Jessica has been with CanScribe since June of 2009 and she is an absolute delight to work with.  Like many of us, she started off at reception and quickly learned the ropes of our Student Services department.  Her patience with students has made her a wonderful asset to this department.  Her patience also carries forward when it comes to training new staff members; which she has become an expert at.

Born and raised in Kelowna, BC (which is rare to find!), she finds any excuse to spend her time outdoors.  She can always be relied on to have a cupboard full of treats that the rest of the staff loves to raid.  We are also extremely thankful for her wonderful cooking skills since potlucks seem to be a regular occurrence at CanScribe.

We can always count on Jessica for a funny joke or anecdote to brighten our day, no matter how cheesy the humor may be!  Students may reach her at jparker@canscribe.com or 1-800-466-1535 for assistance with the MT program.

- Samantha Carnegie
Director of Admissions and Student Services

Finish this training with a flourish by bringing the same intention to your practicum and job search that you had upon initial enrolment.  This is all you.  You did the work.  You passed the quizzes and the midterm.  You completed the transcription modules.  You are so talented!

Here are some ideas for you moving forward:

• Take the pre-final assessment.  This is your opportunity to pinpoint weak spots before writing the final exam.  This is how you increase your chances of achieving high honours.
• Rewrite that final exam because more exposure to that exam means better preparation for pre-employment testing.
• Make sure CanScribe has your proper name and mailing address in order receive your beautiful graduation certificate so you can hang it up in a nice frame for all to see.  Get yourself ready for the practicum by thinking about your communication skill set.  The practicum is designed to act as your first excursion into the MT industry.  This is the best time to hone your communication skills with regard to actively listening to your instructor, being able to effectively get your point across by taking time to think about what your instructor has outlined first, and discussing technical issues that may arise in a calm manner.  Your practicum instructor will appreciate your solid communication skills, and it will be reflected in your final practicum assessment.  What better way to show an employer that you are cool as a cucumber under pressure?  Now that's attractive.

By applying your learned skill set you are well on the way to becoming successful in this industry.  You will enjoy a great reputation as a CanScribe graduate.  Your abilities will open the door for future graduates.  You are smart, and strong and capable.  We are proud to be associated with someone of your calibre.  You have successfully finished all of the modules in the course, staying with it until the end really says it all.  Thank you for spending your time with us.

- Samantha Carnegie
Director of Admissions and Student Services

Tweeting all the time?  Facebook taking over your life?  Connecting to the world and being in touch has never been more important than it is right now.  With the pace of our lives increasing every day, it can seem daunting trying to keep track of all that is going on.  At CanScribe, we will keep you in touch and up-to-date with everything going on in the world of excellence in online education.

Each day, we interact back and forth with hundreds of people over social networks like Twitter, Facebook and LinkedIn.  Not only does this allow us to provide you with up-to-the-minute updates on important issues related to our industry, but it also lets us share fun facts about the industry, trade shows, helpful hints and interesting stories that affect you!

Even if you're signed up as a member on our page, it is also helpful to take a minute to "Follow" or "Like" us on your social networks.  Follow us and we'll follow you.  It is also a great way to stay connected with other students and stay in the loop about the things that really matter - the industry, employment, your training program, and FREE stuff!  We love it when you get involved and it's really easy to become a part of the group.

And don't forget the CanScribe Forum.  It's also a great way to stay connected to your fellow students and receive helpful tips and feedback from others.  There is a wealth of information there on every course module.  We welcome a positive discussion there, and encourage you to be part of it.

Be sure to join CanScribe Career College on Facebook, Twitter and LinkedIn.  Stay connected, keep in touch and exploring the possibilities!

- Carolyn McEwen
Manager Student Services

If you phone a transcription company looking for information about starting your own medical transcription business, be respectful.  You are asking someone to take time out of their business day to help you with your business, and even to help you go into competition with them.  Offer something in return, such as a piece of marketing information that you've found, or a helpful comment on what you liked about their website.

If you're looking for information about medical transcription as a career, do your homework first.  When you call a medical transcription agency, only ask questions that you can't find answers to on their website or from researching various medical transcription training courses.

When contacting a prospective medical transcription agency, it's smart to consider these factors.

