THE COURSE MASSAGE JUNE 2011 DR ABDELNASIR ELSHEIKH-MRCGP-MFFP-UK To maximise success in passing OSCE, one has to develop problem

solving skills centred around patients. Therefore developing and practising CONSULTATION and EXAMINATION skills with patients early is of paramount importance in preparing for the exam. 1. FOCUS ON HIGH YIELD CASES: How are cases chosen? cases that are chosen for exams are likely to have common new STABLE conditions : although this may seem obvious, if you start applying this principle to systems, it helps to narrow the sorts of cases you may encounter in osce., the OSCE Courses will highlight cases which consistently appear in the exam and will make sure that every delegate is examined under OSCE conditions within a safe and supportive learning environment. 2. JUSTIFY YOUR DIAGNOSIS: You can pass an OSCE even if your diagnosis is wrong or you have misinterpreted patient symptoms. What matters is that the symptoms you do pick up and interpret are consistent with the diagnosis you propose and most importantly if you can explain your conclusion with confidence. 3. BEHAVIOURAL ATTITUDE: Always show respect to the patient and to the examiner. FIRST IMPRESSION COUNTS! Learn to control nervous anxiety, maintain good eye contact and never fail to greet and thank your patient at the start and end of the station. 4. FOCUSED HISTORY SKILLS: The purpose of taking a focused history is to ARRIVE AT A DIAGNOSIS and involves the use of open, closed, relevant and specific questions. Remember to ask patients a question such as: "Is there something else you would like to tell me?" SUMMARISE - at the end of taking a focused history, as this will give you some breathing space to put together the facts you have gathered and think about any other RED FLAG questions you have may have missed. A good summary will often engage the patient more; show that you have acknowledged their concerns and the patient will often contribute more information to help facilitate the consultation. 5. COMMUNICATION SKILLS: It is well known fact amongst examiners, that if you are going to fail an OSCE, the likelihood is it will be on a communication skills . Why? - Students often approach communication skills with a degree of rigidity. , this does not work where your INTERPERSONAL SKILLS and SELF AWARENESS are being assessed. A classic example of this is the way in which students will ask about ICE (Ideas, Concerns and Expectations) as if it is a 'tick' in the OSCE box which they can forget about once verbalised. ICE IS NOT A TICK BOX EXERCISE. In osce stations there are often global overall marks and also input from the patients themselves with regards the fluency and rapport with which the student consults. Eliciting concerns and health beliefs in a natural way is key in passing osce stations. This involves self awareness, for example by considering the patient's perspective and putting yourself in their shoes, displaying sincerity and acknowledgment. This takes PRACTICE, PRACTICE, and PRACTICE. Fluency is key! Passing osce will not come from keeping your head in the books. Get out and see some patients to apply, centre and practice the theory!