Just wondering...how many of you have an OSCE?

[scpod]

Well...the Observed Sructured Clinical Exam (OSCE) is over for me. Half of my classmates still have it tomorrow, but I guess it was a wonderful way to start off the two weeks of final exams. During the first semester OSCE you walk into an exam room with a "standardized" patient and take a full history in 15 minutes, then have a 5 minute break. You walk into another exam room and take another full history in 15 minutes, then you have 20 minutes to write up both of them, complete with an assesment and plan. You HAVE to pass this exam in order to continue. We've been doing practices for this since the very first week of school. Two of us have been "double-teaming" a staff physician every other week since the first of August, and practicing on each other as well. But...this was the first time that it really felt like you were "doctor-like." I was soo mazed after the first ine because I knew exactly what was going on. I wanted write up an Rx and tell her that, "It's gonna be alright soon." (These 'standardized' patients are pretty good at it 🙂)

It's pretty hard in some ways, since you are timed so critically, but in some ways I had more "fun" than I've had in my entire semester. It's pretty scary, knowing that you have to do well in order to get to the next semester, but it's also a really great feeling, because it made all the mundane basic science crap seem really important for a change. I guess it put things into perspective.

I guess I was just wondering if any of you other guys go through this and what your feelings are. Best of luck to you ALL on exams!!!!!!!😀 😀 😀

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[Dr JPH]

PCOM does the OSCE.

Good prep for the COMLEX II PE

Too bad real patients arent as easy to intervew as the standardized patients.

You will never get another "my chest hurts, my arm feels heavy, Ive been sweaty all day, my nitro helped but the pain is back and my father had a heart attack when he was my age. whats wrong with me?"

 

[Jamers]

Well...the Observed Sructured Clinical Exam (OSCE) is over for me. Half of my classmates still have it tomorrow, but I guess it was a wonderful way to start off the two weeks of final exams. During the first semester OSCE you walk into an exam room with a "standardized" patient and take a full history in 15 minutes, then have a 5 minute break. You walk into another exam room and take another full history in 15 minutes, then you have 20 minutes to write up both of them, complete with an assesment and plan. You HAVE to pass this exam in order to continue. We've been doing practices for this since the very first week of school. Two of us have been "double-teaming" a staff physician every other week since the first of August, and practicing on each other as well. But...this was the first time that it really felt like you were "doctor-like." I was soo mazed after the first ine because I knew exactly what was going on. I wanted write up an Rx and tell her that, "It's gonna be alright soon." (These 'standardized' patients are pretty good at it 🙂)

It's pretty hard in some ways, since you are timed so critically, but in some ways I had more "fun" than I've had in my entire semester. It's pretty scary, knowing that you have to do well in order to get to the next semester, but it's also a really great feeling, because it made all the mundane basic science crap seem really important for a change. I guess it put things into perspective.

I guess I was just wondering if any of you other guys go through this and what your feelings are. Best of luck to you ALL on exams!!!!!!!😀 😀 😀

No, but reading that I wish I had one! We had one stand. pt. encounter so far :-(.

 

[babyruth]

Really? They must have changed the PD curriculum since I was there because we had quite a few that first semester if I am remembering correctly.

Also, what I heard is that the lady that set up our standardized program at DMU was the one who helped develop the PE in Pennsylvania. Bu that was three years ago, so not sure if it has changed from when we did it.

I do my PE on the 19th. Keeping my fingers crossed.

 

[Jamers]

Really? They must have changed the PD curriculum since I was there because we had quite a few that first semester if I am remembering correctly.

Also, what I heard is that the lady that set up our standardized program at DMU was the one who helped develop the PE in Pennsylvania. Bu that was three years ago, so not sure if it has changed from when we did it.

I do my PE on the 19th. Keeping my fingers crossed.

I think it happens second semester. According to them, we were the first class to ever have one our first semester and that was for behavioral medicine.

 

[Doc 2b]

NSU has them at the end of MS2, we have like 5 or 6 in a row. You guys only have 2 and at the end of your first semester? We have an SPE everymonth or every system which sounds similar but that's only with one patient.

 

[hyperbaric]

TCOM does one per semester.

 

[scpod]

You guys only have 2 and at the end of your first semester? We have an SPE everymonth or every system which sounds similar but that's only with one patient.

Beginning with the 2nd week of school, We meet with a doctor 8 to 10 times during the semester and s/he plays the patient role, Obviously, like any class, you are also expected to practice with your classmates during the semester to get good at it. You aren't actually graded for this part (other than for participation), but you are regularly critiqued. The OSCE at the end of the semester is designed to be like the COMLEX PE, timed and graded, only we have two standardized patients instead of twelve. It seems to be a good way to introduce you to the clinical aspects. Actually, the standardized patients are kind of a relief. They are a lot more forthcoming with information than most of the doctors are. Some of the doctors make you go through hell to get anything out of them.