• Who to speak to: ask for the name of the person in the medical transcription agency who is responsible for hiring or awarding contracts with transcriptionists.
• Time of day to call: when you call, ask if it's a good time to be calling, or if there is a better time to call back to speak to the appropriate person.  Surprisingly, most contacts from prospective or job hunting transcriptionists come in the morning, by telephone, right in the middle of the busy time of our day.
• Know who you're calling: check out their website.  Many transcription agencies have a link on their website which allows you to submit your resume online.  A followup phone call within a few days to confirm they received it is appropriate.  Mention something you found that interests you on their website.  You never know when you may have a chance to sell yourself on the phone when you call to confirm.
• Respect people's time: the medical transcription agency you're calling is your prospective client.  They have something you want; on the other hand, they might not be interested in what you have to offer at this time.
• Be prepared: if you're a new transcriptionist, when you're asked what experience you have, tell them how many practicum hours you have and what specialties you're most proficient in.  Be ready to share one or two value' points about yourself.  It could be that you type 82 words a minute, or that you were the top in your class in English grammar.  Know what your strengths are and be prepared to present them quickly in a positive manner.
• Experience counts: when you're told that they only hire transcriptionists with experience, don't respond negatively.
• Persevere: I know of a medical transcriptionist who first contacted a company 3 years ago; her persistence paid off when they were looking for someone with her qualifications.
• Resumes: inquire how long they keep resumes on file.  Make a note and resubmit as often as reasonable.  Find out if they want hard copies or soft copies.  Find out how they want soft copies submitted - through their web page or by email.  And make sure there are zero spelling or grammatical mistakes in your resume.
• Get creative to get experience: offer to extend your practicum if you are unable to find a paid position if they will give you a reference.  Find a physician who is currently handwriting their notes and offer to transcribe their dictation at a reduced rate for a specific length of time (either provide a digital recorder or ask them to purchase one).  You'll stay in practice and optimize your opportunities to gain experience.  If you are strong in English grammar, offer to proofread transcribed documents for grammar only.  You'll still get experience reading transcribed documents, and continue to build your medical vocabulary.
• Be ready: if you are fortunate to be offered a trial period, make sure you're ready to go.  Be ready with your computer, high speed Internet, up-do-date anti-virus software and firewall software, Microsoft Word, foot pedal, medical spellchecker, and a list of resources for checking everything from drug names to grammar.

- Jo-Ann Clarke, CMT
Senior Academic Officer

CanScribe is and will always be a big believer in giving back to the community and, well, just giving back in general!  In 2009 the CanScribe staff starting donating a portion of each pay to a charitable organization within the community and each month CanScribe will match our contributions.  Our newest organization we are giving back to is the Kelowna Women's Shelter.  I would like to shine the spotlight on them and showcase everything they do for our community!

About the Kelowna Women's Shelter:

The Central Okanagan Emergency Shelter is a nonprofit society, governed by a volunteer Board of Directors.  The Society is a member of BC/Yukon Society of Transition Houses, a network of women's organizations.  They have paid staff and many volunteers who provide services to women and children in the area boundaried by Oyama to the north and Peachland to the south.  The Kelowna Women's Shelter has been offering services to the area since 1977.

Services Provided:

• 24-hour support and counseling services for women and children who have experienced abuse in the family
• Outreach program - It is a free, safe and confidential service for women 18 years and older, who have experienced abuse in a relationship.  The outreach worker will meet with the individual and childcare is provided at the shelter
• Shelter and transition home
• WISH (Women's Interim Supportive Home) allows residents to live for up to one year in a supportive atmosphere with easy access to the staff and services of the shelter
• Inside/Out Violence Prevention Program - this program promotes critical thinking about healthy relationships and relationship abuse through activities, multimedia resources and group discussions

Abuse is Never Okay.

ASKING FOR HELP IS.

For more information: http://www.kelownawomensshelter.ca/

- Jessica Parker
Student Services

Starting your word list early in the course is one of the best gifts you can give yourself.  Whether you use the Li'l Red Notebook, Excel, or have a different, brilliant system, having a word list on your computer to organize the multitude of words and terms you will be exposed to during the course will save you time in researching, will be a valuable resource for exams, and will be something you can use once you are working as an MT.

A word list is only a useful tool if the words you are learning are added to it daily or, ideally, the minute you come across them.  Rather than allocating a day sometime in the future to add 100+ new words and terms into a word list, try adding each new word into your list as it comes up in the course material - this makes creating and building your word list so much easier.

Word list tabs tend to expand and become more specific as you progress through the course and acquire a wider knowledge base.  A word list which starts with tabs for anatomy, grammar, and formatting rules, for example, will expand to include tabs for the medical specialties, operative instruments, oncology terms and staging, and so on.  Some other great additions to your word list tabs might be drugs/dosages and lab values.

Start now to create your word list - you will be so glad you did when it's time to write your final!

- Sandra Stevens, RMT
Instructor

As you enter your transcription career, you will encounter many instances of what is known as medical slang.  It will depend on the hospital or clinic you are working for or the account specifics on whether it will be acceptable to type the slang or the "correct form."

I have listed below only a few examples of medical slang, and there are many, many more.  Also, if you have an account that specifies "verbatim," you would want to clarify if these slang terms are acceptable.

appy - Spell out appendectomy.

bili - Spell out bilirubin.

Yuppie flu - Okay to transcribe as dictated.  Yuppie flu is one of a number of names given to the condition of general malaise and fatigue accompanied by various troublesome infections which results when the body for one reason or another becomes chronically run down.  The condition is known also as chronic fatigue syndrome and myalgic encephalomyelitis.

retic count - reticulocyte blood count test.

jump start - cardiac defibrillation.

white coat syndrome - This is an acceptable term.  The patient is anxious/nervous about being in the doctor's office which results in benign temporary hypertension.

shoot and boot - medicate and discharge.

stepdown unit - a monitored setting not as intense as any type of ICU.

crit - hematocrit; spell it out.

crispy critter - severely burned patient.

triple A - abdominal aortic aneurysm.

dead shovel - obese male patient who dies while shoveling snow.

