NAC candidate pre-exam orientation presentation

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NAC candidate pre-exam orientation presentation

  1. 1. CANDIDATEORIENTATION © NAC / MCC Pre-Exam Orientation 2013
  2. 2. [ NAC OSCE Examination ] The National Assessment Collaboration (NAC) Objective Structured Clinical Examination (OSCE) assesses the competence of candidates — specifically the knowledge, skills and aptitudes essential for entrance into postgraduate training in Canada. The NAC OSCE examination may include problems in:  Medicine  Pediatrics  Obstetrics and Gynecology  Preventive Medicine and Community Health  Psychiatry  Surgery In addition, the candidates will be assessed on their basic knowledge of therapeutic management of common clinical problems.
  3. 3. [ Duration ] The examination duration is approximately 4 hours. Plan to be at the examination site for a minimum of 6.5 to 7 hours. No external contact will be permitted during the examination and sequestering period. Candidates will not be dismissed until the specified time on the information sheet.
  4. 4. [ Items to Bring ] Reflex hammer Stethoscope White lab coatItems that are NOT permitted:  Cell phone, pager, iPod, or any PDA (Palm, Blackberry, etc.)  Pens, pencils, pen lights  Paper, books, notebooks  Bags, briefcases
  5. 5. [ Candidate Notebook ] Do not open your notebook until the examination begins. Inside, you will find a sheet of bar code ID labels and some blank paper for your use during the examination. Never rip out any pages; your notebook must be returned intact at the end of the examination.
  6. 6. [ Organization of the Examination ]TWO PARTS: Written: Therapeutic Management Examination  A series of questions unrelated to any of the patients in the OSCE portion of the examination.Then a short break, followed by the: OSCE  12 clinical stations with standardized patient encounters.
  7. 7. [ Introduction to the Therapeutic Knowledge Component ] A written examination component based on the knowledge of therapeutic content.  Multiple--choice questions — approximately 24 in total. The session will last 45 minutes.
  8. 8. [ Written Therapeutic Knowledge Session ] Wait for the signal from staff before beginning. Questions DO NOT relate to any patient that you will see in the OSCE portion of the examination. These questions test your ability to recognize common therapeutic approaches including the prescription of medications for common clinical problems. Read the questions carefully.
  9. 9. [ Written Therapeutic Knowledge Session ] Record your answer to each question by filling in the corresponding bubble with a pencil (). To change an answer, completely erase the bubble you do not want counted. Only clearly filled bubbles will be scored. – The following marks will NOT be recognized: ,,. If you fill in more than one bubble for a question, you will be scored ZERO for that question.
  10. 10. [ Introduction to the OSCE ] What is an OSCE? Objective Structured Clinical Examination  A form of performance-based testing used to measure candidates’ clinical competence.  During an OSCE, candidates are observed and evaluated as they go through a series of stations in which they interview, examine and treat standardized patients (SPs) who present various types of medical problems. NAC OSCE:  12 stations of 11 minutes
  11. 11. [ Candidate Instructions ] At each clinical station there is a written statement (candidate instructions) that:  Introduces a clinical problem  Directs the candidate to appropriately interact with a patient (standardized patient)  Specifies the task, such as obtaining a focused history, conducting a focused physical examination, or assessing and addressing the patient’s issues  Indicates whether there are examiner oral questions at the 8-minute signal
  12. 12. [ Important Reminders ] Read the instructions carefully  If the task is ―take a focused history‖ – that is what you will get credit for. You will not get credit for advising or educating if the assigned task is focused history taking. Use closed-ended AND open-ended questions  Use open-ended questions such as: ―Can you describe the pain for me?‖ or ―What other changes have you noticed?‖  Limiting yourself to yes/no questions also limits what the patient can answer.
  13. 13. [ Important Reminders ] Listen to the patient  If the patient’s answer is not clear and the issue is important, explore the point further.  You are expected to elicit the patient’s story; if the patient feels you are indifferent, judgmental or hostile, he or she will be reluctant to confide underlying fears or embarrassing information.
  14. 14. [ Important Reminders ] Get full scores on physical examination stations  You cannot receive scores for rectal, genital or vaginal exams unless you indicate to the examiner that you would like to do such an exam.  State what you are doing and report your findings — both positive and normal.Give specific information  Avoid giving generic information.  Advise the patient with information or advice specific to their problem.
  15. 15. [ Important Reminders ] Do not talk too much or too little  By talking too much, you may lose valuable time and miss information.  Use professional courtesies of introducing yourself or explaining briefly why you must ask a difficult question.  Speak in a language that the patient will understand — do not use medical jargon.  Avoid lecturing the patient — engage them instead.
  16. 16. [ Important Reminders ] Your badge has a station number that indicates your start station. Candidate instructions are posted outside each station. READ everything carefully. Pay attention to the statement, which explains your task. A copy of the instructions will be available inside the room for your reference.
  17. 17. [ Physical Examinations] Examiners may intervene by:  Asking you to reread the instructions  The intent is to remind you to refocus on the task and to save you time.  Stopping genital, rectal or vaginal examinations  If such examinations are appropriate, all you need to do is clearly inform the examiner. Help the examiner score by:  Telling the examiner what you are doing (e.g., inspection)  Describing any findings  Include findings that are normal.
  18. 18. [ Physical Examinations] You will be expected to use the hand sanitizer that will be available in every physical examination station. You may be prompted by the examiner. Be sure to drape the simulated patients appropriately. Carry out any maneuvers necessary for assessing the presenting problem.  Examiners only give credit for tasks completed satisfactorily!
  19. 19. [ Signals ] The 8-minute warning signal will indicate:  EITHER that your time with the patient is over and the physician examiner will begin to ask you questions  OR if there are no questions (as indicated on the candidate instructions), that you still have 3 minutes remaining with the patient. A signal also indicates the beginning and the end of each station.  After each final signal, you will have 2 minutes to move to the next station and read your instructions.
  20. 20. [ Oral Questions at 8 minutes ] Physician examiner oral questions may follow the warning signal in the OSCE stations. They:  Are related to the patient you just saw  Ask about matters like diagnosis, management decisions, and/or your response to an ethical issue Candidate instructions on station doors will indicate whether there are oral questions at the 8-minute signal. If there are no oral questions, you will have the full 11 minutes with the patient.
  21. 21. [ Physician Examiners, SPs and Labels ] Hand 1 bar code label to the examiner as you walk into the room (instructions on the door). Examiners observe and assess your performance with preset rating sheets. Standardized patients are trained to simulate patients’ signs and symptoms in a reliable and consistent manner.  Treat them as you would real patients.
  22. 22. [ Signing Out ] Before leaving, you must follow the sign-out procedure. When it is your turn, hand in your:  Candidate notebook (all pages intact)  ID badge  Unused bar code labels  Sign out on the sheet. Congratulations! At this point, the examination is over!
  23. 23. Final Review of Important PointsRead your instructions carefully.Complete the specified task.Demonstrate your clinical skills.You receive credit for tasks completed satisfactorily.Treat the standardized patients as real patients.Do not provide more answers than specified in the question.DO NOT LEAVE without signing out.
  24. 24. Focus on the ExaminationYour group leader and the support staff are there to answer your questions and guide you from station to station.Try to relax and stay focused on the examination.The purpose of the examination is a fair and accurate assessment of your clinical skills.
  25. 25. RESULTS Results will be made available to you in your online account at the MCC 6 to 8 weeks after the exam date. Through your online account, you will be able to:  view your results documents.  share them with other organizations.
  26. 26. [ Questions? ] © NAC / MCC Pre-Exam Orientation 2013

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