The OSCE is an assessment of clinical competence. It involves a standardized patient (SP) and an examiner in timed station. You will be evaluated on history taking and/or physical exam technique, communication skills, organization, and professionalism. In general there is a checklist with the necessary components and an overall Global Rating/Assessment is assigned.
Practice, Practice, and practice some more!!!
To build confidence and speed, practice clinical skills on each other. Find a study partner or group and dedicate practice time together. Download checklists and try to simulate as close as possible the “real” exam setting. Provide constructive feedback (you won’t improve otherwise!) and ensure you stick to the time allotted.
It may be helpful to buy/borrow a physical exam book or view online videos prior to your practice sessions (see resources below). Others prefer to create their own notes; any clinical handbook may serve as a guide (see booklist below).
Dress neatly and professionally. No perfumes/cologne
Clip your fingernails before the exam.
Read the “instructions to the candidate” very carefully. Make notes
Wash your hands! (or carry a hand sanitizer). Although not on the checklist, it is best to get into the habit
Stay in the room and use all the allotted time. Use any extra time to mentally review your performance, you may be able to add some important points
Be complete, organized, and systematic
Treat the SP like a “real” patient… stay in your role, always be respectful and professional
Breathe! Take a few seconds before entering the station to gather your thoughts and think positively!
Greet the patient warmly and introduce yourself (and your role as a student). Clarify how s/he wishes to be addressed.
Make and maintain eye contact.
Avoid medical jargon
“What brings you here today”… ask open-ended questions and don’t interrupt!!
If you don’t know the answer to a patient’s question, say so. “I’m not sure, but I will find the answer/ask someone”
Acknowledge the patient’s concerns. Remember FIFE (FEELINGS, IDEAS, FUNCTION, and EXPECTATIONS)
Be aware of your nonverbal cues. Videotape yourself or ask a partner for feedback. If you’re going to check your watch, don’t be obvious!
Close the interview with a summary of your findings and the plan of action. Always ask the patient “Do you have any questions”.
Collect relevant identifying data (ID)
Identify the Chief Complaint/Entrance Complaint and clarify with the History of Presenting Illness (HPI). There are many mnemonics such as VITAMIN C, CHLORIDE FPP, OPQRSTUV. The idea is to find out how systems developed and the related events
Past Medical History (PMHx): include surgeries, psychiatric illness, Childhood illnesses, hospitalizations, Immunizations
Medications (Meds): ask about current medications, include over-the-counter, herbal/alternative remedies
Allergies: what are they and what happens?
Social History (SocHx): ETOH, street drugs, smoking, diet, sleep pattern, activity level, employment, relationships, sexual history
Family Medical History: parents, siblings, children. Note age of death and the cause of death
Review of Systems (ROS): ask about the common symptoms in each body system.
Physical Examination Stations
Tell the patient when you are ready to begin the physical exam and what you are going to do
Drape appropriately, expose areas as needed. Ask the patient to move clothing or drop gown, do not remove for them unless required.
Help the patient on and off the exam table.
Remember that the patient isn’t just a “warm body” (unless you’re told otherwise), treat him/her with respect at all times
Be systematic and organized, try not to have the patient constantly changing positions for your examination