DFO - "Done fell out" - dialectical expression of syncope.

ex lap - spell out exploratory laparotomy.

lytes - electrolytes; spell it out.

frequent flyer - patient who overuses ER.

FOF - found on floor.

perfed appy- ruptured appendix.

pothole sign - method to gauge sufferers of an acute appendicitis attack.

pee - unless the doctor is quoting the patient, please substitute the word urinate for pee.

- Robin Reynolds, CMT, AHDI-F
Instructor

Linda was born and raised in Kelowna, BC.  She is the newest team member at CanScribe Career College in the Admissions Department.  She has over 15 years of experience in customer service and administration to assist potential students with a new career and life path choices.

During her spare time, Linda enjoys all that the Okanagan has to offer; golfing, gardening and the great outdoors.  She loves learning new things, sharing her knowledge with others and inspiring individuals to achieve their full potential.  She is looking forward to helping potential students get started and working closely with the rest of the CanScribe Career College Team.

- Linda Kovacs
Student Admissions

Starting a medical transcription business can be very rewarding but it can also be a little daunting, especially if you don't have any previous business experience.

Here are a few common questions:

Do I need to register my business?

Not necessarily.  You can always start working as a freelance MT and file your own taxes at the end of the year.  You don't need to register for a GST number until you make over $30,000 per year.  So you wouldn't collect or pay GST.

Most small clients don't mind writing a check to Lisa Jones but if you want to go after bigger accounts it's important to have a professional image and you should consider registering your business.  There are also some extra tax deductions that may apply to business owners.

Do I need to open a checking account?

You can only open a checking account once you have registered your business.  The bank will ask for your business license before allowing you to open your account.

Can I hire other people to work for me?

You definitely can.  As soon as your business starts to grow and you're getting more work than you can handle is a good time to outsource some of it to subcontractors.  Subcontracted MTs still work as independent MTs, which means you're not responsible for employee benefits, taxes, etc.

Want a money saving tip? When your business begins to grow and you are thinking of subcontracting work, why not take on a practicum student? You'll save money and get to test their skills for 100 free hours before you need to make a commitment.

It's really not hard to start a medical transcription business.  The start-up costs are low compared to many other home-based businesses.  You will need equipment such as a computer, a printer, and reference materials.  The latest and greatest equipment is not necessary to get started.

Now, there are some special skills you will need:

Excellent grammar skills
Good listening skills
Basic computer skills with a word processing program
Research skills
Ability to type, your speed will increase with experience
Must be detail oriented
Ability to work on your own
Ability to maintain work deadlines and be a self-motivator

You will also need some computer programs such as a medical spellchecker and a word expander utility to cut down on the amount of actual typing you do.  Some programs, such as Microsoft Word include this type of utility.  It is the best invention by far.

Basic bookkeeping is necessary, but not difficult.  A good bookkeeper is great to have when it comes to taxes and advising you about saving money with tax deductions for your business.

Medical transcription is usually paid by the amount of work transcribed.  Therefore, it is quite normal to charge your clients by the line.  If you charge 13 cents per line and type 200 lines per hour, (this is a very comfortable speed to type) your hourly rate would end up being about $26.00.  There are many positive things about being self-employed, as I'm sure you can imagine.  The flexibility you have with your time - If you want to work late in the day you can, and if you want to work early in the morning, that's up to you.  Running a home-based medical transcription business is a lot of fun.

- Carolyn McEwen
Manager Student Services

Imagine if you will, being visually challenged to the point you are able to only see some color, no shapes, no text, and it just happened 7 years ago.

Now imagine being a medical transcriptionist and maintaining a minimum line count with over 95% accuracy.  It was an experience that left me in total awe of the amazing ability of the human spirit to overcome challenges and persevere.

I did an in-home study with a visually challenged MT.  She used a program called JAWS to assist her with transcription.  JAWS talks out loud and tells you every single function and/or keystroke and has its own set of keystrokes to run the program.  Add in the mix, Shorthand, a program with its own set of rules and keystrokes, and then a platform that has yet another set of keystrokes to perform most functions.  The mouse can be used to float around the screen to try to find certain things, but she relied on keystrokes.

The last part of the scenario was...  as JAWS talks, using keystrokes for 3 programs, and not being able to see any text....the physician talking in your other ear.

Through all of this, she maintained a line count of approximately 125 lph, kept a good QA rating, and smiled as she walked me through her process.

We created macros together to increase her production and ease of navigating around the platform.  She thanked me profusely and sent me home with a hug and a smile.

