A Step By Step Guide
To Mastering the OSCEs
and Patient Encounters
How did we create the
Systematic Approach?
Dr Al Imari,...
OSCEhome Systematic Approach
 Patients visit doctors complaining of a
symptom, not a disease.
 It is all about the diffe...
OSCEhome Systematic Approach
 OSCE stations, as well as real life
patients’ interviews, have limited time.
 Physicians h...
OSCEhome Systematic Approach
 Obviously, there is a need for some sort of an
approach that will fulfil both patients and
...
OSCEhome Systematic Approach
 How did we at OSCEhome formulated the
OSCEhome Systematic Approach ?
www.OSCEhome.com
OSCEhome Systematic Approach
 We started by preparing a list of all signs
and symptoms a physician faces.
 We wrote one ...
OSCEhome Systematic Approach
 Then, we draw a table, assigned a column for
each differential and wrote that symptom/sign
...
OSCEhome Systematic Approach
 Then for every detail, we wrote questions
to ask for or points to examine.
www.OSCEhome.com...
OSCEhome Systematic Approach
 Obviously, there are now, many identical
questions or points to examine concerning this
sym...
OSCEhome Systematic Approach
 Then we arranged these questions and points to
examine in a logical easy flowing flowchart....
OSCEhome Systematic ApproachOSCEhome Systematic Approach
 What about communication skills? It a major
issue to ensure an ...
OSCEhome Systematic Approach
 Now, we have all the needed questions to ask
and points to examine concerning that symptom
...
OSCEhome Systematic Approach
 Again, there are now, many identical
questions or points to examine among all
these symptom...
OSCEhome Systematic Approach
 Now, we have three sets of box files;
1. Chief complaint data gathering box file,
2. Specif...
OSCEhome Systematic Approach
 Remember, in real practice, as well as
during OSCE stations, our time is
limited.
 So, we ...
OSCEhome Systematic Approach
 So we came up with a tree of a step by
step history taking and physical file
boxes.
 Durin...
OSCEhome Systematic Approach
www.OSCEhome.com
OSCEhome Systematic Approach
 Let us take an example. A patient
presented with cough.
1. Introductions box: 5 sentences t...
OSCEhome Systematic Approach
 Most of the patients’ answers will be
“NO”. How long then, will it take you to
ask all thes...
OSCEhome Systematic Approach
 We created similar flowcharts for the
physical examination, counselling, and
ER stations th...
OSCEhome Systematic Approach
 Don’t you agree, it is much more easier
to memorize than 488+ checklists!
 Rest assured th...
OSCEhome Systematic Approach
 You won’t forget anything to ask, do, or
explain. No need to anxious and
nervous.
 You wil...
OSCEhome Systematic Approach
 The systematic approach took three of
us a full year to finalize and eight years
so far to ...
A Step By Step Guide to The Mastering
The OSCEs and Patient Encounters
www.OSCEhome.com
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How did OSCEhome.com created the Systematic Approach to the OSCEs and clinical patients encounters.

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How did OSCEhome.com created the Systematic Approach to the OSCEs and clinical patients encounters. www.oscehome.com. Preparing for Objective Structured Clinical Examination (OSCEs) or Clinical Skills Assessment; USMLE Step 2 CS, MCCQE II, NAC, SAT, PLAB part 2, OSCEs for medical students or International / Foreign Medical Graduates? Would you be interested in help for your Medical OSCE Exam?

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How did OSCEhome.com created the Systematic Approach to the OSCEs and clinical patients encounters.

