Anesthesia OSCE’s help

[Propo Sapiens]

Is there any sort of resource or grading rubric available for the OSCE?

I passed the SOE no problem but failed the OSCE not once but twice. Everyone says to just use the ABA guide and that it’s a piece of cake...but I really don’t know what it is I’m doing wrong. When the report came back I was rated poor in areas I felt I was strong in, and good in areas I thought I bombed. Not sure if it’s something I’m not saying that I should be, or something bad that I’m saying/doing, or if it’s anxiety being seen as lack of confidence.

Before anyone asks, I am not a foreign medical grad and have no issues with English. I just want to get this over with and not have to pay again... and I have two fellowship exams that I need to take but can’t until I pass this thing.

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[IMGASMD]

Michael Ho has a course. Just putting it out there.

 

[jeesapeesa]

michael ho is very helpful actually. he will make sure your game is perfect to the point of over preparedness. he goes out of his way to help.

 

[IMGASMD]

On the OSCEs?

It’s three days during his actually SOE course.....

 

[Justice4all]

try UBP online and offline course. I used the online and it was very helpful. Also look at the breakdown of the OSCE . IC US and monitoring makes up 3/5 of 5 necessary to pass

 

[Propo Sapiens]

Thanks everyone. I’m going to invest in One of the online courses and see how it goes. Week 1

 

[Maverikk]

sorry to hear about your results, that stinks. As someone who had to cram for the orals due to a busy fellowship I understand the stress. The ultrasound and monitoring questions should be straightforward to study for, the resources the ABA give cover it, if this is the area you fell short in I would look into how you're presenting your answers. Look at the areas you did poorly in: if it's not technical (monitoring/US) then do some practices with people and ask them to simulate what you encountered, you need really honest people who give good feedback. Do you need a course, I would say probably not if you have people who are good critics

 

[Propo Sapiens]

Third time's the charm.

There really should be a rubric online of what it is that they are looking for... or maybe work with their actors a little more.

I can't say exactly what I did differently this time other than a complete suspension of disbelief that this was a simulation. I know they have scripts that they have to follow but they do not behave like normal people at all.... especially the surgeon scenario. I knew this scenario is set up for the surgeon to get annoyed. Fortunately this was an easy scenario... open and shut case... so I came out of the gate with the most well thought out and analyzed dissertation of why the patient was high risk and that I understood the surgeon's concern..... and her response was "why are you guys always trying to cancel my cases".

I had to try so hard to swallow my frustration and reply with "....are you kidding...for all the reasons I just said...no surgeon would be this unreasonable"

Is it sad that I recognized/remembered two of the actors from my previous attempts hahaha

I should also consider myself lucky that I was able to take it week 1.... COVID immediately shut down subsequent tests

 

[Justice4all]

Congrats!! A rubric would be nice

 

[IMGASMD]

What did you end up using? Or anything at all?

 

[Justice4all]

I used the UBP OSCE for the 2nd attempt and worked out well.

 

[Propo Sapiens]

What did you end up using? Or anything at all?

UBP OSCE which... best I can explain is that 90% of the stuff they were presenting was either review of common knowledge or things that were completely irrelevant to the test... and the other 10% was high yield, must know (curve balls, minimum expected information, etc)

But ultimately I think it was all the same formula
Say all the information you need to say... even if it's scary or disconcerting
reassure the patient/provider that you are acting in their best interest and will be available should anything bad happen
forget that they are actors

 

[Lashler9054]

What did you end up using? Or anything at all?

I was in a similar situation. I used Ho’s course. If you sign up for his course, you can also do mock sessions. I think it’s really helpful to have another set of ears listen to you during these OSCE scenarios. I finally passed after doing that

 

[pasgasser2]

Is the UBP OSCE a video course or just online PPT slides? I'm hoping to spend the majority of my study time dedicated to the SOE portion and hoping a solid course can help me quickly hit the high yields for the OSCE portion

 

[Justice4all]

Is the UBP OSCE a video course or just online PPT slides? I'm hoping to spend the majority of my study time dedicated to the SOE portion and hoping a solid course can help me quickly hit the high yields for the OSCE portion

PDF file with multiple scenarios

 

[Potatoman1800]

PDF file with multiple scenarios

Is this freely available from somewhere?