I drove through 5 o'clock traffic and it took almost 90 minutes and I did not mind.  I was speechless thinking about this lady who has overcome so much and had nothing but kind words of encouragement and acceptance of her situation.  I was humbled and mortified that I had ever complained about my job and my physical abilities to perform my job and daily activities.

I often think of this lady and try to remember no matter what, we can make our lives better and our jobs easier, we just have to be able to look and see with more than just our eyes.

- Lori DeVaney
CanScribe Instructor

...or is it more like a nice shade of orange?

What I am referring to are the good ol' answer keys!  You do your best and submit all your hard work and poof!  It comes back looking nothing like what you expected or hoped for.

Here's the scoop:
When you are doing your exercises or transcriptions, you are given a set of rules' to follow.  These are called guidelines, account specifics, or account instructions.  You diligently follow them to a T and you click submit.  YIKES!  There is orange everywhere.  All that time and effort...what happened?

What happened is acceptable variation.  This means that there are many different ways to express the same thing.

This is how it works in the course: When you submit your work, it becomes merged with the version that has been stored on the computer, which is only 1 possibility.  Anything that is exactly the same between your version and the computer's version doesn't change.  Anything that does not exactly match the computer's version will show as either orange (indicating your version has something the computer's version doesn't have) or blue (indicating that the computer's version has something that your version doesn't have).

Just because you added something extra doesn't necessarily mean it is wrong.

Just because you missed something doesn't necessarily mean it is wrong.

All it means is that the computer thinks it is 100% correct 100% of the time and there is no give and take.

Here is an example:

You transcribe: Anterior cervical discectomy infusion

The computer has: Anterior cervical diskectomy and fusion

They merge and the key comes back with: Anterior cervical diskectomy and fusion

As you can see, both versions have the same first 2 words.  So far, so good.  Next you see orange and you think that you made a mistake in spelling.  Not so.  This is an example of acceptable variation.  There are 2 ways of spelling this word.  If your account guidelines have not specified a preference, this would not be considered an error.  The final words in that phrase show that you transcribed infusion and the computer has and fusion.  This is an actual error.

See, not so bad.

Even though text comparison like this can result in frustration, in essence, what this is doing is forcing you to recognize an actual error versus an acceptable variation.  Once you have determined your actual errors, note them so you, hopefully, don't repeat them and you can then continue on to the next exercise or report.

It is all a learning process - and it is not an easy one but you'll get there!

Hang in there and if all else fails, take a break, count to 10 and think chocolate!

- Susan Cunningham, RMT
Instructor

Hi my name is Sarah Kennedy, and I am the newest addition to the Student Services Department.  I come to CanScribe with the ability and desire to assist individuals in reaching their educational goals.

I have several years' experience in the weight loss industry, where I helped clients achieve their weight loss goals, and have helped many people improve their health, attitude and life.

I was born in Belfast, Northern Ireland, and immigrated to Kelowna at the age of 10.  I am the eldest of 3 girls.  I'm an avid softball player, self-taught musician, and thoroughly enjoy the outdoors.

Fun Facts about me:

• I am almost 6 feet tall
• I wear a size 13 shoe; and I have to custom order my shoes
• I am not Irish, I am British (common misconception)
• In high school, I used to read the dictionary for fun
• I play guitar, and the first album I learned to play was "Jagged Little Pill" by Alanis Morissette
• I enjoy cooking, baking and BBQing (already started BBQing, couldn't wait any longer)

I have always been interested in health and education, and what better way to get the best of both worlds by working at CanScribe.  I am proud to be a part of one of the most reputable career colleges in Canada, and can't wait to work with all of you!  If you have any questions or concerns, feel free to give me a call at 1-800-466-1535.

- Sarah Kennedy
Student Services

Spring is that wonderful time of year when the sun begins to warm, life is renewed and the world is a flurry of energy once again.  Spring is a time when every cubic inch of air seems to be zipping around at near supersonic speeds, causing spring fever.  We're sure that, just as you do every year, you've noticed a certain change in demeanour, a shift in attitudes and a change in perceptions during winter's thaw.  What hibernation is to winter, a flurry of energy is to spring!  With this new found energy of the spring season why not take the time to put that energy to good use and clean-up.  Why not start with cleaning up what tends to drain that energy away - STRESS!

Attitude control: When you get your attitudes under control, every other aspect of your life improves.

1. Make Connections - It is easy to become so absorbed in a day that you start to tune out those around you.  This can add to a feeling of isolation and stress.  It is more advantageous to your own well-being to reach out and greet others, learn their names, and maybe even win friends in the process.
2. Let Things Go - There comes a time when you recognize that the best solution is to relax and accept that you cannot have everything turn out perfectly every time.  If you feel like you are experiencing too much stress in a situation, ask yourself, "Is this one of those situations where I should just let go?" or "Does this need to be perfect?" The answer may surprise you.
3. Take Charge - Your attitudes improve when you take charge of situations and accomplish a goal.  At the very least, you can take charge of your own workload, relationships, and attitude.  When you hesitate or procrastinate, you undermine your energy and make time more stressful than it has to be.
4. Stay Calm - Whatever it takes - counting to 10, taking deep breaths, going for a walk, or taking a quiet moment for you, concentrate on staying calm.  Avoid overreacting, lashing out, or acting impetuously, which only adds to your stress level.
5. Appreciate the Uniqueness in Others - If you truly think about it, if everyone was just like you it would be boring.  Differences in backgrounds, perspectives, and lifestyles make life more interesting and vibrant.  Work on appreciating the distinctive strengths of others and the richness they bring to your life.

