete a physical examination,
  • determine differential diagnoses, 
  • write a patient note based on their findings.

To facilitate such an assessment, LearningSpace offers a pre-structured section, called Step 2 CS Patient Note:

It is available at the bottom of the New Item list when creating a Post-Encounter Learner checklist.
Clicking it inserts a fully-prepared individual section into the checklist, consisting of items best fit for Step 2 CS assessment.

The textual parts can be modified by clicking the desired field.


As the Step 2 CS assessment requires learners to phrase their responses, point values cannot be calculated by the system, scoring of responses necessitates the active participation of an evaluator: scores are determined by a professionally competent Faculty member. Such an evaluation is referred to in LearningSpace as Open-Ended Question Scoring (OEQS).

IMPORTANT: As in case of all other item types, Step 2 CS Patient Note is NOT scored by default. If the default setting is not changed, answers will not be displayed for OEQS.

Based on user practice, it is recommended that the last item be set scored (by questionnaire), meaning that a Special Section part is created with the necessary questions along which the Step 2 CS section can be scored, then that Section is selected from the drop-down prompted when setting the scoring to Questionnaire.

The Special Section used for scoring does not necessarily have to be created within the same Case.


IMPORTANT: During OEQS grading, answers entered for a Step 2 CS Patient Note item will be displayed on one page for the faculty submitting the grading. However, if the items are separately added, that is, not as one pre-compiled section of Step 2 CS Patient Note, but as a series of Text items (for History and Physical Examination) and Structured Text items (for Data Interpretation), then the answers for the items will be separately displayed for grading - one item per page.

For further information, visit our Case Manager pages and watch the Case Manager Training Videos.