Preparing for Exams OSCE
Dr. Mala Joneja
mj6@queensu.ca
http://www.youtube.com/watch?v=VfExPppvcew
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You may think that standardized exams are a
pain, but everybody has to do them
Preparing for the OSCE
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References:
Bracken Library – Exam section: 3 day loan
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OSCE and Clinical Skills Handbook by
Katrina F. Hurley
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OSCE &LMCC II Review Notes by Zu-Hua
Gao
What is an OSCE?
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What is an OSCE?
Tool for measuring clinical competence
Developed to evaluate clinical performance in medical
students
Test dimensions of clinical competence:
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Physical examination
History taking
Interpersonal skills
Technical skills
Problem solving
Decision making
Treatment and management
How is an OSCE graded?
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How is an OSCE graded?
Binary checklist
Complex skills – Global Rating Scale
(communication or professionalism)
Sequence/Organization
Checklist (the examiner has)
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Introduces self to the patient
Refers to the patient by name
Establishes the purpose of the encounter
Uses open-ended questions to obtain story
Establishes presenting complaint in the
patient’s own words
Draping the patient
Appropriate closing remarks
How should I prepare for an OSCE?
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Interestingly, learning for meaning, a desire
for this, appears to be associated with better
outcome
Literature: OSCE performance = skills +
knowledge / anxiety, self-confidence and
preparedness
Hurley: It may not be possible to prepare
yourself for each question that could be asked
Professionalism
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Professionalism is a big part
Website –examples of scoring
Demonstrated in Communication
Pointers
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Set up the interview
Watch your body language
Don’t interrupt the patient repeatedly
Active listening, repeat back to the patient
FIFE
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Feelings, ideas, fears and expectations –
WHY?
Useful, pays attention to the patient, find out
information in a short amount of time
As a clinician, you are expected to:
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Complete a history and physical
examination
Elicit presenting problems and
details
Elicit past history, family
history, social history,
medications and allergies
Review of systems
Show sensitivity, respect
Explain procedures to patient
Use understandable language
Proper use of medical
instruments
Exam in logical sequence, focus
on system when appropriate
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Establish rapport
Show empathy, tact,
compassion, maintaining
professional and ethical code of
conduct
Concisely communicate results
and findings
Formulate a problem list
ChLORIDE FPP
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Character
Location
Onset
Radiation
Intensity
Duration
Events associated
Frequency
Palliative factors
Provocative factors
VITAMINS C
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Vascular
Infectious
Traumatic
Autoimmune/Allergic
Metabolic
Idiopathic/Iatrogenic
Neoplastic
Substance abuse and Psychiatric
Congenital
IPPA
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Inspection
Palpation
Percussion
Auscultation
LMCC II Exam Tips
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Gao
Practice scenarios with others, time the
scenarios
Verbalize steps, even when practicing,
practice as though it is the exam, as much as
possible
At the exam…
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Read the questions carefully. Be clear about
the objectives of the station.
Shake hands with your patient while
introducing yourself
Be empathic, address discomfort
Mind your body language
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Set the scene, tell the patient what you are
going to do
Speak slowly, clearly, at a volume that is not
too loud
Thank the patient before leaving the room
A surprise question…
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Develop a strategy or system to face each question.
‘if you come upon a question that you have not
studied – or begin to draw a blank, try to relax, take
a deep breath”
Read the instructions to candidate carefully
“Suspend disbelief” – treat the exam patient as you
would a real patient
Don’t be distracted by the examiner
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Introduce yourself to the patient, find out or
confirm patient’s name
Wash your hands
Develop a rapport with the patient
Be conscientious about patient comfort
Drape the patient properly
Explain what you are doing
State what you are looking for
Exam Stress
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http://www.youtube.com/watch?v=j5kgXwPq
Zjg
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This exam is stressful because
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It is mandatory
It is general
It is an OSCE
Exams are stressful because
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It is an evaluation of your performance
It is one day
Reducing Exam Stress
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Accept it.
Prepare for it. Look at the website.
Prepare in groups.
Build confidence.
Practice for the exam.
Rehearse the exam in your mind.
Think positive.
Know what to expect (location, time, format)
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If you think you need help, ask for it:
Dr. Melissa Andrew
Director of Resident Affairs
Email: andrewm@queensu.ca