Time Management: Make the most out of your time.  It is as simple as determining our own productive and non-productive use of time.

1. Show up Early - There is no downside to showing up early.  When you come in early, you have extra time to gather your thoughts and get prepared, and you are sure to make a better impression in every situation.  All the way around, this work habit reduces stress.
2. Be Organized
   • a. - Daily Planner - Whether you use software or plain paper, you need a daily planner to make sure that you are on top of all of your daily details.  When you spend time planning, you reduce time spent executing tasks.  Thorough daily planning is a key tool.
     • i. Write down ideas as they strike you, commitments as you make them, or other important notes.  You will feel less stressed when you know that you have captured important information and can reference it when you need it later.
   • b. - Simplify Your Approach - What could you start doing, stop doing, or do differently to simplify your work approach?  You may be inadvertently making your work more complicated than it needs to be.
   • c. - Drop Unnecessary Activities - Make a list of each activity in your workday and week, from driving the car to sitting in meetings.  Which activities are not necessary?  Can you drop any of them?  Try dropping those activities for a week or a month, and track any changes in your results at work.  You may be surprised by how much more efficient you can be.
   • d. - Finish One Task Before Starting Another - Avoid excessive multitasking.  If you stay focused on a particular task and see it through to its completion, you will get it done quicker and you will stay far more organized than if you attempt to multitask your way through a bunch of chores.
3. Be Present - How many times do you sit in meetings and allow your mind to wander from the subject under discussion?  You are often physically present, but mentally in a totally different place.  When you daydream during meetings, you end up uninformed about the meeting's topic and stressed.  To avoid this tendency, sit up straight during meetings, take notes on the topic, and try to keep in eye contact with the speaker.
4. Avoid Procrastination - Everyone is motivated in different ways.  Find what inspires and energizes you to tackle work issues, instead of putting them off.  Commit to a regular schedule of work output and project completion.
5. Set Priorities - No one likes to leave work at the end of the day or week feeling like they didn't accomplish the most critical tasks.  When you set and adhere to priorities, you avoid stress and keep on pace with the demands of your workload.
6. Protect Your Private Time - Some anxiety-provoking work habits, such as bringing work home or staying at work late, are more exhausting than we may realize.  Sometimes it can't be avoided, but if it becomes a habit, you can start to feel like you don't have a life outside of work.  Try to manage your time at work more efficiently so you can enjoy your time outside of the office.

Now with all that being said, the most important way to reduce that stress is to "ENJOY LIFE!" Now take that energy, get outside and HAVE SOME FUN!

- David Surry
Controller

Sitting in one position and typing for several hours at a time can cause eyestrain, shoulder and backache, and carpal tunnel syndrome.  On average, your body can handle being in one position for about 20 minutes before you will feel the need to change position.  It is very important that you take regular short breaks and also do some stretching exercises.

Below are a few tips and exercises that can help you avoid the above discomforts:

• Check your posture.  Make sure you are sitting up straight.
• Use a firm and comfortable chair.  Make sure that the chair is set at the correct height for your desk.  Your thighs should be horizontal and your feet flat.  Your forearms should also be horizontal.  Your knees should be slightly higher than the seat of your chair.
• Relax your shoulders.  Your upper arms and forearm should form a right angle with your wrist and hand in roughly a straight line.
• Place your mouse at the same height as your keyboard.  When you move your mouse move your whole hand and not just your wrist.
• Wrist flexion exercise: Hold out one arm with your fingers pointed up.  With the other hand gently bend your hand back towards your forearm.  Hold for five seconds.  Repeat on the other side.
• Fan your fingers: Hold your hands out in front of you with your palms down.  Spread your fingers apart as far as you can.  Hold for five seconds, and then make a tight fist.  Repeat three times.
• Stretch your lower back by standing up and pulling each knee to your chest, holding that position for 5 seconds.
• To relax your shoulders, move your head sideways from left to right and back to left.  Then move your head forward and backwards.
• Stand up straight, place your right hand on your left shoulder and move your head back gently.  Do the same thing for the right shoulder.

- Deb Albert, RMT
Instructor

Something I have noticed, in both chat and with practicum students, is that many students don't use the Book of Style for Medical Transcription (BOS).  Many aren't even sure what is being talked about when it is brought up.  Others, who realize that the full text is available in Benchmark KB, find it overwhelming and don't use it because they "can't find anything." I'd like to help you become a little more familiar with what it contains and how it can help you be a better transcriptionist.

