Patient interview

How to interview a patient with a tremor

Other platforms explain it with text and video. In VMS you practice it on the patient.

MD / DOPA
Practice it in VR with Blocky

The key question is when the tremor happens: at rest suggests Parkinson's disease; with movement suggests essential tremor.

Step by step

  1. Introduce yourself and watch

    Get consent and watch the hands at rest and holding a cup. [1]

  2. At rest or in action

    At rest and better with movement, or worse when holding something or reaching. [2]

  3. Onset and spread

    When it started, one side or both, head or voice involved. [2]

  4. Other symptoms

    Slowness, stiffness, small handwriting, shuffling walk, balance problems. [3]

  5. Family and alcohol

    Family history; tremor better with alcohol suggests essential tremor. [3]

  6. Medicines and thyroid

    Asthma inhalers, lithium, valproate, caffeine, thyroid symptoms, anxiety. [3]

  7. Summarize and plan

    Explain the exam and next steps. [1]

Common errors

Practice it in VMS

In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

VMS cases that train this skill

8 VMS cases train this skill: open the case library

Sources

  1. AAMC Core Entrustable Professional Activities (Core EPAs)
  2. NBOME COMLEX-USA clinical presentations
  3. NCCPA PANCE Content Blueprint

Facts and steps follow NBOME COMLEX-USA clinical presentations; NCCPA PANCE Content Blueprint; AAMC Core Entrustable Professional Activities (Core EPAs). VMS is not affiliated with these organizations. Updated: 2026-10-11.