 

[2Fast2Des]

We had a very strong mock OSCE session in residency which was very close to the real one so that was clutch so we knew what to expect format and question style wise. It would have been a bit more challenging without it I feel.. I'm not sure what else to offer if you failed twice, that seems a bit wild

 

[deleted1101762]

I guess you the anesthesiology residents are interested in the findings of our OSCE survey. The following is the abstract
Title: Residents’ perspectives on the introduction, conduct and value of the Objective Structured Clinical Examination-Results of the 1st nationwide questionnaire survey

Abstract

Passing the Objective Structured Clinical Examination (OSCE) is currently a requirement for the majority of candidates to gain American Board of Anesthesiology (ABA) initial certification. Many publications from the ABA have attempted to justify its introduction, conduct and value. However, the ABA has never attempted to understand the views of residents.

A total of 4237 residents and fellows at various training levels from 132 programs were surveyed by asking to fill a Google questionnaire prospectively between March 8th, 2021 and April 10th, 2021. Every potential participant was sent an individual email followed by 2 reminders.

The overall response rate was 16.75% (710 responses to 4237 invitations). On a 5-point Likert scale with 1 as “very inaccurate” and 5 as “very accurate,” the mean accuracy of objective structured clinical examination (OSCE) in assessing communication skills and professionalism was 2.33 (1.00) and 2.14 (1.00) respectively. In terms of the usefulness of OSCE training for improving physicians’ clinical practice, avoiding lawsuits, teaching effective communication with patients and teaching effective communication with other providers, the means on a 5-point Likert scale with 1 as “Not at all useful” and 5 as “Very useful” were 1.86 (1.04), 1.69 (0.88), 1.79 (1.02), and 1.82 (1.07) respectively. Residents unanimously thought that factors such as culture, race/ethnicity, religion and language adversely influence the assessment of communication skills. On a 5-point Likert scale with 1 as “not at all affected” and 5 as “very affected,” the corresponding scores were 3.45 (1.20), 3.19 (1.26), 3.89 (1.30), and 3.18 (1.12) respectively. Interestingly, nationality and political affiliation were also thought to influence this assessment, however, to a lesser extent 2.40 (1.26) and 2.28 (1.26). In addition, residents believed it is inappropriate to test non-cardiac anesthesiologists for TEE skills 2.39 (1.10), but felt it was appropriate to test non-regional anesthesiologists in Ultrasound skills 3.29 (1.21). Lastly, nearly 80% of the residents think that money was the primary motivating factor behind ABA’s introduction of the OSCE. Over 96% residents think that OSCE should be stalled, either permanently scrapped (60.8%) or paused (35.8%).

CONCLUSIONS: Anesthesiology residents overwhelmingly indicated that the OSCE does not serve any useful purpose and should be immediately halted.

 

[s4280390]

try UBP online and offline course. I used the online and it was very helpful. Also look at the breakdown of the OSCE . IC US and monitoring makes up 3/5 of 5 necessary to pass

What if you feel really good about all stations except monitors (feel like I missed 2 out of 3 scenarios). Will I fail the OSCE portion?

 

[IMGASMD]

What if you feel really good about all stations except monitors (feel like I missed 2 out of 3 scenarios). Will I fail the OSCE portion?

Probably not if you killed everything else.

 

[Propo Sapiens]

I guess you the anesthesiology residents are interested in the findings of our OSCE survey. The following is the abstract
Title: Residents’ perspectives on the introduction, conduct and value of the Objective Structured Clinical Examination-Results of the 1st nationwide questionnaire survey

Abstract

Passing the Objective Structured Clinical Examination (OSCE) is currently a requirement for the majority of candidates to gain American Board of Anesthesiology (ABA) initial certification. Many publications from the ABA have attempted to justify its introduction, conduct and value. However, the ABA has never attempted to understand the views of residents.

A total of 4237 residents and fellows at various training levels from 132 programs were surveyed by asking to fill a Google questionnaire prospectively between March 8th, 2021 and April 10th, 2021. Every potential participant was sent an individual email followed by 2 reminders.