 

[Luba Licious]

Beginning with the 2nd week of school, We meet with a doctor 8 to 10 times during the semester and s/he plays the patient role, Obviously, like any class, you are also expected to practice with your classmates during the semester to get good at it. You aren't actually graded for this part (other than for participation), but you are regularly critiqued. The OSCE at the end of the semester is designed to be like the COMLEX PE, timed and graded, only we have two standardized patients instead of twelve. It seems to be a good way to introduce you to the clinical aspects. Actually, the standardized patients are kind of a relief. They are a lot more forthcoming with information than most of the doctors are. Some of the doctors make you go through hell to get anything out of them.

I agree (with your first post, too). As stressed out as I was about the thing (had a horrible mock OSCE), it turned out to be pretty cool. Of course, as I was doing my write up I kept thinking of things I should have asked, and probably will get nailed for it, but it was cool to feel like my work was going to pay off someday.

 

[Luba Licious]

Well...the Observed Sructured Clinical Exam (OSCE) is over for me. Half of my classmates still have it tomorrow, but I guess it was a wonderful way to start off the two weeks of final exams. During the first semester OSCE you walk into an exam room with a "standardized" patient and take a full history in 15 minutes, then have a 5 minute break. You walk into another exam room and take another full history in 15 minutes, then you have 20 minutes to write up both of them, complete with an assesment and plan. You HAVE to pass this exam in order to continue. We've been doing practices for this since the very first week of school. Two of us have been "double-teaming" a staff physician every other week since the first of August, and practicing on each other as well. But...this was the first time that it really felt like you were "doctor-like." I was soo mazed after the first ine because I knew exactly what was going on. I wanted write up an Rx and tell her that, "It's gonna be alright soon." (These 'standardized' patients are pretty good at it 🙂)

It's pretty hard in some ways, since you are timed so critically, but in some ways I had more "fun" than I've had in my entire semester. It's pretty scary, knowing that you have to do well in order to get to the next semester, but it's also a really great feeling, because it made all the mundane basic science crap seem really important for a change. I guess it put things into perspective.

I guess I was just wondering if any of you other guys go through this and what your feelings are. Best of luck to you ALL on exams!!!!!!!😀 😀 😀

Not to split hairs, but the O is for "Objective". Which is stupid because the whole thing is SUBJECTIVE. And it's funny how in the syllabus they spell it out, then say that it is, by necessity, subjective. So why not call it a SSCE? 😕

 

[group_theory]

PCOM does the OSCE.

Good prep for the COMLEX II PE

Too bad real patients arent as easy to intervew as the standardized patients.

You will never get another "my chest hurts, my arm feels heavy, Ive been sweaty all day, my nitro helped but the pain is back and my father had a heart attack when he was my age. whats wrong with me?"

Ohhh ... that's easy ... there is a somatic dysfunction (also known as an osteopathic lesions to old timers) in the T4-T5 area that is causing these symptoms ... a perfect indication to do OMM on that area ... also don't forget to dome the diaphram and do some lymphatics drainage techniques to enhance circulations ... and probably some cranial too since the primary respiratory rate must be slow due to increase stress/pain and anxiety

What's that? Get a 12-lead EKG and compare to old EKG, get cardiac enzymes, give ASA and beta-blocker (if no contraindications), and get ready for cath lab? But we're DO students, not MD students (haven't you guys noticed i've been signing my notes OMS?) 😕





OSCE is good prep for the COMLEX II PE ... unless you have already taken the COMLEX II PE ... then it's just another hoop to jump through

 

[scpod]

O is for "Objective".

My bad 😳

 

[DragonWell]

Not to split hairs, but the O is for "Objective". Which is stupid because the whole thing is SUBJECTIVE. And it's funny how in the syllabus they spell it out, then say that it is, by necessity, subjective. So why not call it a SSCE? 😕

Actually, the standardized patients are kind of a relief. They are a lot more forthcoming with information than most of the doctors are. Some of the doctors make you go through hell to get anything out of them.

Since it is so subjective, how do they grade something like this? (OSCE or PE?)

My first patient was fine, but my second seemed PO'd as soon as I walked into the room. She seemed ready to pick apart any question I asked:

Me: Have you ever been diagnosed with any medical disease?
Patient: What do you mean by medical disease?
Me: Uhh, cancer, heart disease, diabetes, hypertension?
Patient: You mean do I have any medical conditions?
Me: Uhh, yeah.

