I'm pretty sure about what you're thinking …….. "What? Who cares how good I wash my hands on the exam. I am already running out of time here…it is an awkward silence when my mind is racing as to what system I am going to examine …..the point is that I wash my hands. Right?" Correct…… I hear you …….. What's on my mind was more like " How best can you use your time and impress the patient while you wash your hands (sorry chewed up the "un-underlined" words in the title- is that even a word, I wonder ? Okay back to topic….) 1. Excuse yourself while you go to wash your hands 2. Don't turn your back completely to the patient. Stand diagonally, so you can still glance at them (eye contact) while you wash 3. Keep a conversation going P.S. You don't want someone just watching your back, do you ? at least NOT the SP, huh? "So what do you do Mr/Mz George? Is your job stressful (you just asked the stress Q here and saved time too!) How about at home? Do you exercise ? That is a good stress reliever, as you probably know". (You threw in the exercise Q too ..and….. cut short on the history taking time …Bravo…..Go on now…to your PE.