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Preparing for Exams OSCE Dr. Mala Joneja [email protected] http://www.youtube.com/watch?v=VfExPppvcew You may think that standardized exams are a pain, but everybody has to do them Preparing for the OSCE References: Bracken Library – Exam section: 3 day loan OSCE and Clinical Skills Handbook by Katrina F. Hurley OSCE &LMCC II Review Notes by Zu-Hua Gao 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 How is an OSCE graded? How is an OSCE graded? Binary checklist Complex skills – Global Rating Scale (communication or professionalism) Sequence/Organization 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 patient’s own words Draping the patient Appropriate closing remarks 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 Professionalism Professionalism is a big part Website –examples of scoring Demonstrated in Communication Pointers Set up the interview Watch your body language Don’t interrupt the patient repeatedly Active listening, repeat back to the patient FIFE 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: 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 ChLORIDE FPP Character Location Onset Radiation Intensity Duration Events associated Frequency Palliative factors Provocative factors VITAMINS C Vascular Infectious Traumatic Autoimmune/Allergic Metabolic Idiopathic/Iatrogenic Neoplastic Substance abuse and Psychiatric Congenital IPPA Inspection Palpation Percussion Auscultation 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 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 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… 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 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 http://www.youtube.com/watch?v=j5kgXwPq Zjg 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 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) If you think you need help, ask for it: Dr. Melissa Andrew Director of Resident Affairs Email: [email protected]