# ◾ How to Set Up Step 2 CS Patient Note 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**](/doc/step-2-cs-patient-note-YvVH2uJxc8)**:** It is available at the bottom of the **New Item** list when creating a [**Post-Encounter Learner**](/doc/post-encounter-learner-part-Dsb7Mo6i7o) checklist. Clicking it inserts a **fully prepared individual section** into the checklist, consisting of items best fit for Step 2 CS assessment. ![](https://outline-production-attachments.s3-accelerate.amazonaws.com/uploads/6c0da235-ff99-49fd-81af-d32f613692dd/3c92b28d-ba9f-46c1-9f6f-b5775be9f86b/76910091.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA4EOUDTOVUICLPZ4P%2F20260909%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20260909T120000Z&X-Amz-Expires=86400&X-Amz-Signature=48962746971f68c2c8a2a8749a0bc462063d31c39704c87702c425fb5da56503&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject) The textual parts can be modified by clicking the desired field. As the Step 2 CS assessment requires learners to **phrase their responses**, the system cannot calculate point values. 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**](/doc/open-ended-question-scoring-oeqs-F51zi8XITN) (OEQS). :::warning ***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. ::: :::success Based on user practice, it is recommended that the **last item be set scored** (by questionnaire), meaning that a [**Special Section**](/doc/special-section-xF3FCRRpqE) 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***](/doc/special-section-xF3FCRRpqE). ::: :::tip The Special Section used for scoring does not necessarily have to be created within the same Case. ::: :::info ***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. Still, as a series of [**Text items**](/doc/text-PjSbuSmn61) (for History and Physical Examination) and [**Structured Text**](/doc/structured-text-Ut7O0LkBNp) items (for Data Interpretation), the answers for the items will be separately displayed for grading - one item per page. ::: :::tip For further information, visit our [Case Manager](/doc/case-manager-QdAIr4bLwJ) and [Cases - How to](/doc/cases-how-to-S8rL7UJ2ib) pages or watch our [Case Manager Training Videos](/doc/case-manager-training-videos-r2kVtDydfr). ::: --- **Documents** - [User Guide](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/user-guide-WPv4VxhtWB) - [FAQ](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/faq-YoxOQOjvnY) - [Training Videos](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/training-videos-D2ycsEwqPt) - [Module Introduction Videos](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/module-introduction-videos-I6OQ6H7SUT) - [Release Notes](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/release-notes-BcFFMsc0RV) - [Distance Learning with LearningSpace](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/distance-learning-with-learningspace-eAfwW23Hxg) - [Preventing Copy-Paste in LearningSpace](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/preventing-copy-paste-in-learningspace-sPD0IIUuk0) - [Important Technical Notification Regarding Adobe Flash Player](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/important-technical-notification-regarding-adobe-flash-player-eQtMLwLmTJ) - [iPad support - Technical information](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/ipad-support-technical-information-dLmeFvKofC) - [TeamViewer Link](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/teamviewer-link-QyKZBMqUT9) - [YouTube videos about LearningSpace](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/youtube-videos-about-learningspace-TMb3zdc0LC) - [Customer Aftercare One-Pager](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/customer-aftercare-one-pager-GBWMe1BcfS) - [Case Studies](https://kb.learningspace.elevatehealth.net/s/ent-hs/doc/case-studies-VcAbFqXSz7)