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SMEC OSCE Revision

Objective Structured Clinical Examinations16 stations 4 rest stations6mins each (except for long history taking station = 12mins)So it lasts about 2hrs

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SMEC OSCE Revision

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    1. SMEC OSCE Revision Practical Skills Session Thurs 19th March 2009

    2. Objective Structured Clinical Examinations 16 stations + 4 rest stations 6mins each (except for long history taking station = 12mins) So it lasts about 2hrs… You will survive ?

    3. The practical skills stations… BP measurement Hand hygiene Basic Life Support Urine testing BMI measurement Asthma: Peak flow meter & inhaler instruction

    4. More practical skills stations… Blood film examination Growth charts Histology E-OSCE (Information Retrieval) Movement disorders Sensory Awareness- Visual impairment

    5. Anatomy stations… Surface Anatomy Skeletal Anatomy Organ Anatomy

    6. BP Measurement Useful website: http://www.abdn.ac.uk/medical/bhs/ British Hypertension Society tutorial Noorie

    7. Hand Hygiene N.B. It’s not just about your hand-washing technique! Know your bacteria ? Adam

    8. HAND WASHING Part One Avoid potential contamination: ties, watches, etc Prepare station: paper towel/warm water Your six steps to clean hands DON’T TOUCH ANYTHING!

    9. Example questions... What precautions do the medical team take to prevent spread of infection? What are the main bacteria or viruses found in hospital? What are the medical and surgical interventions that lead to Hospital acquired infection?

    10. BLS N.B. There’s a phone in the station- use it… (before commencing CPR but after assessing situation) Elf

    11. Urine Testing N.B. Examiner might ask you what the results mean and what you would do next… Stuart

    12. Urine Testing This station is “easy to do” and “easy to fail” This is a no-person station; examiner will ask guide you on what he wants It’s not just about the “doing”, it’s very much about the interpreting

    13. Urine Testing Wash hands. Checks: Sample: ask examiner: Is it from the correct patient (would normally check name and dob) Is it fresh? Is it clean-catch MSU? Dipsticks: are they in date Look. Should be gloves (wear them!) and perhaps a gown (if there is, wear it!) Comment on colour, turbidity and odour Colour: keep it simple (straw: normal; colourless: dilute (DM, lots of water in, diuretics); pink or red (blood... beetroot) brown/black (bile, iron) Turbidity: cloudy: infection, mucus, blood, bilirubin Odour: no one’s ever done that! (but: foul smell: infection; DKA: peardrops/acetone) Give specimen a gentle shake (with lid on!!!) – if it froths, comment on this (= protein in sample) Take out a dipstick, close dipstick pot Open sample, put in dipstick vertically (fully immerse, 1-2secs) take out and keep horizontal Close the specimen bottle! Read the result according to the chart from thumb up comparing against dipstick bottle (don’t touch bottle) . Read them as you see them i.e. say ++ for protein not just protein. NB. Some you can read immediately (closer to thumb), others take up to 60s. Demonstrate awareness of this by looking at clock Discard the dipstick appropriately, the gloves and gown Wash hands ... be ready to interpret,

    14. Urine Testing – interp.

    15. BMI Measurement N.B. Don’t forget to get consent Shahina

    16. Peak flow meter and inhaler instruction N.B. Ask what the patient knows/understands already Adam

    17. PEAK FLOW Introduce yourself: ‘my name is...’ Actor(/ress) has asthma, check for their understanding. “I have been asked by you GP/Dr. to show you how to use a peak flow, is that okay?” (NB. CONSENT) Your usual steps to using a Peak Flow

    18. SOME ADVICE... Once you explain everything, demonstrate it once yourself, replace mouth piece and ask them to try It is better to stand-up and take a deep breath in. Take care, don’t use jargon (e.g. airways better than bronchioles) NB. Peak Flow should be used in the morning, in the evening and whenever they’re SOB Best of three, NOT average Use their turn-dial

    20. Blood Film e.g. RBCs Histology Useful book: Wheater’s Adam

    21. Histology Slides from year 1 and 2 List of MCQ Questions Example from last year: Ovaries Label: Graffian follicle, primary, secondary? When is it released? Hormones influencing release?

    22. Blood Films Microscope (DON’T TRY AND ADJUST) From Blood-related scenario (Sc345) Questions: Is this anaemia? What type of deficiency? Macro or micro-cyte?

    23. Growth Chart N.B. Growth velocity = rate of growth/year Height Prediction = Father’s Height + (Mother’s Height + 12) 2 Stuart

    24. Growth Chart Alternative Height Prediction formula (probably easier to remember) = parents’ average + 7cm (boys) parents’ average – 7cm (girls) Use the right chart – correct gender and “stature for age” (don’t plot on the weight chart!) Anything above 97 percentile or below 3 percentile warrants further investigation

    25. Growth Chart Short stature could be due to: Physiological (parents’ height) Pathological Congenital: Turner’s, CF Chronic disease Endocrine: hypopituitarism Drugs: steroids Environment: poor diet and abuse

    26. E-OSCE (multiple choice) Movement Disorders Useful website: Youtube! Elf

    27. Sensory Awareness Visual Impairment Adam

    28. SENSORY AWARENESS VISUAL IMPAIRMENT READ READ READ THE CARD OUTSIDE!!! You’ll need to take the patient to bed... Remember to introduce yourself to the patient, not the dog! Remember to consent For this I’ll need to demonstrate...

    29. Surface Anatomy Skeletal Anatomy Organ Anatomy Noorie

    30. Final words of wisdom: 1. Don’t panic & 2. Practice Don’t forget to visit studentmec.com for OSCE notes:

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