Hi there here I am going to share my experience of OSCE exam.
It is something all of us are scared of,but with right preparation and good coaching it can be better.I still haven’t got my results but I will be bold enough to say that the coaching I took made me feel somewhat confident about the exam as every day is like a mock exam while over there in the coaching.
Here are the station-
1. Paed CPR-in this I followed the old guidelines as according to our course co odinatr whose an ATLS instructr herself these guidelines hold good till march.At the end with 1-2mins to spare when examiner told me to sit down I explained to her the new guidelines are coming into force later she said its ok and didn’t ask me to expand on it.Keep your cool and do it properly as she will tell u to stop after 1-2 cycles if u r doing it right so you will never be short of time.
2. Paenut allergy-here child is getting discharged and before that chat to mother confirming diagnosis,explaning to her bout it and to tell her to come after 4 weeks for peanut allergy appointment.
3. Examination of patient with meningitis(don’t take history)-the patient was having severe photophobia,so I asked for lights to be dimmed,but wasn’t done,then while examining him wanted to check pupil size and relexs but he wasn’t opening eyes due to pain,so asked examiner should I proceed he looked sternly and said do whatever u want.so I just examined till stage the patient co operated apologizing to him.then checked for kernigs test,its imp to ask patient where he feels the pain in this test,leg or back or to neck and then do all other test.told examiner I would like to end with full neurological examination of limbs but no equirpmnt was given for it.
4. patient to be operated under local Anaesthesia for hernia and he is apprehensive,have chat-council the patient ask him pervious allergy to GA which is positive so they giving LA this time,then explain done by specilalist and has no pain,at times he may feel touch but no pain,tell him to maintain same precautions as for GA so that if need be and he needs to be given GA he should be prepared.
5. Inform partner about ecplampsia and need for C/S and talk to him.
6. Lady with pain abdomen-for me she was uncooperative inspite of my attempts of being friendly,it turned out to be PID but she didn’t give me positive history of any problem down below,as I didn’t ask directly about discharge,for people who did ask she told them.here anyway you had to give DD.
7. Digital rectal examination-was left lobe craggy .
8. Palpitation in 33yrs lady-ruled out everything and finally in dd was to rule out heart problem and it seems it turned out to be arrythmias.so rule out stress,thyriod problem,panic attacks,congetl problems,and all other normal things and then mention could be arrythias.
9. Patient being discharged after dvt on warfarin so council her.dont forget to tell her that there is interaction between many common pain killers and over the counter drugs and also herbal medicines,so always tell chemist about it.
10. 65yrs old Lady with rheumatoid arthritis with lack of sleep-rule out everything and then finally she said she was lonely,for some she opened up and said she lost her husband 6mnths back same time as lack of sleep period,so council her about bereavement and then assess for depression.and management.
11. 23yrs old asthamatic PEFR and given with 2 charts,explain to patient.
12. Examination of Diabetic foot.
13. Otoscopy and tests for ear -I was the second person on this station and in otoscopy for me the internal ear was I guess by mistake on mid position so I could see half of one condition and half of another so I told examiner this,but he got up but didn’t check it for me or help,so all I could do is exaplin what I would be looking for and what little I could see,but as soon as I was leaving I turned back and saw him confirming if actually there was a problem,so hope he takes that into consideration.i wonder what the first guy in that station gave as diagnosis as there was a problem.A word of caution that please practice these well as otherwise in the exam it is clearly visible and u should be able to make out what it is(unless u have bad luck like me and its midway hehehehe)
14. 70yrs old patient with diabetic retinopathy with diabetes 20yrs,all risk faactrs positive,tell him bout it and management.
15. 55yr old guy with back pain history n DD
16. rest station.
my main concerns durin the exam was to get teh names of the patient right as it really stirrs them up sometimes if you get them wrong.
but dont forget to be really apologetic in case u do mix up the names which is possible,if you show ur really sorry for mixing up the names u really build a rapport with the patient,that helps as they will then assist you in ur histry taking,trust me on that.
you may feel that asking 20 questions will help you but thats not always teh case,even if it takes 30secs to establish a relationship with patient its good to invest that time in it.
incase they are getting discharged,congraulate them ask them are they happy/apprehensive etc.
if they are worried for an admitted family member,show they ur concernec and not just a parrot rattling off medical data to them.
after you finish you first station things just move up fast and for me the rest station was in the middle so it seemed like ages being in there and i didnt fancy that as i was getting my tempo going and then that got stalled with teh rest station.
its all about controlling ur nerves,the ones where i lost my cool are teh ones i didnt perform to my potential!!!
learn from my mistakes and correct them when its u whoze facing the OSCE !!!!
Note: originally posted at http://www.rxpgonline.com/postt41406.html