Book Reviews – Non-Fiction
Fundamental Clinical Situations:
A Practical OSCE Study Guide,
Fourth Edition
Jason Joannou (OT6)
Fundamental Clinical
Situations:
A Practical OSCE
Study Guide,
Fourth Edition
What is this OSCE thing coming up at the end of this year?
If you’re like me, lots of people
have been warning you about it
and make it sound like it’s some
ferocious beast with massive
Pieter J. Jugovic
teeth that eats medical students
Richard Bitar
for
lunch.
Fortunately,
Laura C. McAdam
Fundamental Clinical Situations:
A Practical OSCE Study Guide
Elsevier Canada, 2004
is around to demystify this
OSCE thing and help you pre$24.99
pare for it. Created by medical
students at the University of
Toronto, this guide enables to you to rapidly and efficiently go
through common clinical scenarios that clerks, residents and
staff physicians encounter every day.
The OSCE, or Objective Structured Clinical Examination, is an
evaluation of a candidate’s clinical skills. The candidate is
required to exhibit a minimum level of competency before
being allowed to progress in their medical career. The introduction to the guide gives a good description of the format of
an OSCE, what is expected of the candidate and the examiner,
some useful hints about what to do during an OSCE, and how
to prepare for it. The guide is a suitable study tool for any level
of medical education, whether you are a second year medical
student, or a first year resident..
The main portion of the guide is a compilation of 68 clinical
scenarios. The scenarios are divided into four groups: (1) scenarios for directed histories, (2) scenarios for directed histories
and physical examinations, (3) scenarios for physical examinations, and (4) special scenarios. The topics covered in each of
the first three groups of scenarios span a great range, from
problems commonly seen in infants to those seen in the elderly and from infectious diseases to psychological and social
problems. The “special scenarios” group covers a smorgasbord
of topics from the interpretation of abdominal and chest X-rays
to how to deal with patients who are angry or patients whose
medical decision-making competency is in question.
Each clinical scenario begins with a short (3- to 5-line) paragraph entitled “Instructions For Candidate”. This paragraph
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describes common presentations for specific illnesses such as
diabetes, alcoholism, congestive heart failure and meningitis.
From this the candidate is supposed to start his/her history and
physical. Listed there is a checklist of the signs, symptoms and
risk factors that the candidate should ask about in the interview
as well as examinations and maneuvers that should be done
during the physical examination. As well, these are accompanied by a checklist through which the candidate can assess his
proficiency. The more checks the candidate gets, the better
he/she is doing. Also, at the end of each scenario is a “PostEncounter Probe”. This section consists of a series of questions that the candidate should be able to answer about the
chief complaint of the OSCE scenario. Typically, questions are
about risk factors, signs, symptoms and differential diagnoses
for certain illnesses.
The set up of the scenarios make it really easy for you and a
bunch of your med school buddies to get together and act out
each scenario. The checklists provide a great objective way to
monitor how you are doing, and really lets you know where
your strengths and weaknesses are. As well, if you feel you
want or need to learn more about any aspect of a scenario, the
two main references listed for each scenario are the MCCQE
study notes and the Essentials of Clinical Examination
Handbook, both of which are already a part of most U of T
medical students’ personal libraries.
The remainder of the guide consists of a page of common medical abbreviations and a useful appendix. The appendix contains a slew of normal ranges for common laboratory tests in
both MGH and SI units, along with conversions factors to SI
unitss. As well, there is a useful dermatome map and a list of
commonly prescribed drugs with their generic names and their
brand names in Canada, the U.S., and Australia. There are also
some examples of X-rays in the appendix, but they are of poor
quality and not very useful.
Overall, the guide is a good buy at $24.99. It is small and easy
to carry around, and all you really need is one for a group of
friends to study from and act out the scenarios. You’ll definitely need more than just the guide to prepare for the OSCE,
but it is a great and quick way to make sure you didn’t miss
anything when you are studying for the OSCE.