How to crush the OSCEs?

[SandP]

I am an M2. Is there anyone out there that consistently crushes OSCEs? How do you prepare/what do you do? I keep getting lower marks in my communication skills even though I ask open ended questions and the comments from the graders don't make sense (one said, "watch note writing") as the only explanation (what does that even mean?). Others say that I didn't probe to understand the patient's concerns of what they thought the diagnosis is.

I guess those are things easy to correct, but they seem minor to dock my communication grade so much. The interesting thing is that when I had seen a video of a doctor interviewing a depressed patient, that was the only case in which I performed better than my peers in communication. I learn by seeing, I guess.

What can I do to really excel at OSCEs?

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[bashwell]

It's good you're asking as an M2. I think I learned most of mine as an M3 and beyond.

In general, the best thing to do is practice, practice, practice. But remember it's not practice alone that makes perfect, but "perfect" practice makes perfect, meaning someone can do a bunch of histories and physical exams but be doing all of them in the wrong way. Instead, you have to watch someone who knows what they're doing and model them.

And as it's often said, "see one, do one, teach one". So watch someone who knows what they're doing take a good history and physical exam, then try it yourself (hopefully they can watch you do it and offer you feedback), and eventually you can get to the point where you are teaching others which helps reinforce what you know too.

 

[SandP]

It's good you're asking as an M2. I think I learned most of mine as an M3 and beyond.

In general, the best thing to do is practice, practice, practice. But remember it's not practice alone that makes perfect, but "perfect" practice makes perfect, meaning someone can do a bunch of histories and physical exams but be doing all of them in the wrong way. Instead, you have to watch someone who knows what they're doing and model them.

And as it's often said, "see one, do one, teach one". So watch someone who knows what they're doing take a good history and physical exam, then try it yourself (hopefully they can watch you do it and offer you feedback), and eventually you can get to the point where you are teaching others which helps reinforce what you know too.

Did you ask to see one on the wards? How can I practice before that?

 

[.hematoma.]

I've gotten A's on all my OSCE's so far for what it's worth. I personally think it comes down to you showing that you are legit concerned for the SP. That means shaking their hand firmly, asking your standard OLDCARTS + "has this happened before" + "what do you think is causing this" in a non-robotic manner, and incorporating little things to make the patient hella happy with you. I do the following:

1. While washing my hands I ask them where they drove from, and then I say some bull about the weather. If they live near a beach, I ask if they think their beach is better than the beach of another city. Get it?

2. If they comment on something about their life that is worth being nice about, just do it. If pt is an army vet, thank them for service. If pt tells you she been married to husband for 40 years, congratulate her with a smile and tell her how great it is she's been with him that long. I can't tell you how many times little comments like this pleasantly surprise the patient and they can't hold in a smile. You want that; in real life, if you do this, they'll come back to you for future appointments.

3. Touching. Depends on the patient, but I'll say that most patients appreciate a kind touch, but be smart about it. WWII vet with PTSD? Don't hold his hand. 70yo woman who wants to spend more time with grandkids but can't because of joint pain? Tap her hand lightly when congratulating her on the great family she's raised. Touch is also about the physical exam. When you are listening to heart sounds, listen with one hand and put your other hand on the patient's shoulder. And Jesus help the 60 yo SP get up from a supine position by holding her hand.

4. Smile damn it. If you don't smile and are nervous, your SP will feel it. Remember they teach us mirroring? How we are supposed to mirror our patients? Guess what, they do it to. If you feel nervous or uptight, they'll be like that too.

5. Don't go on a rampage about all the medical jargon you know. If someone has diabetes and they don't understand what it is, don't talk about how glucose promotes potassium channel closure for insulin release. Make an analogy to real life, like a tug of war between insulin and glucose and someone cutting the rope. Ask them questions to clarify what you are saying.

6. Be in the moment. Make eye contact. The patient wants 100% of your attention; even if you don't give a rat's ass to be there, fake it.

 

[LyMed]

I don't usually write anything unless I have to. It's more just testing your communication skills. I just talk to the patient and can go over an entire hx and recall it without having to look down.

Smile, pause, be polite and empathetic.

 

[deleted407021]

My school is very clinical skills/OSCEs heavy even in first year and something I've noticed about myself and my fellow classmates who also do very well with SPs is that most of us have had a lot of face-to-face volunteer or work experience with real patients, in the past. It also helps that I worked closely with some very good physicians who were loved by their patients and I try to emulate how they worked. Lots of good eye contact, asking about thoughts and feelings and showing genuine interest. Good doctors never seem to talk down to their patients and they explain things in plain English. I even write without breaking eye contact most of the time and a few folks have mentioned they appreciate that. Give the patient time to talk -- they're telling you a story.



Idk, think of a really good doctor you know of, if you have one, and try to be like him or her

 

[firstaidforever]

Our osce awards went to the most charismatic students. It really requires more social talent than academic know-how.

Practice being friendly more than anything else.