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:
  • 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!

Please feel free to comment.

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