OSCE tips

Start Your Studying NOW!!!

Posted on by Doctors

Start your studying NOW

How to prime your NAC studying success in 3 easy steps

 

Ultimately, your success is in reach. The NAC, much like the LMCC and all OSCE style exams that you will encounter in Medicine are very easy to master. The secrets behind your success will be ifound the strategies you chose to implement NOW. The scooner you set the groundwork for your study habits, the sooner you can implement them into a succesful routine that WORKS.

 

The mechanics of your studying is just as important as the content you study.

 

So without further ado, please see below the study tips for success with NAC

 

  1. How? Schedule:You very likely, while waiting to do the NAC are working a full time job. The first key to success for studying is to start NOW. Print off a calendar or find an agenda and make a schedule and stick to it. In this schedule, outline specific time that you are going to dedicate to your studies. There are 5 forms of studying that I will outline below that you will need to plug into this schedule. On top of this, write breaks into your study schedule, nothing is more discouraging than burn out and going blanking on content – so make a schedule and stick to it, breaks included.

 

  1. Where? Find a Space that works for you It is extremely important for you to find a space that has a strong balance of distraction and complete concentration. Beginning now, start to feel out where you find the best space for optimal focus. Some locations I have found successful include :
    1. Coffee shop
    2. Outside
    3. Library
    4. Home
    5. Friend’s house

The biggest thing to remember is that if it doens’t work change it up. With long-haul studying you want to keep locations fresh if they start to stagnate, the last thing yu want is to find yourself doing busy work rather than focusing on the content.

 

  1. Who ? Studying solo or in a gorup is a completely personal decision. I have found that a good balance of both delivers excecllent results in the NAC. I used a hybrid method that was very helpful, I first covered all the necessary material on my own, highlighting relevant inforamtion. The videos that I have developed here will be an excellent resource for you in thsi independent phase. Next, I used groups to help augment my independent studies. You too may find it helpful to work in groups and talk through difficult to remember and points and role play various OSCE exam scenarios – taking turns being patient and physician – this gives you the exposure to the material from two different perspectives.  Depending on your personality, if you start early enough, you will be able to feel out the balance that is best for you. Some thrive in group environments while others may find that solitude is the best answer.

*Keep in mind that the subjects you are working on, the timing of your studies and your personal schedule ( as outlined in point 1) will play an integral role in if you study with others.

 

What books should I use to study for the NAC OSCE?

Posted on by Doctors

 

This is a common question that we receive from IMGs all over the globe. With more people fighting for residency in Canada it’s important to crush this exam and increase your chances of a potential CaRMS match.  Unfortunately there are not a lot of study options out there. When we completed our NAC OSCE in 2014 nearly everyone showed up to the exam with the NAC OSCE comprehensive review in print or on a tablet, they were rushing through it, trying to load the last few things into their memories. Unfortunately this book is less than ideal. There are overwhelming negative reviews of this book on Amazon which state that the book does not reflect the content of the exam well, it does not reflect the current therapeutic guidelines required for the exam, there are various errors and even grammatical and spelling mistakes in the book. Nearly every review advises you to look elsewhere in your preparations.

So, what should you study? We suggest picking up a copy of OSCE and Clinical Skills Handbook by Katrina F. Hurley MD. Why this book? Well it was written by well established Canadian physician to help medical  students and residents for prepare for OSCEs. It covers nearly every possible case you could see on the NAC and will force you to think in depth about the exam as well as help you improve your history and physical skills. It came highly recommended to us when we were preparing for our NAC OSCE by various administrators of the exam and was extremely important to securing a high score and a residency position. A read through it will help you identify your area’s of weakness and allow you to practice, practice, practice. We found this most effective by doing mock OSCEs over, and over, and over, and over (you get the idea).

 

Hope that helps, happy studying!

