Common OSCE stations

       Paul Lord
Overview

• Common approach to all OSCE stations
  – What to expect
  – Advice for any station


• Common themes
  – Intro to topics
What to expect
• Change in format from previous years
• 10 minute stations
  – No mini-stations
  – No OSLERS
• Examiners still expect you to cover the same
  competences

• All stations on one day are the same in all exam
  locations
• Most stations change from day to day – not all
What to expect
• Similar to previous years exams
  – Stations may have introductory information and
    time to prepare
  – Some stations are brief and you will get to leave
    early if completed
  – Don’t worry if you haven’t finished – you can still
    get full marks
An approach to all stations
• Smile
• Listen to what is being asked – you can always ask the
  examiner to repeat/clarify
• Introduce yourself
• Obtain consent

• WASH YOUR HANDS
   – Gloves may be available on some stations

• Take your time
   – Look around the station – there may be clues
   – stop and think whenever you need to
The examiners
• Friendly
   – May prompt you
   – Will point things out for you

• Uninterested (rude!)
   – Will give no indication of how you are doing
   – Look like they don’t want to be there

• They are all trying to find reasons to pass you –
  not fail you
Patients
Too obstructive               Too helpful
• Will not give you any       • Will not shut up!
  information
• Are worried about ‘giving   • Can use up all of your time
  away the answer’
                              • Don’t be afraid to interrupt
• Remember what your
  objective is
COMMON THEMES
Types of station
• Communication

• History taking

• Examination

• Spotters

• Disease investigation and management
Communication
• In every station!

•   Handling complaints
•   Breaking news
•   Obtaining information / consent
•   Ethical discussions

• Remember that it is still a quantitative exam
Communication
• Previous stations

  – Anxious parent +/- Non-accidental injury

  – Complaint about a GP in your practice –
    confidentiality

  – Explain a procedure – consent

  – Counselling e.g. HIV testing
History taking
• Formally – OSLERS
  – Can you take a comprehensive history
  – Common chronic/stable diseases


• Shorter stations
  – Can you obtain pertinent information in limited
    time
  – Emergency situations – e.g. chest pain
Examination
• Full and comprehensive
  – Neuro exam
  – Visual fields
  – Cranial nerves

• Quick and specific
  – “listen to this heart sound”
  – “examine this patients lower limb joints”
  – Followed by discussion about your findings
Spotters
• Used to be 5 minute stations
• May now include more discussion about the
  disease

• Always stable/chronic problems

• Don’t be afraid to talk to the patients
  – Ask how long they have had it and what
    treatment they have had
Spotters
• Previous examples
  –   Rheumatoid hand
  –   AV Fistula
  –   Dermatology – either eczema or psoriasis
  –   Diabetic foot
  –   Leg ulcer
  –   Total knee/hip replacement (X-ray or patient)
  –   (neurofibromatosis)

• Don’t forget death certificates – this came up
  every day last year!
Diseases and investigation
• Common diseases
  – Ischaemic heart disease
  – Diabetes
  – Stroke
  – Inflammatory Bowel Disease
  – Rheumatoid Arthritis
  – Chronic renal failure
Management

• Basic Life Support

• Acute coronary syndrome

• Make sure you can quickly list investigations
  and management of common diseases
Overall
• WASH YOUR HANDS

• Take your time

• Ask for help from the patient

• Stations are usually basic – you can get lots of
  marks for the correct approach

Common osc estations

  • 1.
  • 2.
    Overview • Common approachto all OSCE stations – What to expect – Advice for any station • Common themes – Intro to topics
  • 3.
    What to expect •Change in format from previous years • 10 minute stations – No mini-stations – No OSLERS • Examiners still expect you to cover the same competences • All stations on one day are the same in all exam locations • Most stations change from day to day – not all
  • 4.
    What to expect •Similar to previous years exams – Stations may have introductory information and time to prepare – Some stations are brief and you will get to leave early if completed – Don’t worry if you haven’t finished – you can still get full marks
  • 5.
    An approach toall stations • Smile • Listen to what is being asked – you can always ask the examiner to repeat/clarify • Introduce yourself • Obtain consent • WASH YOUR HANDS – Gloves may be available on some stations • Take your time – Look around the station – there may be clues – stop and think whenever you need to
  • 6.
    The examiners • Friendly – May prompt you – Will point things out for you • Uninterested (rude!) – Will give no indication of how you are doing – Look like they don’t want to be there • They are all trying to find reasons to pass you – not fail you
  • 7.
    Patients Too obstructive Too helpful • Will not give you any • Will not shut up! information • Are worried about ‘giving • Can use up all of your time away the answer’ • Don’t be afraid to interrupt • Remember what your objective is
  • 8.
  • 9.
    Types of station •Communication • History taking • Examination • Spotters • Disease investigation and management
  • 10.
    Communication • In everystation! • Handling complaints • Breaking news • Obtaining information / consent • Ethical discussions • Remember that it is still a quantitative exam
  • 11.
    Communication • Previous stations – Anxious parent +/- Non-accidental injury – Complaint about a GP in your practice – confidentiality – Explain a procedure – consent – Counselling e.g. HIV testing
  • 12.
    History taking • Formally– OSLERS – Can you take a comprehensive history – Common chronic/stable diseases • Shorter stations – Can you obtain pertinent information in limited time – Emergency situations – e.g. chest pain
  • 13.
    Examination • Full andcomprehensive – Neuro exam – Visual fields – Cranial nerves • Quick and specific – “listen to this heart sound” – “examine this patients lower limb joints” – Followed by discussion about your findings
  • 14.
    Spotters • Used tobe 5 minute stations • May now include more discussion about the disease • Always stable/chronic problems • Don’t be afraid to talk to the patients – Ask how long they have had it and what treatment they have had
  • 15.
    Spotters • Previous examples – Rheumatoid hand – AV Fistula – Dermatology – either eczema or psoriasis – Diabetic foot – Leg ulcer – Total knee/hip replacement (X-ray or patient) – (neurofibromatosis) • Don’t forget death certificates – this came up every day last year!
  • 16.
    Diseases and investigation •Common diseases – Ischaemic heart disease – Diabetes – Stroke – Inflammatory Bowel Disease – Rheumatoid Arthritis – Chronic renal failure
  • 17.
    Management • Basic LifeSupport • Acute coronary syndrome • Make sure you can quickly list investigations and management of common diseases
  • 18.
    Overall • WASH YOURHANDS • Take your time • Ask for help from the patient • Stations are usually basic – you can get lots of marks for the correct approach