Wednesday, February 14, 2007

A Step By Step Guide to Mastering the OSCEs!

The One Of A Kind Systematic Approach To Medical OSCE Exams Preparation!

Objective Structured Clinical Examination, OSCE, also called Objective Standardized Clinical Examination is tough. OSCE exams like USMLE Step 2 CS, MCCQE II, PLAB Part 2, AMC Clinical, TRAS 2, Medical Students OSCEs, Medical Schools Finals, and Clinical Skills Assessments for International or Foreign Medical Graduates are really difficult and stressful. That is what it is. I’m not going to say it is easy as what clinical educators and OSCE organizers usually claim trying to make it acceptable for you.

OSCE Exams consist of several clinical encounters (called stations) with specially trained actors playing the role of a patient with some sort of a medical complaint (called Standardized Patient, SP).

Let’s take few minutes here to imagine your situation during the OSCE. This is an important step as you may realize that the first step to deal with any issue is to completely understand what it is.

You will find a lot of articles and web pages describing what are the OSCE exam procedures. They present the OSCE in a scientific academic context. I am sure you already have read several of these.

Are you?… Did you read between the lines?… Have you achieved an understanding about how your physical and mental status will be during the OSCE exam?

Well, let me explain it for you. Just concentrate. Imagine yourself in a hallway with several other candidates each standing in front of a closed door. Several individuals are watching you for any violation of the rules. Then a bell or a buzzer goes on. You have one or two minutes to read a full page hanged on that door describing what the station ahead is and what is you required to do.

Usually, you’ll need to read the instructions several times because you’re nervous, you heart is racing and your mind isn’t catching what your eyes are reading!

Then, a second bell/buzzer sounds. You knock the door and enter the room. In each room, you will find a new patient and a different room setting. In some OSCE Exams, an examiner is present in the room. In such cases, you have to hand out the examiner one or two of your identification stickers that you may have looked for them and didn’t find. Remember you are nervous.

Then you have to start as your limited time has already been started when the second bell/buzzer went on. You need to get information from the SP or may be examine or consult him/her. Your voice is low. Your hands are shaking. You look unconfident and don’t know what to do. You are at the center of focus of both the SP and the OSCE examiner (present or through video monitoring). Both are watching you carefully. Listening to you.

Those SPs are well trained not to give you any information unless you specifically ask for it. That is not like real life medical encounters where the patient will say everything when you ask about the reason of their visit. So, you have to know what questions you need to ask, The OSCE Examiner checklist.

As you were asking, the patient replies by questions for you. Questions like ‘What do you mean?’, ‘Do I have to answer that?’, ‘Is this relevant to my problem?’, ‘Why are you asking this?’. All these questions are intended to shake you if that wasn’t a reflex of your poorly phrased questions. You start to lose control over yourself and the encounter. You start to make fatal mistakes like being disrespectful to the patient and unprofessional. You’ll jump from topic to topic unorganized. And you’ll forget to ask questions that are important to fulfill the examiner checklist! That examiner who is sitting or standing closely observing you and filling out your checklist and writing comments.
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Suddenly the bell/buzzer goes on again. The station is over. Oh my God. There are still tons of questions that I have to ask. I missed this station. You’ll start the process of self-blaming. You’ll feel hopeless.
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As you proceed, you’ll try to hold yourself up. You’ll find that you had already wasted substantial time of the minute before the next station or in some exams where there is a post encounter oral or writing question period or patient notes writing period.
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The cycle starts again and again.

By the fourth or fifth station, you’ll feel exhausted and your brain starts to ache. You’ll feel unable to think about the coming station and you start to give up claiming that you’ll do your best.
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Did you get what I wanted you to understand? Let me put it in summary:
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· You will be nervous, irritable and cannot think straight.
· You will be physically and mentally exhausted.
· Your time is running fast and is not enough.
· Some SPs will be challenging you intentionally and waist your time.
· You need to be organized and manage your time effectively.
· You need to know in advance what to ask, as there is no time to think.
· You need to be careful about how to phrase your questions and comments in order to be respectful and empathic. Remmeber, no time to think.
· You need to ask your questions intelligently in order not to lead the patient or trigger programmed time wasting and problem evoking conversations.
· You need to be and appear confident, organized, and professional.
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Is that easy?… Of course not.

Is it impossible to do?… Of course not.

Thousands of medical students, residents, and graduates have done it…. Okay, so it is not easy and at the same time not impossible. You need to assign the needed time and effort to prepare yourself to the OSCE Exams and you’ll be just fine.



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But how to prepare yourself for the OSCEs?
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This ebook, A Step By Step Guide To Mastering The OSCEs, will help you to:

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1. A Step By Step Flowcharts To Follow Through Out Your Organized Controlled Medical Interview OSCE Exam.

2. A Complete History Taking Templates For All Common OSCEs In ALL Specialties.

3. Ready To Use Questions Templates Of What & How & When To Ask, Not Only Checklists That You Need To Figure Out How To Cover In Your OSCE Exam.

4. Question Templates That Cover All Related Differential Diagnosis And Covers The Checklists Without The Need To Think About The Case.

5. A Step By Step Guide Of How To Perform A Physical Examination, What To Examine, And What To Tell The Patient And The OSCE Examiner (if present) While Examining The SP.

6. A Step By Step Guide To Follow About What, When, And How To Manage Any Emergency Setting OSCE Station.

7. How To Organize A Counseling Station In The OSCEs.

8. Complete Carefully Phrased Sentences Of How To Approach Sensitive Issues Like Menses, Sexual History, And Abuse In An Ethical Manner.

9. Master Verbal Communications Indirectly By Just Memorizing The Templates and Perform Them In Your OSCE Exam.

10. How To Unlock Difficult Medical Encounters? To Deal with 20 Difficult OSCE Scenarios Like Depression, Breaking Bad News, .......



Let’s start. You can do it.
We can help you pass the OSCEs with high score.
You just need someone to show you specifically how to do it, and We can help. Let’s start.



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Dr. Alimari, MD
www.oscehome.com
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