The Association for Healthcare Documentation Integrity (AHDI), who publishes this style guide describes it as "streamlined and strategically reorganized flow of critical data, enhanced explanation of standards and practical application, robust examples taken from clinical medicine settings, and so much more." Heavy description.

More simply put, the Book of Style is a reference guide to the format preferences of medical transcription.  It is a reference for grammar, punctuation, and usage.  It helps explain these style preferences using practical medical samples.  It also discusses some of the current and future trends that will affect our industry.

As you know, the first style reference at any job is always the client specifics.  They will have rules and formats particular to their organization that must be followed whether they are standard or not.  However, these specifics are never all inclusive.  For any point of style not covered by those specifics, your first reference should be the BOS.  Most jobs will expect you to be familiar with it and to adhere to it.  Many employers will expect that you have access to it as a reference, which they may or may not provide.

The BOS is broken down into 5 main sections, which contain a large quantity of information.  The BOS is invaluable as a reference guide for doing day-to-day transcription.

• Section 1 - The Legal Medical Record - This section offers a general overview of medical documentation basics.  Topics such as document types, formats, turnaround times, editing, and privacy issues are covered here.
• Section 2 - General Standards of Style - This section is divided into chapters 4-9 covering everyone's favorite topics; grammar, usage, punctuation, capitalization, plurals and possessives, and abbreviations.  It is very clear early on to an MT that doctors are forming their dictations while reading their own notes, lab reports, and prior documents.  They are also often distracted by office personnel, phones, lunch, etc.  They are summarizing and tying things together as they think it through themselves in a busy office setting.  They are not visualizing the page in front of us or paying close attention to grammar standards.  They leave that to our expertise.  This results in many statements that do not easily lend themselves to the application of standard grammar rules.  While we can easily edit "the patient were admitted", it isn't so easy to clearly break up and transcribe a run-on sentence that goes on for 6 lines before Dr.  Verbose takes a breath.  Studying the components of language at the base level can help us decide how to deal with the phrases we hear in our sound files when we can't just rephrase the whole thing.
• Section 3 - Measurement and Quantification - "There is arguably no more critical information recorded and relied upon than the numeric values that represent a wide variety of indicators for both cause and effect in managing disease." The 3 chapters of this section cover the basics of numeric references to help ensure that values in the record are easily understood by all readers.
• Section 4 - Specialty Standards - If you want to know how to transcribe labor stages or heart sounds, how would you decide which of the above chapters to look at?  No generalized grammar or numeric topic readily addresses these types of questions, but they must also be formatted in a standard way so that they are clear to all recipients of the record.  The information found in the 12 chapters of section 4 is related to unique topics and quirks of individual specialties.
• Section 5 - Resources: Industry Trends and Standards - This section discusses a bit about the history of the industry and the evolution of some of the standards, as well as the future of where our industry is headed.

All of the above is included in the Benchmark version of the BOS.  In the hard copy, there are several appendices containing sample reports, the AHDI's Statement on Verbatim Transcription, a glossary of sound-alike words, model job descriptions, industry abbreviations, and an index.

Whew---That is one big book of information to be expected to be familiar with and adhere to on the job.  The Book of Style is overwhelming to read all at once and difficult to search if you don't know that something is there in the first place, how it will be worded, or where it might be tucked in.

The BOS is often called the Bible of transcription rules and styles.  From that thought, let's take a look at how it is indexed and how to find entries referenced by your instructor or keep track of ones you want to find later.  In Benchmark, the book is organized in a folder tree format, much like your C drive.  Each folder has a + in front of it that opens the folder a little further into subtopics.  When referencing those subtopics, the chapter and then individual references are indicated.  BOS 6.2.3 refers to chapter 6 (punctuation), topic 2 (The Comma - Separating), entry 3 (Independent Clauses).

Hopefully, the above gives you an idea of the basic layout and where to look for general topics.  But even the most ardent grammar geek and dedicated MT student would have to admit that reading it from cover to cover would probably be a cure for insomnia, to say nothing of how time consuming it would be when you have a schedule to keep up with.

Think of it more like the dictionary.  You wouldn't really retain much if you started on page 1 and tried to memorize a language.  Instead, go for a word of the day or, in this case, topic of the day.  To become familiar with it when I first started using it, I would look at a random entry or 2 every day before I started working and reread it when I finished.  The topics are actually very short and easy to understand.  This process took less than 5 minutes before and after working.

My purpose was never to memorize each entry, though if you use it enough, you start to.  Rather, I would remember that a topic was covered.  When the issue came up, I would know it was there and be able to find the reference again later.  I would suggest that you start with everybody's favorite, Section 2 and Section 3.  These are the most universal topics, and the ones you should be most familiar with when you start working.  When you are on the job, you can start picking topics on the specialities you work with the most.

- Marcia Gordon, CMT
Instructor

As I have worked with many students over the past few weeks assisting them through the prefinal assessment, I have been reminded of my own training 38 years ago.  Now that I am working with students again, I recall from my own observation the four stages of growth and development in becoming a seasoned, advanced medical transcriptionist.

