Udechuku OSCE Tips 2004
Dr Adaobi Udechuku
Presented at Victoria Branch of ANZAPT meeting, September 2004
HOW I PREPARED
Attended as many OSCE tutorials as I could and put my hand up to be the candidate as many times as I could
Tried to develop a standard introduction line to set self up eg“ Hello Mrs Y I am Dr Adaobi Udechuku, thank you for coming. We don’t have much time today but I understand that you have been having difficulty with X, Y, Z”. You can use the same intro for each station as you only see each set of examiners once and it makes things familiar and sets the scene for you.
Read the question and ask yourself what is the aim, thrust, must not miss thing in this scenario
If the scenario involves a diagnostic clarification while reading think of list differentials then use this list to develop your screening questions when taking the focused history part of the task
If task has 3 parts divide time given to perform tasks into 3 eg if have 15 mins then 2 minutes to present spend approx 5 mins on each task don’t spend much more as you can get more marks for having a go at task three than trying to maximise marks for task 1
Bought and used Management of Mental Disorders 1 & 2 especially useful for anxiety disorders in how to do CBT but obviously didn’t help me much with station2!)
Read through case management, QI, careers, NGO sections of Mental Health in Australia
Bought/photocopied 2 OSCE books and used bits of them
Looked at OSCE section of http://www.trickcyclist.co.uk
Used clinical situations as mini OSCEs eg discharge planning meeting, family meetings, case conferences, doing a cognitive assessment on patients, doing physical examinations on patients with FULL neurological exams
Day before read over College Ethics, clinical practise guidelines, went over neurological examination, went over Abnormal Involuntary Movement Scale examination.
THE ACTUAL OSCE
Had to spend 1 hour in room with other candidates making polite conversation and planning when best time to do final toilet stop was.
You need to bring photo id
You can only take in you pen/s, timer, small snacks and stethoscope.
Wouldn’t bring stethoscope along unless it is a good luck charm as they will provide all the examination materials needed including stethoscopes.
Bull dogs will get you water and barley sugars if you need them.
Everything extra you bring including wallet, phones will be placed in an envelope or basket and labelled.
The examiners have a photocopied sheet with everyone’s photograph on it so you don’t have to give them stickers.
You are grouped into coloured streams and given a number (the station that you start at) (you are given this information in the letter that they send a week or so before. If you start at the bye station, you leave the room 20 mins early.
You are taken with your colour group to the examination area. Placed in front of the station and told to wait with your back against the wall until the star reading bell rings. There were arrows taped onto the floor and heaps of bulldogs around to ensure you moved in the right direction at the right time.
The examiners will introduce you to the patient and then reread your task in an abbreviated form. By my second station I realised that it just wasted time so I tried to acknowledge them with a smile and get on with seeing the patient.
If used my timer but also checked the time with them a few times.
I finished “early” stations 1, 3 and 6 but and decided before hand not to leave but excused myself from the patient saying I just wanted to look over our notes then paraphrased my understanding checked it agreed with theirs asked if there was anything else they wanted to raise and by then my time was almost up so I would end with something like – thank you for coming in today I will make that appointment and see you in X weeks.
I always tried to terminate the interview and was able to do so with all of them except the renal patient!!!!
Tips in retrospect
I don’t think they are trying to fail you
The OSCEs are much more about performance than the OCI so the more practice you can have the better
Try when practicing to think of yourself in what ever scenario is set and then think ok this REAL patient has walked in with this REAL problem so I have to management them just like I do each day (same applies for the OCI really)
Even if you have passed the GME you can still pick up marks in the medical station so at least ensure your neurological exam is slick, you can do an AIMs, you know something of common psych/medical disorders eg SLE, alcoholic liver disease (gast and peripheral stigmata), cachectic anorexic or basic examination technique eg respiratory, cardiovascular
You have 6 stations which contribute 1/6 of 50% of you overall mark so you can fail 1 (almost 2 in my case) and still pass.
If you have a bad one or come across your nemesis do the best you can then walk out, take a deep breath as you are herded to the next door, say your mantra, steady yourself and then put it behind you so you give yourself the best chance with the next 1/6th.
You always get marks (at least 10%) for engagement, rapport building, manner so make an effort at the beginning of each one before you rush into the tasks to so some engagement stuff – general questions, open-ended questions, mirroring etc
It is your OSCE so if you feel like you want to stop and go over some things do so, if you are not happy with the room arrangement eg you have to have the table to the right side to write then rearrange things