Me: Have you ever been hospitalized?
Patient: No...Do you mean treated in the hospital?
Me: Um, yes.
Patient: Oh, yes, I've been treated in the hospital.

Kind of painful to play semantics with her for 15 minutes, but I persevered. She also checked her script a few times during the interview, which made me feel a little less confident that she was giving me the "correct" info. All in all it was a good experience, and I think I'll come out OK, but the second patient kind of freaked me a bit. It's kind of scary that so much of our grade is riding on one person's opinion of us. What happens if they wake up on the wrong side of the bed, or don't care for the tie we picked that day?

 

[Red Beard]

We have one at COMP as well. We're taking our semester final OSCE tomorrow actually. We have 30 minutes to take a history and perform a basic physical exam.

For one 4-hour session per week since the beginning of school we have been working with standardized patients or with each other. Its been alright so far...although sometimes it seems a little disorganized and annoying to be doing for 4 hours when you have a hard test coming up.

Something I thought was funny was seeing an advertisement in the newspaper calling for standardized patients. Being so close to LA, we get a lot of out of work actors who have a certain 'flair.'

 

[Red Beard]

Since it is so subjective, how do they grade something like this? (OSCE or PE?)

My first patient was fine, but my second seemed PO'd as soon as I walked into the room. She seemed ready to pick apart any question I asked:

Me: Have you ever been diagnosed with any medical disease?
Patient: What do you mean by medical disease?
Me: Uhh, cancer, heart disease, diabetes, hypertension?
Patient: You mean do I have any medical conditions?
Me: Uhh, yeah.

Me: Have you ever been hospitalized?
Patient: No...Do you mean treated in the hospital?
Me: Um, yes.
Patient: Oh, yes, I've been treated in the hospital.

Kind of painful to play semantics with her for 15 minutes, but I persevered. She also checked her script a few times during the interview, which made me feel a little less confident that she was giving me the "correct" info. All in all it was a good experience, and I think I'll come out OK, but the second patient kind of freaked me a bit. It's kind of scary that so much of our grade is riding on one person's opinion of us. What happens if they wake up on the wrong side of the bed, or don't care for the tie we picked that day?

Interesting. Our SPs are given an evaluation sheet to fill out after we see them. "Rapport" is only a little part of the grading. Its mostly "did the student ask about x,y,z." Seems more fair and less subjective that way than letting some actor arbitrarily assign you a grade.

 

[scpod]

She also checked her script a few times during the interview, which made me feel a little less confident that she was giving me the "correct" info.

My two were absolutely great. Of course I had the 3:50PM slot on the first day, so they had done quite a few that day already. They should have be familiar with the scenario by then.

 

[scpod]

Interesting. Our SPs are given an evaluation sheet to fill out after we see them. "Rapport" is only a little part of the grading. Its mostly "did the student ask about x,y,z." Seems more fair and less subjective that way than letting some actor arbitrarily assign you a grade.

Well, 50% of the grade comes from the writeup, so they can tell if you asked all the right questions. But, 50% of it comes from the patients evaluation of you and how confident they are of your abilities, your demeanor, eye contact, etc. That's an important part to look at as well. Of course, 50% of your grade might be a little much.

 

[ImNoSuperman]

We have OSCE's at the end of each block at OUCOM. My first was after blood and immunity; it was an iron deficiency anemia caused by menorrhagia... only problem was that my patient was in her 60's and already went through menopause. Good experience, likewise.

 

[San_Juan_Sun]

We have OSCE's at the end of each block at OUCOM. My first was after blood and immunity; it was an iron deficiency anemia caused by menorrhagia... only problem was that my patient was in her 60's and already went through menopause. Good experience, likewise.

vag bleed + after menopause = endometrial CA until proven otherwise

 

[raptor5]

Had OSCE at PCOM. Do not know how useful it was b/c I was still clueless when 3rd year started. My notes look nothing like my OSCE notes did. I try to keep things to a page or less now.The funny thing is I still see interns writing 2 pages (progress notes).

 

[ImNoSuperman]

vag bleed + after menopause = endometrial CA until proven otherwise

Thanks for the response, but we won't have reproductive until end of 2nd year. This was just Blood and Immunity and the OSCE was dealing primarily with oncological/hematological disorders. I asked one of the preceptors during our briefing after the OSCE and she said, "The patient was lying, she still has a menstrual cycle." The patient probably shouldn't have said that she was post-menopause. We had a slide in the exam room of a peripheral blood smear that showed microcytic/hypochromic RBC's. This w/ her presentation confirmed my suspicions. I'll keep your suggestion in mind when we get to reproductive block next year! Peace.