OSCE Format, new Certification Examination

Welcome to the
Candidate Orientation
for the
OSCE Format of the Clinical Skills Component of the
new Certification Examination
in Family Medicine

Introduction
Meet Dr. Campbell and Dr. Fournier. They will be
taking the OSCE portion of the clinical skills
component of the new Certification Examination in
Family Medicine today. Let’s follow them as they go
through the examination process.

Certification Examination in Family Medicine, OSCE portion

Purpose of the OSCE
The OSCE portion of the new Certification Examination
in Family Medicine is a clinical skills assessment
comprised of a series of patient-based encounters.
The purpose of this portion of the examination is to
make a fair and accurate assessment of your
clinical skills.


What to bring
The list of items to bring to the exam is included in the
Candidate Information Sheet that will be sent to you by
mail prior to the examination.

Items to bring to the exam Items to leave at home
Reflex hammer Your lunch

Lab coat Pencil

Entrance card Electronic devices

Stethoscope


Coat check
A coat check will be provided at the site to store your
personal items during the examination and
sequestering period.
However, as storage space will be limited, we ask that
you please leave all large bags and handbags at
home.


Candidate registration
Dr. Fournier has arrived at the examination site. Once
he has registered, support staff will hand him an ID
badge, a pencil and a notebook before directing him to
the orientation room.


Candidate orientation
During the candidate orientation on examination
day, the facilitator will give a brief presentation and
answer your questions.


Candidate notebook
In her notebook, Dr. Campbell will find bar code labels
and blank pages.

I can use my notebook
throughout the examination for
reference and note taking. The
notebook will not be graded.
I won’t tear out any pages
because I have to hand in my
notebook INTACT at the end of
each examination day. This
includes the label backing
sheet.
Each notebook contains a few
extra labels. If I lose one or two,
I don’t need to worry.


Overview of the OSCE
The Saturday session of the examination is comprised
of 10 patient-encounter stations. Each station is
10 minutes in length. Some of these stations may be
rest stations.


Start station

My start station will be written on the
Candidate Information Sheet I will
have received in the mail and on my
ID badge.
I will start at this station number and
will then go through the remaining
stations in numeric order.

I don’t have to remember this and
other details. Exam staff will be there
to guide me and answer my
questions during the examination.


Timing of OSCE stations
10-minute stations

• You will have two minutes to read the
candidate instructions posted by the door
before the buzzer sounds, prompting you to
enter the room.
• You will then have 10 minutes in the room.
– A warning buzzer will sound at nine minutes.
– A second buzzer will signal the end of the station. At
this point, you will have to leave the room.
• You will then get two minutes to read the
instructions for the next station, and so on.

Candidate instructions
In any given station, you may
be asked to do one or more of
Before entering the
room, I will read my the following tasks:
instructions carefully
in order to determine – Perform a physical
what my task is for examination
the station.
The instructions will
– Obtain a history
also be available in – Manage an acute patient
the room.
problem
– Respond to a patient’s
concerns


Sample
Joseph Trans, 40 years old, presents himself to your office with a
2-hour history of abdominal pain.
IN THE NEXT 10 MINUTES:
• CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION.
As you proceed, EXPLAIN TO THE EXAMINER what you are doing
and DESCRIBE ANY FINDINGS.
GIVE 1 LABEL TO THE EXAMINER.
My task here is to conduct a physical examination.
Therefore, I won’t ask history questions to the patient.
I’ll treat the standardized patient as a real patient because
I will only get credit for tasks I complete satisfactorily.

More sample stations are available.

Bar code labels

As I walk into the room, I hand one bar
code label to the examiner.


Oral questions
In some stations, the examiner will ask me one to three brief questions
after the warning buzzer. In these stations, I will not be able to continue
interacting with the patient after the warning buzzer, even after I have
finished answering the examiner’s question(s).
The oral questions are related to the patient I just saw and are about
matters like diagnoses, management decisions, or ethical or legal issues.
The candidate instructions will clearly state whether there are oral
questions for a station.


