Anesthesiology OSCE Exam

[Pepperblock]

Hi guys last year I took the SOE and OSCE. Unfortunately I did not pass the OSCE part. Based on them I failed in the non technical parts of the OSCE. Informed consent, the QI, etc. US and diagnostic station I did great. My point is that I really don't know what else to do for this OSCE. I thought that I rock this part that day and that was not the case. Any advise? Have any of you do the Ho review in Raleigh for the OSCE?

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[getdown]

For the osce portion all you have to do is go over the PDF examples they have on the aba site. They were pretty much exactly what those examples were. The only thing you had to study we're maybe the basic TEE views if you're not cardiac trained. I would NOT spend any money prepping for the OSCE portion.

For the QI. Just use the plan - do - study - act format.
PDCA - Wikipedia

Honestly, I don't know what else to tell you about informed consents or going over bad outcomes with patients. Gotta be thorough, be compassionate, show empathy, show them you care, reassure them your gonna have their best interest in mind ... You know basically what you would do in your daily practice. Unless you don't do that which I would then say you should start.

You can PM me for more questions or my address cause I just saved you couple thousand on Ho courses.

 

[Pepperblock]

For the osce portion all you have to do is go over the PDF examples they have on the aba site. They were pretty much exactly what those examples were. The only thing you had to study we're maybe the basic TEE views if you're not cardiac trained. I would NOT spend any money prepping for the OSCE portion.

For the QI. Just use the plan - do - study - act format.
PDCA - Wikipedia

Honestly, I don't know what else to tell you about informed consents or going over bad outcomes with patients. Gotta be thorough, be compassionate, show empathy, show them you care, reassure them your gonna have their best interest in mind ... You know basically what you would do in your daily practice. Unless you don't do that which I would then say you should start.

You can PM me for more questions or my address cause I just saved you couple thousand on Ho courses.

Thanks, but that is exactly my thing. During the test I did the more compassionated possible talks with coherent assessment and plans. Even literally kneeling to the surgeon. Ethical issue, not an easy one but I said the same as my friend said. It is just frustrating.

I really appreciate your advise. That is exactly my point. Let see if one of the palliative people here can mock me.

 

[Gern Blansten]

Thanks, but that is exactly my thing. During the test I did the more compassionated possible talks with coherent assessment and plans. Even literally kneeling to the surgeon. Ethical issue, not an easy one but I said the same as my friend said. It is just frustrating.

I really appreciate your advise. That is exactly my point. Let see if one of the palliative people here can mock me.

I am going to go out on a limb and guess English is not your first language, based on your use of "compassionated" and a few other interesting words. If you literally kneeled in front of the surgeon, it was likely at that point that you failed. If, by kneeling, you actually meant that you allowed the surgeon to bully you into an unsafe anesthetic plan, again, it was likely at that point that you failed. I am guessing that your communication is lacking as well if your English is not very good. I am going to take the other side of this and say that you actually do need someone to assist you with this exam. The examiners want to know that you will be a strong physician who is an advocate for the patient's well-being and who will not roll over to all the whims of the surgeon who wants to proceed simply because it is most convenient for him/her.

Based on what you wrote, you are either trolling us or you completely rolled over and proceeded with a case that likely should have been cancelled instead of recognizing the issue, optimizing the patient, and planning for a return to the OR at a later date.

Good luck.

 

[Pepperblock]

I am going to go out on a limb and guess English is not your first language, based on your use of "compassionated" and a few other interesting words. If you literally kneeled in front of the surgeon, it was likely at that point that you failed. If, by kneeling, you actually meant that you allowed the surgeon to bully you into an unsafe anesthetic plan, again, it was likely at that point that you failed. I am guessing that your communication is lacking as well if your English is not very good. I am going to take the other side of this and say that you actually do need someone to assist you with this exam. The examiners want to know that you will be a strong physician who is an advocate for the patient's well-being and who will not roll over to all the whims of the surgeon who wants to proceed simply because it is most convenient for him/her.

Based on what you wrote, you are either trolling us or you completely rolled over and proceeded with a case that likely should have been cancelled instead of recognizing the issue, optimizing the patient, and planning for a return to the OR at a later date.

Good luck.

I understand your point. And true, english is not my first language, but I use does words in the sense that I was very careful in wording and the reasoning of the cancelation, further stabilization and plan to follow to bring the patient back in and coherent manner. The same with the informed consent which I heard the change it after my group because they were expecting 4 consents for a 7 min period. But may be is what you said, they did not understand the language but I never had an issue with that ever, even in the CS the Oral part of this test or in my residency/fellowship. This is not to scare anyone, I know no one (personally) who has fail this test, not the OSCE nor the SOE (for my year of training I mean)...

Thanks anyway.

 

[Gern Blansten]

 

[Pepperblock]

Yup, the 4%. Looking back into the content outline I figured. I did not do a couple of task for the respective stations. A $1,100+ mistake.

 

[parliamentarian]

Did you actually kneel during the exam? As in physically getting down on one knee?

 

[Pepperblock]

Did you actually kneel during the exam? As in physically getting down on one knee?

lol a joke, I meant to say that I did it in a professional way and very informative but I did not cover a couple of the things in their check list.

 

[pgg]

Everyone at the ABA that had anything to do with creating this ridiculous OSCE debacle needs a firm kick square in the gonads.

 

[xtina0]

I'm going over the osce stuff and without giving away the details can you guys say the monitors section was straightforward or were there detailed changes (CVP tracing you need to catch like Aortic stenosis). or was it just basic rhythm changes?

Also if you know all the TEE images they have listed are you good as well?

 

[anbuitachi]

definitely not looking forward to this test. can not believe someone created this garbage BS and is charging 4 figures for it. someone should be protesting.

