Objectives Structured Clinical

Examinations (OSCE)

By: Raniah Al-jaizani, M.Sc

Background

Traditional assessment methods useful for

evaluation of knowledge, but not necessarily

of skills

Clinical skills represents amalgam of clinical

knowledge and communication/interpersonal

& problem-solving skills

Performance based assessment provides

unique vehicle for measurement of clinical

skills

What is OSCE

Objective

Structured

Clinical

Examination

OSCE - Objectives

All the candidates are presented with the

same test

OSCE - Structured

The marking scheme for each station is structured

Specific skill modalities are tested at each station

History taking

Explanation

Clinical examination

Procedures

OSCE – Clinical Examination

Test of performance of clinical skills: not a

test of knowledge

The candidates have to demonstrate their

skills

Why we Need OSCE?

The desire to improve the quality of our

evaluation techniques and ever-changing

curriculum

Such a test would be very helpful & gives a

better evaluation of students therapeutic

decision-making & performance in therapeutic

courses

Realizing that skills domain is difficult to test

with either written examination format

Defining OSCE

OSCE consists of multiple short (5-20 minute) stations

Each is examined on one-to-one basis with: examiner & real/simulated patient known as standardized patients (SP)

SP are persons trained to simulate a medical condition in a standardized way, each station requires the candidate to perform a specified task/series of tasks

Stations may be active or non-active

OSCE Stations

Based on therapeutic topics we will cover it in 442 PHCL

you will be dealing with 3 active stations

For each station you will be given 10 minutes

Each station will consist of a SP which in your case will

be an actor.

Before the station you will be given a form. Which

includes a task (e.g. recommend dose adjustment in

case of..) & instructions (e.g. a physician approaches

you with questions about adjusting medication in case

of….)

OSCE Stations

You will enter the station & introduce yourself to the SP

The SP will handle the case according to a specific

training

SPs follow a certain script to play with you during the

encounter

These scripts are written in details including patient

general look, cloths, emotions, and all negative and

positive answer

In order to evaluate you the SP and/or the OSCEs

examiners will be given a checklist to fill out while

observing you

OSCE Stations

These checklists are standardized to reduce

examiners' bias

On these checklists, there are station specific points

(i.e. points to cover the case in particular) & general

performance points (i.e. points to cover general things

like introducing yourself)

SPs will reveal information when specific related

questions are asked. For example, if you don't ask

about all their medication now and in the past, they

won’t give you the list of medications they are taking

Check List (Evaluation Form)

Medical knowledge specific to this station, such us,

symptoms, signs, associated factors, risk factors,

management plan….

Data gathering skills: Your way of patient information

collection

Documentation: summarizing the findings of the

patient encounter & initial patient work-up

Communication & interpersonal skills

OSCE Test for Therapeutic II

Do I need to study for the test?

In normal circumstances the test would be part of the

course evaluation so you will need to study

Do I need to bring anything with me?

Your brains!

Your smile

A calculator

Will you provide me with anything in the station?

The station form including: Your task & instructions

Some stations require having a drug information

handbook, in such situations we will provide for you

How will I move from a station to another?

Depending on the availability of SP you will enter the

room and wait in front each station

Each station will be marked with a number including

rest stations

You will be given clear instructions on how & where to

move during the exam

How will I move from a station to another?

You will now enter the first station

After 10 minutes a bill will ring you will all come out of

the stations, & a second bill will ring which means

move to the next station but do not enter, then a third

bill will ring which means enter the station

So there will be 3 bills

What are the stations available on the day of examination?

In usual circumstances you should not know the

stations, but it depends on what you have covered

over therapeutic courses.

What are the stations available on the day of examination?

1. Diabetic patient education on how to use insulin

2. Adverse drug reactions: antihyperlipidemic

3. Adverse drug reactions: antidiabetic

4. Prevention of secondary diabetes complications

5. Type II diabetic patient with compromised kidney or

liver functions

What are the stations available on the day of examination?

6. Patient with newly diagnosed respiratory tuberculosis

7. Antibiotic dosage adjustment in meningitis &

compromised kidney function

8. Osteoporosis patients starting new treatment

9. Patient on lipid lowering drug requiring counseling

10. Switching from sliding scale to regular insulin dosing

11. Case puzzle

“I cannot say whether things will get better if we change; what I can say is they must change if they are to get

better”

Georg C. Lichtenberg