Objective structural clinical examinaton(OSCE).

Objective structural clinical examination (OSCE) is a form of performance-based test used to measure candidates’s clinical competence.

OSCE is the most feared of all medical examinations. It involves the examination of patients under the pressure of closure scrutiny and this can be proved, to be the breaking point for many candidates.

In medical education, candidates are required to go through series of stations, six procedure stations and six question stations, it may also include one or two resting station depending on the number of candidates.

HOW TO EVALUATE CANDIDATES DURING AN OSCE

Candidates are observed and evaluated as they go through each station. Candidates are highly focused, and they are given very specific instructions. A structured marking scheme(check list) is used by examiners and this makes OSCE a reasonable, better and consistent way to examine students.

EXPECTATIONS

Candidates are expected to demonstrate different skills at each station, but there are some general skills that you will need to display at all the procedure stations, e.g. greeting the examiner and introducing self.

At each station you are expected to show that you can:

i.            Approach patients in a professional and caring manner

ii.            Carry out the procedure carefully, smoothly and systematically.

iii.            Present your findings systemically, eloquently and accurately.

SKILL NEEDED

Skills needed to do well in OSCEs include:

1.       Communication skills. First impressions matters a lot in OSCE, therefore students must be confident in what they do. OSCEs are about good communication, you have to show that you can communicate  with both the patient and the examiner succinctly, accurately, logically and professionally.

·         You must be neat.

·         Be polite to patients and the examiners

·         Always remember to introduce self to the patients

·         Always ask for patient’s consent before you start the procedure.

·         Always say “please” and thank the patient in a sincere manner when you have finished the procedure.

2.       Observation skills:

·         Utilizing good observation skills to collect history is very essential.

·         Ask patient if they have any pain in any part of the body, especially in the area you are about to examine e.g care should be taken during an abdominal examinations.

·         Always look at the patients face during the palpation and remind patient to tell you if they experience pain or discomfort.

3.       Case presentation skills:

·         Candidates should think before speaking and speak as clearly and fluently as possible.

·         There is additional marks given to candidates who present without looking at their booklet.

·         If you say something that you don’t mean or you know is wrong, take it back as quickly as possible, apologize and offer the correct answer.

·         Do not guess, be honest in the face of ignorance.

COMMON MISTAKES INCLUDES:

i.                     Use of strange or annoying terms.

ii.                   Excessive waving of hands around.

iii.                  Use of verbal tricks e.g “you know” , “ok” , “like” , “you see” etc

iv.                 Use of abbreviations.

v.                   Not introducing self to the patient properly by not using your full name e.g My name is Obi David, a final year medical student.

vi.                 Not reading the instructions well before starting a procedure.

vii.                Not washing the hands before and after a procedure.

CONCLUSION

Do not be put off by the examiners attitudes, they are human and will display the full range of personalities. Some examiners are friendly and approachable, some are inscrutable and while some are downright bad tempered.

The key to OSCE success is practice and there is no replacement for it. Reading is almost not enough, you need to take every opportunity to practice your clinical skills.