The overall response rate was 16.75% (710 responses to 4237 invitations). On a 5-point Likert scale with 1 as “very inaccurate” and 5 as “very accurate,” the mean accuracy of objective structured clinical examination (OSCE) in assessing communication skills and professionalism was 2.33 (1.00) and 2.14 (1.00) respectively. In terms of the usefulness of OSCE training for improving physicians’ clinical practice, avoiding lawsuits, teaching effective communication with patients and teaching effective communication with other providers, the means on a 5-point Likert scale with 1 as “Not at all useful” and 5 as “Very useful” were 1.86 (1.04), 1.69 (0.88), 1.79 (1.02), and 1.82 (1.07) respectively. Residents unanimously thought that factors such as culture, race/ethnicity, religion and language adversely influence the assessment of communication skills. On a 5-point Likert scale with 1 as “not at all affected” and 5 as “very affected,” the corresponding scores were 3.45 (1.20), 3.19 (1.26), 3.89 (1.30), and 3.18 (1.12) respectively. Interestingly, nationality and political affiliation were also thought to influence this assessment, however, to a lesser extent 2.40 (1.26) and 2.28 (1.26). In addition, residents believed it is inappropriate to test non-cardiac anesthesiologists for TEE skills 2.39 (1.10), but felt it was appropriate to test non-regional anesthesiologists in Ultrasound skills 3.29 (1.21). Lastly, nearly 80% of the residents think that money was the primary motivating factor behind ABA’s introduction of the OSCE. Over 96% residents think that OSCE should be stalled, either permanently scrapped (60.8%) or paused (35.8%).

CONCLUSIONS: Anesthesiology residents overwhelmingly indicated that the OSCE does not serve any useful purpose and should be immediately halted.

shocker

The test is a complete farce. I can see the argument for wanting to make sure people who graduate aren't tools or misrepresent the field of anesthesiology.... but the exam was ill-conceived and honestly ill performed. The amount of suspension of disbelief I had to do to communicate with those actors...

And I have ADHD and thus ADHD-related test-anxiety which is honestly the reason why I screwed up and why I never do as well on exams as I am clinically strong.

The only thing that actually worked for me was meditating for 20 minutes before the exam and going in with a "I don't give a ****" attitude

 

[Propo Sapiens]

What if you feel really good about all stations except monitors (feel like I missed 2 out of 3 scenarios). Will I fail the OSCE portion?

Depends on the miss.

It can be hard if you don't look at echo's daily to be shown a TEE clip of the LVOT for a few seconds and be asked what the finding is. I would say, still rely on the clinical picture and just mention what you're thinking. Don't just say "It's MR and I will give epinephrine". Because they may pick an image with some degree of septal hypertrophy +/- SAM and maybe some MR. EPI is bad for HOCM. Phenylephrine is bad for MR.

A better answer is to incorporate whatever the clinical scenario they have, look at the TEE for volume, function, valves, rhythm and you can always suggest more than one thing or be a little more general but still answer the prompt

 

[IMGASMD]

Depends on the miss.

It can be hard if you don't look at echo's daily to be shown a TEE clip of the LVOT for a few seconds and be asked what the finding is. I would say, still rely on the clinical picture and just mention what you're thinking. Don't just say "It's MR and I will give epinephrine". Because they may pick an image with some degree of septal hypertrophy +/- SAM and maybe some MR. EPI is bad for HOCM. Phenylephrine is bad for MR.

A better answer is to incorporate whatever the clinical scenario they have, look at the TEE for volume, function, valves, rhythm and you can always suggest more than one thing or be a little more general but still answer the prompt

I am not sure about this. I also took it twice.

I don’t remember what I did or didn’t do the first time. But the advice I got was to keep the TEE and monitors simple. Don’t get too fancy with the answers. To paraphrase: the board is not looking for answers only the cardiac anesthesiologists can detect. They’re looking for something “big”. The most troubled answers were from the cardiac trained people.

These screens come and go fast. For some of the scenarios, I didn’t have time to write/read fast enough. I made a few educated this time around. I passed.

The boards example document actually has many links imbedded within the pdf. If you know everything they presented for TEE, I think you’d be fine.

They didn’t really give you a list for abnormalities officially, but if you know everything from the examples, I think you’ll probably be okay. But none of those are really official, so obviously the more you know, the more you know.