OBJECTIVE STRUCTURED CLINICAL EXAMINATION “OSCE”

OBJECTIVE STRUCTURED CLINICAL EXAMINATION“OSCE” Dr. Nawal Al Sinani Consultant Obs & Gyne King Abdulaziz University Hospital

OSCE O : OBJECTIVE S: STRUCTURED C : CLINICAL E: EXAMINATION

WHAT DOES IT TEST ? • 1. HISTORY TAKING. • FACTUAL KNOWLEDGE. • 3. INTERPRETATION OF LABORATORY RESULTS AND • CLINICAL DATA. • ABILITY TO FORMULATE DD. • 5. COUNSELING SKILLS. • 6. CLINICAL PROBLEM SOLVING.

Why OSCE?

OSCE • Why OSCE? • WHAT DOES IT TEST ? • HOW TO RUN IT?

This station is to test your ability to take relevant history • Mrs. Fatma is 38 weeks pregnant lady complaining of headache

Data interpretation • A 38 years old patient, Gravida 8 para 6+1. Her previous delivery ended by cesarean section due to failure to progress. • She is now around 28 weeks • Her family doctor have ordered a GTT and she brought the result for you for advise

Instruction for the Simulated Patient (Examiner) • Doctor can you tell me is my GTT result normal or not? • Is there any danger (complications) for me from this condition? • Is there any risk for my baby?

Data Interpretation • 28 years old Gravida 10 Para 9+0, at 13 weeks of gestation came to the clinic complaining of: Palpitation and shortness of breath. • A complete blood count (CBC) test was performed. • You are require to interpret the result of the CBC

Postnatal Examination • You are the house officer in the ward and in the morning round you came across this patient who had delivered 24 hours ago. • How would you assess her?

During the morning round you came across a 28 years old who has delivered 24 hours ago.She was found to run a temperature of 390 c.How would you approach her • Mode of Labour: Spontaneous • Mode of Delivery: Spontaneous • Outcome: 3 Kg baby Boy • How is the baby: Well in the nursery • Duration of labour: 12 hours • Any history of SRM: Loss of fluid for 3 days • Symptoms of upper or lower respiratory tract infection • Symptoms of UTI (upper or lower) • Amount, and nature of Lochia

You were urgently called to the labour room by the obstetric nurse.A patient who just had her episiotomy sutured by your colleague has suddenly became pale and drowsy with rather heavy vaginal bleeding • What is the differential diagnosis of post-partum hemorrhage (mention 4)? • What are the immediate measures that should be taken in this case? • What is the most likely cause of this patient collapse? • How would you confirm This diagnosis

What is the differential diagnosis of post-partum hemorrhage (mention 4) • Uterine Atony • Lacerations of the Genital tract • Uterine Inversion • DIC

What are the immediate measures that should be taken in this case? • (A) Air Way • (B) Breathing • (C) Maintain Circulation IV infusion

What is the most likely cause of this patient collapse? • How would you confirm This diagnosis? Uterine Atony Abdominal Palpation for Uterine fundal height and consistency

An 18 years old primigravida presented to the emergency room in labour • What important informations you want to know about this case? • How would you confirm the patient diagnosis?

What important informations you want to know about this case? • Is she booked or not • How many weeks is she now ( LMP) • Is there any known medical problem? Yes 38 weeks No

How would you confirm the patient diagnosis? • Symptoms: • Character of the pain: regular in pattern, increase in frequency and intensity. • Signs: • Show. • Cervical Changes: effacement and dilatation • Loss of fluid per vaginum

Other Areas can be testes: • Fetal Monitoring: • Routine tests in ANC booking clinic • GCT and GTT • PET profile • Anemia • Postpartum complications: e.g. DVT, Fever, Hemorrhage

OBJECTIVE STRUCTURED CLINICAL EXAMINATION “OSCE”