OSCE Practice

1. 1 OSCE Practice A/Prof Stephen Lew 3 May 2010

2. 2 Learning Objectives At the end of this session, we will: Better understand the OSCE exam format Better understand how to learn from OSCEs Be able to utilise this knowledge to increase confidence with OSCEs Be able to plan how to write your own OSCE

3. 3 Exams at Semester 9 1 Long case MCQ paper 5 station OSCE Sem 8 and 9 = 22.5% of total MBBS score

4. 4 Why OSCEs Increase validity and reliability More certain mapping to curriculum Better standard setting (pass score) More fair? More fun?

5. 5 OSCEs Objective Structured Clinical Examination OR Over Stimulation and Crying Event OR Opportunity for Showing your Competence and Excellence

6. 6 OSCE performance Lucky? Nervous? Confident? Uncertain? Competent? Practised? Understood?

7. 7 Administrative details Friday 25 June 2010 Various locations 5 stations of 7-9 minutes each Cover all 6 blocks, incl practical procedures

8. 8 OSCE Practice Each group workshops 4 cases from their block 4 pairs briefly work up 1 case each Whole group then refines them to 2 cases for complete write up These two cases are then formally used for the group doing the block next First, organising group to ensure equipment, volunteers, finalised by Thu May 13 Clinical School provides two examiners OSCE practice in week of 17 May

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10. 10 OSCE Preparations See one, do one, teach one ? see many, write some, learn some (learn how examiners think) Get a template Pick a topic from your block guides Core clinical presentations? (SOB, chest pain …) Core clinical condition? (IHD, HT, asthma, pneumo…) Physical examination skill? (CVS, Dyspnoea…) Procedural or practical skill? (ECG, admin O2) Medical imaging? (CXR, CT …)

11. 11 Writing your own OSCE – points to remember Candidate instructions - explicit Examiner instructions – case time and question time Mark sheet – 0,1,2 points Simulated patient instructions, if needed Equipment list, if needed

12. 12 Writing your own OSCE – points to remember There are only one or two ‘points’ or ‘tasks’ to the case (ie a construct ; eg how to take hx of LOW) They all come blueprinted from the curriculum (so read the block guides#) 7, 8 or 9 minutes only Include process skills (introduction, rapport, DeBug) The setting/environment is important and not as artificial as you think (look for clues)

13. 13 Think of your own OSCE – sample Sample mark sheet (Not Uni of Melb) SENSORY EXAMINATION OF LOWER LIMBS This station assesses the candidate’s ability to perform a sensory examination of the lower limbs THIS IS A 7 MINUTE STATION Please mark one response for each item 1 Appropriate introduction 2 Explains purpose of the examination 3 Observes the patient from the end of the bed Examiner asks the candidate “What are you specifically looking for on observation of this patient?” 4 Candidate comments on relevant abnormalities (ulceration, wasting, fasciculation, abnormal movements and posture) 5 Establishes whether the limbs are painful/tender Examiner asks candidate to assess ONLY the light touch and proprioception modalities Light touch 6 Explains the examination to the patient 7 Performs the examination correctly 8 Assesses the dermatones 9 Tests the two limbs alternately Proprioception 10 Explains the examination to the patient 11 Performs the examination correctly 12 Candidate presents the findings in a logical, succinct manner 13 Confirms the presence of a peripheral sensory neuropathy 14 Treats the patient courteously throughout 15 Leaves patient comfortable 16 Does all of the above in a fluent, professional manner 17 Examiner’s total score ______ Overall rating Unsatisfactory Borderline Satisfactory

14. 14 OSCEs Objective Structured Clinical Examination OR Over Stimulation and Crying Event OR Opportunity for Showing your Competence and Excellence

15. 15 Above all