Margaret Heidenreich
Analysis of OSCE Performance
1.22.2012
The OSCE exam was a very interesting experience. Although very nerve racking at the
time, I believe it was beneficial as a self-reflection tool. After reviewing the film, there are
multiple areas I could improve on as a health care professional. In addition to this, I have a
couple of suggestions that could have made me better prepared for this session.
First of all, there were a couple of nervous tendencies that I could have done without
during this office visit. I continually clicked my pen, adjusted my clothing and hair which was
distracting and could be perhaps taken as nervous actions to the patient. Also, by touching my
clothes/hair I contaminated my hands. I think it would’ve helped not to have pens/clip boards in
my hand because they are also a distraction, and be perceived as though my full attention was not
on the patient. I was also talking too quickly at times perhaps losing the patients attention at
times. While I was standing doing my physical examination, I again was nervously rocking back
and forth on my feet, playing with my stethoscope, etc, which it would be best to try to
consciously not do these things.
Next, I found that I was cutting off the patient’s speech a lot, not letting her think to
respond to my questions, and finish her sentences. I would be asking another question before I
got a response to the first. Not good! In addition to this, I jumped around with my train of
thoughts too much. I would ask a history question, then ask about the episode, then ask another
history question. I should have asked about the episode she had, gotten all the information from
that, then asked all history questions, etc. This cohesion would have made the episode make
better sense to me, and helped the patient memory of the occurrence as well.
In addition to these issues, I didn’t give the patient a thorough plan of care for when she
left the office. I should have presented which tests I wanted her to get, when the next office
appointment should be, what blood tests I would perform, when all these results would be back,
and what conditions I was looking for. This lack of a congruent plan made me seem unsure as to
what I wanted to do. I believe this was my biggest problem during this patient exam, because
this is the reason patients come to see a health professional.
Last, I wonder if I took the patient’s blood pressure correctly. She was surprised that it
was high, and maybe in my nervousness I mistook her pressure. Not only is this a rookie
mistake, but stupid in real life because it would make a false reading for my patient! Hopefully,
that was not the case; however hand blood pressures are probably still closer in accuracy then
those automatic machines!
There were a couple things that could have helped me to prepare for the OSCE a little
better. The lack of knowing the procedure of the OSCE was the biggest problem I had. The
instructions weren’t real clear as to when we should go in, when the exam finishes, whether we
should dismiss the patient, when to talk to the camera and give our SOAP note etc. I think it
would be beneficial to explain to students how the full exam works. A step by step including
that: we will walk into a room with the patient already in it, you will need to do an exam and
history, decide during the exam your plan of action, and then tell the patient the plan of care and
dismiss them afterward. This lack of instructions made us more nervous because we weren’t
sure we were doing the correct thing the whole time. For example, I didn’t know I could give
my soap note once I was done with the patient; therefore I sat in the room for twenty minutes
waiting for the cue to present to the camera. Other than that and the lack of real patients
describing actual problems they have, the exam was quite an interesting experience.