What you will find, as did I, is that over the years you become better at your work and your mind will expand with the challenges you face.  As I have described real world experiences to my students, our exchange seems to ease their learning experience as they comprehend the stage at which they find themselves and how their perspective will change over time.

Perhaps understanding the stages of growth and development that students undertake could accelerate your development.  I have outlined below the stages of student development to be expected in your career.

Stage 1:

• During stage one, the MT student is taught to focus on many tasks simultaneously to include spelling, pronunciation, the slang form of and abbreviations of medical and English terms, punctuation, grammar, formatting, research techniques to verify accuracy, mastering listening skills, and the many rules and variations of the rules of transcription.  During this stage, the student feels bombarded and stretched.  The student's self-confidence takes a beating yet the challenge is irresistible.
• As growth-seeking beings, this type of challenge is one that the highly intelligent individuals will thrive upon because it makes them feel worthy and alive with a feeling of accomplishment as the student's confidence slowly improves with each accomplishment.
• During this time, the student will find that slowly many tasks become easier and second nature, thereby releasing the frustration level.  This is because the student absorbs the tasks performing them as a natural reflex.  The work of transcription slowly develops a sense of easing of the pressure.
• Of note, the listening skills are at the stage where the student is listening to one word at a time.  The drawback to this form of listening is that what was read in the previous paragraph is not retained and therefore, errors will tend to be made in regard to catching a dictator error or mistake.  Also, critical thinking skills are still as yet underdeveloped, so rationalizing is limited.  At this stage, the student is not yet capable of hearing properly but with patience, this will come.

Stage 2:

• During stage two, the research skills are improving.
• The spelling of medical terms is also improving as with experience, the student is becoming accustomed to the formatting used in the Latin and Greek spelling and combining of terms, such as with the "O" connector, as in anteroposterior versus anterior-posterior.  It means the same thing, but due to the listening skills being so immature at this stage, the student will likely not hear the "O" in anteroposterior.
• The student is introduced to grammatical and punctuation challenges and must at this point ensure the understanding is clear to prevent errors that are costly on evaluations.  Less is more in the form of commas.  Punctuation must be learned as in the use of the semicolon (;) and when its use appropriate.  The semicolon is used only between two independent clauses that are related in thought.  An independent clause could stand alone as a sentence, with a subject and a verb often linked by "therefore." For example, "The patient's blood glucose remains elevated; therefore, Insulin 70/30 is added to his medication regimen." At this stage, the student will no longer err in the use of punctuation, as well as using fewer commas for fear of changing the meaning of the dictator's words.
• More care and focus is given to remaining as verbatim as possible in order to ensure the patient's health and wellness is not at risk.  Formatting to include more "white space" around paragraphs makes a report more professional looking and easier for the reader to skim quickly for vital information, i.e., lab values, vital signs, medications, numerical values-measurements...all in Arabic numerals and not spelled out, always keeping in mind who is reading the document and how to make it easier to process.
• Even more important, the student is learning the importance of flagging any questionable interpretation and that flagging is an opportunity to learn when the final result is reviewed and either confirmation or correction sets in the student's mind how to handle a similar experience in the future.
• At this stage, a noticeable improvement in hearing is noted.  The student realizes that listening to the entire sentence has replaced hearing only one word at a time.  Even more importantly, the student is beginning to visualize what the dictator is describing as if telling a story and possibly anticipating what the dictator will say next.  This skill will enhance the student's ability to reason out a word or phrase that the dictator could be saying that has been heard clearly and trying it on for size, to see how it fits, and if it makes sense.  This rationalizing is due to an improvement in critical thinking skills.
• At this stage, the student will realize fewer errors in the transcription as well as less flags are being used because of the growth in confidence and recognition.

Stage 3:

• In this stage, the student has advanced significantly in comprehension as many of the rote tasks are now second nature.  As rote tasks recede into the automatic response part of the brain and are handled without the awareness of the student, other roles are enhancing.
• Focus is now turned to listening more fully.  Instead of hearing a sentence at a time, the student can now comprehend a full paragraph at a time as the dictator describes the history of present illness.
• The student is visualizing much more clearly now and transcribing with increased accuracy more difficult terms that are becoming more commonplace in everyday dictations still anticipating what the dictator will say next.  The familiarity is comforting to the student which increases her self-esteem and attitude.
• Former annoying quirks of dictators are no longer even noticed and the student is staying more tuned in to the task at hand with a more polished and professional attitude and less judgment or criticism of the dictator's style as it is becoming evident that complaining is not helping; however, realizing that the annoyances are part of the job and are easily overlooked.
• At this stage, the student may feel a tangible change inside as realization reveals the work is becoming easier and flows more smoothly with fewer interruptions or halts to look up words and less research interrupts the students flow.
• The mind comprehends full paragraphs at a time and now the student will begin to notice more misquotes by the dictator or incorrect dosages of medications from one paragraph to another.  If the dictator says "left side" in the introduction but in the body of the report quotes the "right side," at this stage the student will hear this error immediately because of the retention of information in the mind advancing along with reduction of cognizance of the many automated skills that have become second nature.  Critical thinking skills leap forward again.
• More "ah-ha" moments will be experienced as this advanced student now realizes she is in the process of becoming an advanced medical transcriptionist.

