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How can I do well on an OSCE?
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The
OSCE is an assessment of clinical knowledge, skills, and attitude. The
communication skills you demonstrate and the process you go through
in obtaining a history or performing a physical examination are more
important than determining a diagnosis.
The
best way to prepare for an OSCE is repetitive practice. When you are
able to perform all of the tasks on the course objectives for a complete
medical history and physical examination in an organized and efficient
fashion, you are ready for the OSCE.
After
the first year, it is important to understand that some cases are designed
to present more than one diagnostic possibility. Keep your mind open
to all possible diagnoses and explore the relevant ones as time permits.
Students
are encouraged to use the Clinical Skills Center to practice clinical
skills on each other. The CSC hours are 8:00 a.m. to 4:30 p.m., Monday
through Friday. To use the CSC for practice, you must make an appointment
at 603-1920. Professional conduct is expected at all times and all posted
CSC rules must be followed.
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General Tips
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Dress
neatly and professionally.
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Clip
your fingernails before the exam.
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not attempt to communicate with the patient out of role or other
than as a physician to a patient. |
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Stay
in the room and use all the allotted time.
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Do
not try to make a diagnosis.
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Be
as complete as possible. Do not skip clinical skills just because
you know (or think you know) the diagnosis.
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Let
the proctors know if you have any problems.
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Communication
Tips (All Stations)
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Knock
before entering the exam room.
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Greet
the patient warmly.
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Make
physical contact with the patient (shake hands or appropriate
touch).
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Introduce
yourself by name and as a student.
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Elicit
or confirm the patient’s name.
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Explain
your task to the patient.
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Make
and maintain eye contact.
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Ask
clear questions.
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If
you use medical jargon, explain yourself.
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If
you don’t know the answer to a patient’s question, say so.
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Acknowledge
the patient’s concerns.
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direct and honest, but also be sensitive. |
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Close
the encounter when the audio signal is given to leave the station.
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History Stations
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Sit
at eye level with the patient (don’t “hover over” the patient).
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Use
an open posture (arms uncrossed, leaning forward).
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Begin
with broad, open questions, and then move from the general to
the specific.
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Avoid
multiple questions. They confuse the patient and can cause you
to miss important checklist items.
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Use
nonverbal encouragement.
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pauses and give the patient time to answer. Don't rush the answers
or cut the patient off with another question. |
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Ask
follow-up questions. You said you don’t smoke. Did you ever smoke?
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| Elicit
the 8 attributes of any symptom. |
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your mind open to all possible diagnoses and explore the relevant
ones as time permits. |
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Summarize!!!!
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Physical Examination
Stations
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Use
a stethoscope with separate bell and diaphragm heads.
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that proper auscultation technique requires that the stethoscope
be placed directly on the patient's skin. |
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Wash
your hands with soap in front of the patient before beginning
the physical examination.
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Talk
before you touch. Tell the patient when you are ready to begin
the physical exam.
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Describe
the maneuvers either before or as you perform them.
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Always
use patient gowns and drapes to maintain patient modesty and
comfort.
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Never
examine through the patient’s gown.
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Do
a focused (not comprehensive) physical examination based on
the presenting problem.
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If
you believe a rectal, pelvic/genital, or female breast exam
is indicated, tell the patient. The patients are trained to
deal with this part of the physical examination.
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you ask a patient to lie back on the examination table, pull
the leg rest out, then help the patient sit back up and return
the leg rest. |
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Help
the patient on and off the exam table.
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After
the first year, some SPs will have positive physical findings.
Some findings may be simulated, but should be accepted as
real.
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