 

[2Fast2Des]

Money money money money! That's why. Not sure why the ABA is trying to milk us when they can just increase supervising ratios if they are really want to make some moolah

 

[getdown]

I'm going over the osce stuff and without giving away the details can you guys say the monitors section was straightforward or were there detailed changes (CVP tracing you need to catch like Aortic stenosis). or was it just basic rhythm changes?

Also if you know all the TEE images they have listed are you good as well?

Go to the ABA OSCE site and look over their review material. There are video examples on there of what you'll see which mirrors what you see day of exam quite well.

 

[DM27]

I can second that their examples (and any monitoring video questions you may have had on your ITE) replicate the format/layout of the monitors section well from what people have told me.

 

[vector2]

I'm going over the osce stuff and without giving away the details can you guys say the monitors section was straightforward or were there detailed changes (CVP tracing you need to catch like Aortic stenosis). or was it just basic rhythm changes?

Also if you know all the TEE images they have listed are you good as well?

If aortic stenosis can be caught using a CVP tracing then I definitely need to go back to medical school.

 

[xtina0]

If aortic stenosis can be caught using a CVP tracing then I definitely need to go back to medical school.

My fear is that they can give you the cvp tracing and ask you to identify the likely pathology just like they do on the boards.

Thanks everyone. It seems as though it will be straight forward. Not cvp tracing specifics ... hopefully.

 

[getdown]

My fear is that they can give you the cvp tracing and ask you to identify the likely pathology just like they do on the boards.

Thanks everyone. It seems as though it will be straight forward. Not cvp tracing specifics ... hopefully.

They try to make it relevant for generalists. If it's a pathology that requires someone to be cardiac trained to recognize, it's likely not going to on there. PA pressures are fair game though.

 

[AdmiralChz]

My fear is that they can give you the cvp tracing and ask you to identify the likely pathology just like they do on the boards.

Thanks everyone. It seems as though it will be straight forward. Not cvp tracing specifics ... hopefully.

Yep you better know which pathology impacts the x vs y descent.

...

Come on. The stuff they pick is mega obvious and not subtle - I went through it and it wasn’t hard, at all.

 

[deleted171991]

If aortic stenosis can be caught using a CVP tracing then I definitely need to go back to medical school.

It can. If you pass the central venous catheter through the PFO.

I have stopped (re)learning about the CVP tracing 5+ years ago. I have NEVER seen ANYBODY diagnose ANYTHING just by looking at one.

 

[Pepperblock]

I'm going over the osce stuff and without giving away the details can you guys say the monitors section was straightforward or were there detailed changes (CVP tracing you need to catch like Aortic stenosis). or was it just basic rhythm changes?

Also if you know all the TEE images they have listed are you good as well?

I had just monitor changes. Easy things that I guess I cannot share... basically the same way they describe in the content outline. MI,PEA,nonstemi,stemi, insuflation changes, anaphylaxis, bronchospasm. Just identify changes and most likely Dx.
TEE, be ready for treatment of the things in the pathology list. The same things you have to be prepare for your oral portion..
I hope this helps you. Best.

 

[wickedskillz]

If you failed osce based on the communication portions it isn't an easy problem to fix. You'll of course want to improve for next time, but I think it's a hard part of the test to practice for.

I had a patient family that I had to describe a complication to, and a surgeon that wanted to proceed despite my medical advice. In both situations, the actor stayed very angry throughout the encounter despite my reassurances, and I had to repeat things like saying sorry again and again. In real life breaking bad news situations, I feel like most people have the initial emotional reaction of anger/grief, you address it, give them time to process and usually they'll calm down and move on. I like to try to focus most of the conversation on helping them move on. This exam didn't allow for that, which made it challenging.

I would probably start searching YouTube for videos of informed consent, breaking bad news etc. You want to emphasize being empathetic, staying calm and professional, making sure you listen well and answer questions, etc.

After that, you probably will have to ask some colleagues to role play with you and just try to find little ways to improve your approach.

I don't think the exam situation is very realistic and very possibly you have no problems with this in actual clinical practice. You just need to know how to talk like the aba wants to you to talk for one morning.

 

[Pepperblock]

If you failed osce based on the communication portions it isn't an easy problem to fix. You'll of course want to improve for next time, but I think it's a hard part of the test to practice for.

I had a patient family that I had to describe a complication to, and a surgeon that wanted to proceed despite my medical advice. In both situations, the actor stayed very angry throughout the encounter despite my reassurances, and I had to repeat things like saying sorry again and again. In real life breaking bad news situations, I feel like most people have the initial emotional reaction of anger/grief, you address it, give them time to process and usually they'll calm down and move on. I like to try to focus most of the conversation on helping them move on. This exam didn't allow for that, which made it challenging.

I would probably start searching YouTube for videos of informed consent, breaking bad news etc. You want to emphasize being empathetic, staying calm and professional, making sure you listen well and answer questions, etc.

After that, you probably will have to ask some colleagues to role play with you and just try to find little ways to improve your approach.

I don't think the exam situation is very realistic and very possibly you have no problems with this in actual clinical practice. You just need to know how to talk like the aba wants to you to talk for one morning.

Best advice, thanks a lot!

 

[Pepperblock]

Hey guys. Thanks for your advise. I passed the OSCE this time. At last Board Certified!.
UBP OSCE review is very good and I strongly recommend it.
Thanks a lot!

 

[wickedskillz]

Hey guys. Thanks for your advise. I passed the OSCE this time. At last Board Certified!.
UBP OSCE review is very good and I strongly recommend it.
Thanks a lot!

Lmao they have an osce review now?? Congrats on passing friend, glad you knocked it out!!