Medical equipment
If a station requires the use of medical equipment other
than a stethoscope and a reflex hammer, it will be
provided in the room.


Patient management stations
During the examination, you might be asked to
manage a patient problem.
In these stations, a standardized health professional,
such as a nurse, might be present in the room.

I will direct the nurse to order any tests
or perform any procedures I believe are
appropriate for this patient. Download a
I may be evaluated on my interaction video clip of a
with the nurse. candidate in this
If a standardized health professional is type of station
present in the room, the candidate
instructions will clearly state so.


Physician examiners
• Examiners observe and assess your
performance with pre-set score sheets.
• A second observer may be present to
observe protocols and to ensure exam
quality.
• In physical examination stations:
• Tell the examiner what you are doing and
briefly describe your findings.
• You must demonstrate your clinical skills.
You will only get credit for tasks
completed satisfactorily.


Examiner interventions
Examiners may intervene:
• By asking you to reread the
instructions.
• To protect the standardized patient.
• To stop you from doing genital or
rectal examinations.
– If such examinations are
needed, clearly inform the Download a
examiner that you would video example
perform them. of an examiner
intervening
• By reporting findings if they
are available.

Standardized patients (SPs)
SPs are trained to simulate patients’ signs and
symptoms in a reliable and consistent manner.

Treat them as you would treat actual
patients and accept their simulated
findings as real.

You may be scored on
the way you interact with
them.


Rest stations
• Rest stations may be included in the examination for
each session.
• During these stations, there are no patients, no
questions and no evaluations.
• Please sit quietly. You can take this time to rest
before your next station.

I might sit through a few rest
stations during the examination.


Sequestering
For security reasons, candidates may be required to
remain on site before or after the examination session.
• You will not have access to your personal belonging
or telephones during this time.

Any breach of the rules or lack
of co-operation on my part
could invalidate my examination
results and prevent access to
my future examinations.


Sign out
Before leaving after each exam day, follow the
instructions of the site staff:
• Hand in your notebook (leave all pages intact,
including the backing sheet from your bar code
labels and any unused labels);
• Hand in your ID badge;
• Sign out on the sheet.


Confidentiality reminder
During the application process, we agreed to use examination
materials solely for the purpose of completing the examination
and to not disseminate or reveal to others the examination
materials or content.

That means we CANNOT divulge
station content, patient portrayals
and findings, oral questions, etc., at
ANY TIME even after the
examination is over.


What do I do if…
I have to go to the bathroom?

You can use the washrooms:
• Before you start the examination
• While in sequestering
If you have an urgent need at other times,
please inform site staff.


What do I do if…
I lose my notebook and/or my bar code labels?
I feel ill?
I don’t know where to go?

Consult the site staff as soon as possible.

The staff members are there to help you and
are aware of the protocols to follow.

It is imperative that you remain calm and
co-operative.


Helpful tips

• Read your instructions carefully.
• Complete the specified task(s).
Joseph Trans, 40 years old, presents himself to your office
with a 2-hour history of abdominal pain.
IN THE NEXT 10 MINUTES:
•CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION.
As you proceed, EXPLAIN TO THE EXAMINER what you are
doing and DESCRIBE ANY FINDINGS.
GIVE 1 LABEL TO THE EXAMINER.


Helpful tips
Inside the station

• Demonstrate your clinical skills. You will not get credit
for simply SAYING you would do something (with the
exception of genital and rectal examinations).
• You will only receive credit for
tasks completed satisfactorily.
• Treat the SPs as you would treat
real patients.


Useful links

The College of Family Physicians of Canada
www.cfpc.ca

The new Certification Examination in Family Medicine
http://cfpc.ca/2013_CCFP/


Questions?
And remember, site staff will be available
throughout the day to answer your
Please take the time to
questions and guide you to your stations.
review the information in
this presentation and on
the cfpc.ca website. If
you have any questions
on examination
day, you can ask the
facilitator during your
Candidate Orientation.


OSCE Format, new Certification Examination

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