Really enjoyed the opportunity to provide RACGP OSCE feedback today in a pre-exam course. Key points to focus on:
- READ the task, write down the key points in reading time, stop during the case and check where you’re up to.
- Have a plan. In reading time think about every case as a new patient – pmhx, psu hx, meds, allergies, social, fhx, cigs, alc, immunization, pap, mammo etc. Write it down on your paper so you can check it off!
- Think about your differentials and use an acronym as a reminder: http://radiopaedia.org/articles/surgical-sieve-mnemonic.
- What is the most likely diagnosis, an alternative and the thing you shouldn’t miss?
- There is prevention usually in every case. Read the Red book. Choose one activity a week until the exam to focus on in your practice. Eg. ask everyone >70 about falls prevention.
- Learn de-stressing techniques – leave the ‘failed case’ behind. You can do not so well and still pass. Importantly move on and give the next case your full attention – Just as we do in real life.
- Don’t talk just about the ‘disease’ but also the ‘dis-ease’. Consider the impact of the diagnosis on the patient’s ADLs and lifestyle.
- Ask a supervisor or peer to watch your practice, even if only one consult a week and to give you feedback.
- Going to work is the best practice! But this relies on sound systems and groundwork and feedback.
- There is no point making empathic statements for the sake of it. They should not be tokenistic.
- Patients don’t like being told they are obese or overweight. Relate it to their current problem and use as a management technique. E.g. Mrs X, I think it’s useful for us to talk about keeping in the healthy weight range – this might assist with improving your back pain. Much more patient-centered than ‘you are obese’.
- Thoughts and comments welcome!