 

Author Bio:

Dr. Katrina Hurley graduated from medical school at Memorial University of Newfoundland in 2001. She pursued a residency in Emergency Medicine at Dalhousie University and concurrently completed the Clinician Investigator Program and a Masters in Health Informatics. She has been an Emergency Physician at the IWK since 2009 and is an Assistant Professor in the Department of Emergency Medicine.

Dr. Hurley is the Division of Pediatric Emergency Medicine Research Director.

 

Sample OSCE Case 1 – Solution

Posted on by Doctors

 

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We will be doing a series of Sample Osce cases for you to practice and review, followed by a case review the following week.  Read the Stem, proceed to rehearse the case, what questions would you ask, will you do a physical exam? If so what will you examine? Be sure to talk out loud explaining what you are doing and why you are doing it. “I’m listening to the heart for any evidence of murmurs etc…

CASE 1:

68 year old Anita MacDonald has presented to the clinic today reporting that she has been feeling “down” for the last 3 months. She reports that her husband passed away 4 years ago and is in otherwise good health. In the following 8 minutes please conducted a focused history. Do not perform a physical exam. Do not perform a mini mental status exam. At the 8 minute mark the examiner will ask you a series of questions.

SOLUTION:

  • Enters room, hands sticker to examiners
  • Washes hands
  • Introduces self to patient
  • Patient delivers opening response/line
  • Asks about onset of Sx
  • Asks how long Sx have been present
  • Asks about SIGECAPS
    • Sleep changes more/less
    • Interest in daily life
    • Guilt – feelings of worthlessness, hopelessness, etc
    • Energy – lack of
    • Concentration – can they focus? are they easily distracted
    • Appetite – more? less?
    • Psychomotor – are they lethargic? are they agitated?
    • Suicide? have they had thoughts of self harm? harming others? If so do they have a plan? who?
  • Ask about other redflags
    • Hearing voices others don’t hear
    • Seeing things others do not see
    • Paranoia
  • Social Hx
    • Who is at home with them?
    • Support? family, friends?
    • Pets?
    • Smoking? Alcohol? Recreational Drugs?
    • Income/Work/Welfare
  • Previous Medical Hx
    • Depression? Mental health?
    • Overall Medical Hx
  • Medications
  • Review of Systems if time permits/any other concerns
  • FIFE
    • How do you feel about your mood?
    • Do you have an ideas about what has led to your mood factors
    • How is this affecting your function?
    • What are your expectations?
  • Close the interview
  • Prepare to answer series of questions such as:
    • What is your next step in management of this patient?
    • What is your primary diagnosis, give 2 differential Dx
    • If this patient were actively planning to harm themselves what would be your next step?

Sample Osce Case 1

Posted on by Doctors

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We will be doing a series of Sample Osce cases for you to practice and review, followed by a case review the following week.  Read the Stem, proceed to rehearse the case, what questions would you ask, will you do a physical exam? If so what will you examine? Be sure to talk out loud explaining what you are doing and why you are doing it. “I’m listening to the heart for any evidence of murmurs etc…

 

CASE 1:

68 year old Anita MacDonald has presented to the clinic today reporting that she has been feeling “down” for the last 3 months. She reports that her husband passed away 4 years ago and is in otherwise good health. In the following 8 minutes please conducted a focused history. Do not perform a physical exam. Do not perform a mini mental status exam. At the 8 minute mark the examiner will ask you a series of questions.

Geeky Medics OSCE Videos

Posted on by Doctors

The next iteration of the NAC OSCE is in March, to be a successful applicant with CaRMS one should obtain at least an 80% score on the OSCE. Now is the time to begin reviewing and practising. This will give you about 3 months of constant study and preparation.

A group of British medics have put together a great series of videos to help you prepare your basic skills for the NAC. These videos will help remind you of all the proper ways to conduct physical exams. Keep in mind that you will be asked to diagnose and treat patients in the NAC OSCE and that in order to pass the exam these videos do not provide enough information about diagnosis, management, and treatment.