  1. 1. A Step By Step Guide To Mastering the OSCEs and Patient Encounters How did we create the Systematic Approach? Dr Al Imari, MD www.OSCEhome.com
  2. 2. OSCEhome Systematic Approach  Patients visit doctors complaining of a symptom, not a disease.  It is all about the differential diagnosis of symptoms and signs.  This is the main focus of physicians during patients’ interviews, right? www.OSCEhome.com
  3. 3. OSCEhome Systematic Approach  OSCE stations, as well as real life patients’ interviews, have limited time.  Physicians have no choice but to be focused and to organize the interview in a time efficient manner.  On the other hand, physicians have to be vigilant not to miss anything! www.OSCEhome.com
  4. 4. OSCEhome Systematic Approach  Obviously, there is a need for some sort of an approach that will fulfil both patients and physicians goals.  An approach that will explore all the patients’ presenting issues in a limited time frame.  An approach that will protect both the patients and physicians. www.OSCEhome.com
  5. 5. OSCEhome Systematic Approach  How did we at OSCEhome formulated the OSCEhome Systematic Approach ? www.OSCEhome.com
  6. 6. OSCEhome Systematic Approach  We started by preparing a list of all signs and symptoms a physician faces.  We wrote one sign or symptom on a separate sheet of paper.  Then for each symptom or sign we wrote all the possible differentials. www.OSCEhome.com
  7. 7. OSCEhome Systematic Approach  Then, we draw a table, assigned a column for each differential and wrote that symptom/sign presentation details, quality, duration, relation to other symptoms/signs, and red flags.. Etc.. www.OSCEhome.com Symptom / sign DDx 1 DDX 2 DDx 3 DDx 4 ….. ….. ….. ….. ….. ….. ….. ….. ….. ….. ….. …..
  8. 8. OSCEhome Systematic Approach  Then for every detail, we wrote questions to ask for or points to examine. www.OSCEhome.com Symptom / sign DDx 1 DDX 2 DDx 3 DDx 4 ….. Do you ….. Is it ….. How is ….. Do you ….. Is it ….. How is ….. Do you ….. Is it ….. How is ….. Do you ….. Is it ….. How is
  9. 9. OSCEhome Systematic Approach  Obviously, there are now, many identical questions or points to examine concerning this symptom among all these differential diseases.  We started to merge the diseases’ columns into one set of questions. When the same question is required for several diseases, we placed these diseases’ names between brackets after the question to help us later with the clinical decision making process. www.OSCEhome.com
  10. 10. OSCEhome Systematic Approach  Then we arranged these questions and points to examine in a logical easy flowing flowchart.  We have noticed that there are some details that are not required if you are just screening for a symptom and not thoroughly gathering details about it. So, we divided the to ask/do list into two files, we placed the must ask/do important ones up in the list for screening, and the rest at the bottom for detailed data gathering sub-file, and just in case we run out of time. www.OSCEhome.com
  11. 11. OSCEhome Systematic ApproachOSCEhome Systematic Approach  What about communication skills? It a major issue to ensure an easy going interview professional organized interview and to achieve a mutual understanding and respect.  We rephrased the questions to meet communication skills guidelines. e.g. English language issues, open ended questions, non- leading questions, respective manner ..etc. www.OSCEhome.com
  12. 12. OSCEhome Systematic Approach  Now, we have all the needed questions to ask and points to examine concerning that symptom on a separate sheet of paper.  We placed the sheet in a separate file, labelled it with the symptom/sign name.  Then, we repeated the same process for all other signs and symptoms. www.OSCEhome.com
  13. 13. OSCEhome Systematic Approach  Again, there are now, many identical questions or points to examine among all these symptom/signs.  We started to gather identical questions or points to examine into a separate file box and crossed it out on that symptom/ sign sheet. e.g questions about medications, past illnesses, social, ..etc. www.OSCEhome.com
  14. 14. OSCEhome Systematic Approach  Now, we have three sets of box files; 1. Chief complaint data gathering box file, 2. Specific symptom/sign box files, and 3. Standard questions box file. www.OSCEhome.com
  15. 15. OSCEhome Systematic Approach  Remember, in real practice, as well as during OSCE stations, our time is limited.  So, we carefully went into each of these box files and rearranged the questions and points to examine for maximum time efficiency. www.OSCEhome.com
  16. 16. OSCEhome Systematic Approach  So we came up with a tree of a step by step history taking and physical file boxes.  During the patient interview, you go through the file boxes one by one.  You only open the box files you need. www.OSCEhome.com
  17. 17. OSCEhome Systematic Approach www.OSCEhome.com
  18. 18. OSCEhome Systematic Approach  Let us take an example. A patient presented with cough. 1. Introductions box: 5 sentences to say. 2. Chief Complaint: 10 question to ask. 3. HPI: 15 questions to ask. 4. Respiratory question box: 10 questions to ask. 5. Standard questions box: 14 questions to ask. 6. Wrap up box: Sentences for 8 points to explain. www.OSCEhome.com
  19. 19. OSCEhome Systematic Approach  Most of the patients’ answers will be “NO”. How long then, will it take you to ask all these questions and wrap up the case?  FIVE minutes! And you have COVERED all the guidelines and checklists. www.OSCEhome.com
  20. 20. OSCEhome Systematic Approach  We created similar flowcharts for the physical examination, counselling, and ER stations that, with practice, will take you just 5 minutes to perform.  ONE flow chart of 7 steps with 23 history taking and 24 physical examinations boxes to choose one depending on the case ! www.OSCEhome.com
  21. 21. OSCEhome Systematic Approach  Don’t you agree, it is much more easier to memorize than 488+ checklists!  Rest assured that all the guidelines and checks in ANY checklist are fulfilled, including communication skills. www.OSCEhome.com
  22. 22. OSCEhome Systematic Approach  You won’t forget anything to ask, do, or explain. No need to anxious and nervous.  You will be on a relaxed autopilot mode! Letting you focusing on the clinical decision process and communication skills. www.OSCEhome.com
  23. 23. OSCEhome Systematic Approach  The systematic approach took three of us a full year to finalize and eight years so far to tweak.  Don’t you agree, it is worth a try? It is yours in just few minutes.  Save your time and effort and get your copy now at www.OSCEhome.com ... www.OSCEhome.com
  24. 24. A Step By Step Guide to The Mastering The OSCEs and Patient Encounters www.OSCEhome.com

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