Preparing for Exams - OSCE

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Preparing for Exams - OSCE

• Dr. Mala Joneja
• mj6_at_queensu.ca

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• http//www.youtube.com/watch?vVfExPppvcew

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• You may think that standardized exams are a pain,
  but everybody has to do them

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Preparing for the OSCE

• References
• Bracken Library Exam section 3 day loan

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• OSCE and Clinical Skills Handbook by Katrina F.
  Hurley
• OSCE LMCC II Review Notes by Zu-Hua Gao

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What is an OSCE?

• What is an OSCE?
• Tool for measuring clinical competence
• Developed to evaluate clinical performance in
  medical students
• Test dimensions of clinical competence
• Physical examination
• History taking
• Interpersonal skills
• Technical skills
• Problem solving
• Decision making
• Treatment and management

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How is an OSCE graded?

• How is an OSCE graded?
• Binary checklist
• Complex skills Global Rating Scale
  (communication or professionalism)
• Sequence/Organization

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Checklist (the examiner has)

• 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 patients
  own words
• Draping the patient
• Appropriate closing remarks

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How should I prepare for an OSCE?

• 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

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Professionalism

• Professionalism is a big part
• Website examples of scoring
• Demonstrated in Communication
• Pointers
• Set up the interview
• Watch your body language
• Dont interrupt the patient repeatedly
• Active listening, repeat back to the patient

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FIFE

• Feelings, ideas, fears and expectations WHY?
• Useful, pays attention to the patient, find out
  information in a short amount of time

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As a clinician, you are expected to

• 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

• Establish rapport
• Show empathy, tact, compassion, maintaining
  professional and ethical code of conduct
• Concisely communicate results and findings
• Formulate a problem list

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ChLORIDE FPP

• Character
• Location
• Onset
• Radiation
• Intensity
• Duration
• Events associated
• Frequency
• Palliative factors
• Provocative factors

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VITAMINS C

• Vascular
• Infectious
• Traumatic
• Autoimmune/Allergic
• Metabolic
• Idiopathic/Iatrogenic
• Neoplastic
• Substance abuse and Psychiatric
• Congenital

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IPPA

• Inspection
• Palpation
• Percussion
• Auscultation

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LMCC II Exam Tips

• Gao
• Practice scenarios with others, time the
  scenarios
• Verbalize steps, even when practicing, practice
  as though it is the exam, as much as possible

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At the exam

• 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

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A surprise question

• 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
• Dont be distracted by the examiner

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• Introduce yourself to the patient, find out or
  confirm patients 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

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Exam Stress
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• http//www.youtube.com/watch?vj5kgXwPqZjg

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• This exam is stressful because
• It is mandatory
• It is general
• It is an OSCE
• Exams are stressful because
• It is an evaluation of your performance
• It is one day

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Reducing Exam Stress

• 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_at_queensu.ca