crack the nac

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.

 

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.

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!