 

You should be able to complete all of these physical exams without thinking by the end of January.

 

OSCE Prep – Some Physical Station Basics

Posted on by Doctors

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So you’ve registered, and are getting yourself ready to tackle the Observed Clinical Encounters. Here are a few pointers for the Physical and History Stations. By the time the exam day comes, you should have these actions memorized. They will become second nature for you, which will ensure you get those automatic points.

 

Physical Stations:

 

  1. When you enter the room – always sanitize your hands. These are free points when it comes to the encounters. The examiners need to see you do this, and it sets the stage that you have  taken measures to ensure hygienic practices and the examiners always look for it off the bat.

 

  • NOTE: ensure your nails are trimmed before the exam. It will prevent you from accidentally scratching the simulated patient, and also demonstrates hygienic practices to the examiner.

 

  1. If the patient is required to be exposed in any way,state that you will be draping the patient accordingly, and then do so. This shows patient care and is important in all OSCE scenarios. If you have to expose smaller parts of the patient’s body- check in with them that lifting their johnny shirt, asking if they are in agreement with you proceeding. These are simulated patients, they will always say that proceeding is fine.

 

  1. Whether you are looking for particular findings, or physically manipulating the patient, tell the examiner everything you are doing. TALK OUT LOUD. This is important. The examiner cannot read your mind. The more explicit you are explaining yourself, the more likely you will catch anything you may have originally missed, and the more points you will obtain for being very straightforward. There are two schools of thought when it comes to talking out loud. They are outlined below.

 

You can do this one of two ways, you can speak to the patient addressing them as “you”

ex: I am now looking for any discoloration on your shins and lower extremities

You can also address the examiner directly “I am now checking the patient’s lower extremities for discoloration”

 

  1. Periodically check in for patient comfort, especially when palpating or have any contact that requires pressure or manipulation of joints. Make eye contact with the patient, and ask if any manipulation you are doing causes pain or discomfort.

 

5 Common OSCE mistakes

Posted on by Doctors

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Having spent over 10 years working with a variety of OSCE’s for medicine, physiotherapy, pharmacy, and nursing I’ve seen some pretty big mistakes, generally though there are very few big mistakes students make in an OSCE. Here are the five most common small mistakes that can knock you down a few points at a time.

 

  1. Not having a game plan when you enter the room. Once you read the instructions jot down a few short notes of what you need to do and the order you need to do it in. This will keep you on track and focused. I’ve seen nerves get the best of many students leaving them missing out on important sections for a history or a physical.
  2. Not treating the OSCE as a real situation. It’s true, OSCE stations are not like real life, they are short, you are required to do things that you may or may not do in real life. These interactions can feel fake and contrived to the student. As an examiner this can come across as lack of interest, arrogance, or just plain incompetence. Do your best to play along with the situation, show empathy, and respect to the patient.
  3. Thinking there are secrets or tricks. OSCE cases have no tricks, no hidden secrets, no surprise twists. The cases are straight forward you are not going to be expected to diagnose depression when told to examine a knee nor are you expected to uncover a rare disease or illness from an obscure symptom. Stations are straight forward and designed to test common conditions/situations.
  4. Missing out on easy points/checks – items like “introduces self to patient” “washes hands” “summarizes” “closes the interview” “show’s empathy” are all simple, short and can be worth points in a variety of OSCE situations, on top of that these tick boxes are just mainstays in professional bedside manner.
  5. Forgets to sign post an interview. For the benefit of yourself, the examiner, and the patient it is important to signpost your interview. I’m going to ask you about your family Hx… I’m going to ask you some questions about your social Hx, I’m going to ask you about your previous medical Hx, I’m going to examine your hip, your knee, etc. This helps cement what you have and have not done and keeps you on track, as well it normalizes the questions and demonstrates you are carefully conducting an exam/history in a logical and organized fashion.

Hope that helps!