Stage 4:

• In this stage, the student is now a highly advanced individual.  Critical thinking skills are continually engaged and advanced.  Any question asked about what the dictator describes, the student will be able to answer.  For example, why is the social history important and how does it benefit this patient's healthcare?  The social history reveals stresses in the patient's life, lifestyle choices, such as sexual habits that could reveal the origin of a disease process.  Such critical thinking skills enhance the student's ability to unravel garbled dictation using logic to decipher inaudible dictation.
• Research skills are highly advanced and less time is spent searching for information and instead answers are found within seconds.
• Sitting in front of a computer for up to 8 hours a day is not a stress at all.  Production increases to the point where a goal can be set to reach 1100 lines a day if desired, or even more.
• The posture of the student improves to reduce fatigue.  The student understands that sitting erect with a straight back, shoulders back, both feet flat on the floor, and hands on the keyboard bent at the elbows in the perfect ergonomic position will allow for hours of transcription without any sign of fatigue.  This also lessens back strain and likely carpal tunnel due to bad posture and work form.
• The typing speed can increase to 125 wpm and the mind is sharp, alert, focused, and the student can work flawlessly.
• Rarely does interruption interfere with the flow because the mind has now memorized the many terms used repeatedly.
• The listening skills are the last to develop fully.  In comparison to stage 1, the ability to clearly hear an ESL dictator has improved to the point that the student is no longer intimidated by difficulty once presented.  Anticipation of the dictator's style will allow for improvement in the listening skills yet again.  The advanced individual can hear the entire document flawlessly recalling what was dictated in the beginning and that the verbiage agrees with the conclusion.  The transcriptionist's mind at this advanced state is a fine-tuned, well-oiled machine.  The work flows effortlessly, with confidence.
• At this stage, the student will begin to recognize what specialties appeal to her most, ESL?  Cardiology?  Surgical/op notes?
• Also special skills being revealed in the student will begin to appear.  Some transcriptionists are recognized by their employer as someone who can transcribe any specialty and pick up the terminology quickly.  This ability is always enhanced by advanced research skills, attention to detail, pride in one's work, critical thinking skills and never leaving anything in doubt unflagged.
• The reliability of an MT is also noticed by an employer who asks, "Who can I call on to help with this backlog of work and do a job well?" The answer is always on the tip of the tongue of an employer who has watched and observed the MT's work over time and come to trust it.  Certain individuals always stand out.
• There are times when an employer will have a problematic account and will seek help from an advanced MT to save the account by asking, "Who can I put on this account on whose accuracy I can count and who will do the best job for us?" If you are ever called to assist in this manner, you have proven yourself and you are worth your weight in gold to an employer.  Your job is secure and you will be in great demand.  This is the ultimate goal of the highly advanced MT.  Everyone has the potential of reaching this goal in time.  An advanced MT is never intimidated by a specialty or dictator.

Now is the time to ask yourself, at which stage are you?  Most students are at stage 1 or 2, which is appropriate.  Rarely is a student of your young experience advanced beyond this ability.  Advancement comes with time and experience.  Stage 4 could take 10-20 years to achieve.  An advanced critical thinker could take less.

Attitude is of utmost importance as well.  Are you a complainer?  Are you still making excuses about your development by blaming the dictator?  The best that can be said about a dictator's flaws is that, "it is what it is." This will not likely change, so the best way to overcome and improve is to accept this fact as part of the job.  Freeing yourself of the ego attachment to this excuse will open your heart and spirit to realize your greatest potential.

Can you take constructive criticism graciously?  The greatest opportunity for you to learn is from the feedback you receive from your teachers and employers.  Accept their feedback as graciously as you can and use their feedback to help elevate you through the various stages of development.

Medical transcription is a career that can only be learned from the mistakes you make.  Don't be afraid to make mistakes and don't be too hard on yourself when you do.  Forgive yourself and release the guilt.  You are expected to make mistakes and guilt will only cloud your mind and block your abilities to hear, think, evaluate, and rationalize.  Be in alignment with your work before you begin.  Set your goal to do your very best.

Life teaches that from adversity comes our greatest growth.  Tests and grades best serve you by providing tools to assist you in rising to a higher stage of learning.

I've always told my students that there are no shortcuts.  Every experience you have in your career as a medical transcriptionist will benefit you in the future.  Be thankful for each and every experience, the good and the bad, because with each you become a wiser person through the continual learning that your career will offer you.

- Trudi Griffith, CMT, AHDI-F
Instructor

We are so proud of all the CanScribe graduates and would like to congratulate you for a job well done!  Please keep in touch and share your experiences with us!