After what was a rather packed afternoon of 16 mock OSCE bases we have sat down and reviewed the mark sheets. This has revealed some common themes amongst certain stations and some overall pointers for the exam in general.
All of our candidates have received individual feedback on the day, but we would like to share the following for those who couldn't make it or if our candidates would like a reminder.
We divided the stations we ran into broad themes and these will form the headings used in this post:
Avoid judgemental statements, especially when asking about drugs/alcohol/sex.
Try to keep an open mind with regards to diagnosis at the start and focus down based on patients answers.
Remember to ask about diabetic control if a patient tells you they have diabetes - this can also apply to other chronic health problems.
Practice, practice, practice... These are guaranteed to come up, so practice on patients, friends and family. You need to be able to do these with your eyes shut. Be aware examinations can come up as a teach me base.
Remember to verbalise what you are doing, explain to the patient and explain to the examiner in one move. However do make sure you are doing what you say you are.
Also consider offering a chaperone for examinations (especially if an intimate exam)
If breaking bad news remember to ask for a nurse to accompany you, and to explain your role in the situation to the career/family.
If having a difficult conversation/referral don't get angry, keep calm, consider sitting down.
ALS, APLS, ATLS are guaranteed to come up in some form during your exam.
Verbalise the algorithms and share your mental mode, this keeps the examiner and your team in step with where you are. It can also help them know where you are going.
Certain things just need to be memorised:
Resus drugs and doses
Special circumstances for in my sitting we had a pregnant trauma case.
Talk to the patient as you perform the skill (especially if there is an actor as patient).
Washing hands and PPE are easy marks, don't forget to introduce yourself (#hellomynameis).
Again consider offering a chaperone.
Remember the basics – you can't teach everything in 7 mins.
Ask what the student already knows before you start.
Have a structure to follow.
If asked to teach about an abnormal gas/ecg ask where is the patient and are they safe?
The pie charts before the station are vital, they will tell you where the marks are allocated - if there is a large proportion of leadership for example you will need to be fairly hands off. You will have time to study the pie chart before beginning the base.
Don't be phased by a difficult or challenging base and when it is over move on. You don't need to pass every base to pass the exam.
As with all exams with appropriate preparation it is possible to pass, this course and others like it are a good tool, but practicing is key. Part C is broadly reflective of real ED scenarios and this makes it passable. Also it has an advantage over a clinical shift as you only have on patient at a time! So go into it knowing you deal with these same things everyday and that you do have the knowledge to pass it!
Good luck to all those sitting the exam...