- Aim
- Overall format
- Content of the stations
- Skills to be tested
Aim
1. The aim of the OSCE is to test your clinical and
communication skills. It is designed so that an examiner can
observe you putting these skills into practice.
Overall format
2. When you enter the examination room, you will find a series
of booths, known as 'stations'. Each station requires you to
undertake a particular task. Some tasks will involve talking to or
examining patients, some will involve demonstrating a procedure on
an anatomical model and others will involve watching a video clip
and recognising clinical phenomena. Details of the tasks are
explained below under 'Content'.
3. There may also be one to two rest stations in the circuit. At
some tests one of these two stations will contain instructions
asking you to perform certain tasks as if you were at a real
station. These are pilot stations and the results will not count
towards your overall OSCE grades.
4. You will be required to perform all tasks. You will be told
the number of the station at which you should begin when you enter
the examination room. Each task will last seven minutes.
5. Your instructions will be posted outside the station. You
should read these instructions carefully to ensure that you follow
them exactly. An example might be:
'Mr. McKenzie has been referred to you in a psychiatric
outpatient clinic because of problems with his memory. Please
conduct a cognitive assessment in order to establish the most
likely differential diagnosis'.
6. A bell will ring. You may then enter the station. There will
be an examiner in each station. However, in general, you will not
be required to have a conversation with the examiner; you should
only direct your remarks to him or her if the instructions
specifically ask you to do so. You should undertake the task as
instructed. A bell will ring after six minutes to warn you that you
are nearly out of time. Another bell will ring when the seven
minutes are up. At this point, you must stop immediately and go and
wait outside the next station. If you finish before the end, you
must wait inside the station but you should not speak to the
examiner or to the patient during this time.
7. You will wait outside the next station for one minute. During
this time you should read the instructions for the task in this
station. After one minute a bell will ring. You should then enter
the station and undertake the task as instructed.
8. You should continue in this way until you have completed all
of the tasks. You will then have finished the OSCE.
Content of the stations
9. Each station consists of a scenario. An examiner will be
present and will observe you at work.
10. The scenario could be drawn from general adult or old age
psychiatry appropriate to a Senior House Officer (SHO).
11. Although the tasks you will be instructed to do will involve
a number of skills, one skill will predominate.
12. The skills to be tested are
set out below. They will not necessarily be tested in the order
given here. Under each skill area you will find some examples.
Please note that these are only examples; other
topics will be tested.
History taking
Your candidate instructions will set the scene. You will be
asked to take a history from an actor pretending to be a patient (a
simulated patient). The actor will have been given all the
necessary information to be able to answer your questions
accurately. You should treat him or her just as you would a real
patient.
Examples: depression, anxiety, panic, memory
difficulty, and drinking problem.
Examination skills
You will be asked to examine a particular part of the body. You
may have to examine a simulated or real patient or perform the
examination on an anatomical model. Although you should talk to the
patient as you would to a patient in real life, you should only
take a history or give a diagnosis if the instructions require you
to do so. You may be asked to explain your actions to the examiner
as you go along.
Examples: examination of cranial nerves,
examination of motor system, fundal examination
Practical skills/use of equipment
This is to assess some of the practical skills an SHO needs. The
stations concerned will normally involve anatomical models rather
than patients.
Examples: application of ECT electrodes,
application of ECG leads, etc.
Emergency management
These stations will test whether you know what to do in an
emergency situation. You may have to explain what you are doing to
the patient or to the examiner. Your instructions will make this
clear.
Examples: resuscitation
Communication skills
There will be a communication skill element in most stations.
However, in some stations this skill will be the principal skill
tested. Areas tested may include interviewing (including
appropriate questioning, active listening, explaining clearly,
checking understanding) and building rapport (including showing
empathy and respect, sensitivity to others' emotions and coping
with strong emotions in others).
Examples: instructions for discharge from
hospital, explaining treatment, consent for ECT, and explaining
prognosis.