Year 1 OSCE

8/6/2019 Year 1 OSCE

1/13

OSCE REVISION SESSION

1st

Year 2009


2/13

OSCE 101SMILE!

Introduce yourself

Ask for consent

Hi! My name is Georgia and I'm a first year medical student from Monash University the GP

has just asked me to ask you a few questions about why you've come in today is that ok?

Speak loudly you'll seem confident!But not too loudly yelling = intimidating

Also have your barcode sticker ready to hand to the examiner -

They'll say/think something like Wow what a prepared and organised student

Even if you have never heard of the procedure you're being asked to perform...

AppearingOrganised = Good First Impression = Good Mark!

Wash your hands or wear gloves!


3/13

General HistoryMy PCL tutor told me last week - All you need to be able to do as an intern is

take a good history

So essentially, this is one of the most important skills you will learn in your

medical career make sure you can do it well!

It's very simple make sure you can do it in your sleep!

PresentingComplaint

W W Q Q A A B

Family History

Social History

Past Medical History

Include Alcohol, Smoking, Illicit Drugs


4/13

CPR

You have entered the room to find Jennifer is

unconscious on the floor.

Task:

Please commence immediate management

including assessment and resuscitation of this

patient, with verbal explanation of each step.


5/13

CPR

D

R

A B

C

D

Put gloves on!

anger

esponseNo Response CALL AN

AMBULANCE

irway

reathing

ompressions

efibrillation

This station requires interaction with the examiner.

Consent??


6/13

General MSExam

Joe Peters, aged 23, comes to see the doctor because he is worried

about his left shoulder. Joe has noticed that sometimes throwing a

baseball is painful. There has beenno recent injury. He plays baseball

every weekend and has recently increased his training.

You are a medical student at your General Practice placement, you

have been sitting in with the GP. The GP has asked you to examine

Joes shoulder.

Task:

Please examine Joes LEFT shoulder and explain

your findings to the patient.


7/13

MSExam

ASK

- Consent

- Current Pain

- If anything is

uncomfortable orhurting

- To remove shirt

LOOK

-Contour and

posture

-Skin

-Swelling

-Muscle bulk

-Compare with

other side

FEEL

Tenderness

Swelling

Bony landmarks

Joints

MOVE

- Passive First

- Flexion

- Extension

- Internal Rotation

- External Rotation

- Abduction

- Adduction

- Compare both

sides

- Active movement

TEST

-Special tests

specific to joint:

- Shoulder:

Painful ArcEmpty can

Winged scapula


8/13

GENERALMS TIPS

- Ask patient to tell you if there's any pain

- Always do passive movement FIRST

- Have patient take their shirt off (if applicable)

- Test BOTH limbs to compare


9/13

Not just Theme IV:

- anatomy

- risk factors


10/13

MSE

Francis Smith is a 22 year old found wanderingnaked outside the local shopping centre last night. He/she

was initially highly agitated but is now more settled however still refuses to say much. Francis lives locally

and there is no record ofprevious contact with the hospital.

Please interview Francis, focusing on the history of the presenting complaint and conduct a Mental State

Examination. You are not required to conduct comprehensive cognitive testingOR a COMPLETEMini

Mental State Examination. You are not required to comment on insight orjudgment.

After 5 12 minutes you will be asked to present your mental State Examination findings to the examiner.

Tasks:

1. Take a BRIEF history of the presenting complaint.

2. Perform a relevant Mental State Examination.

3. Briefly present your Mental State Examination findings to

the examiner.


11/13

MSE

A B S M A T P C

Appearance

- clothing

- gate- posture

Behaviour

- body language

- social appropriateness

SpeechLanguage

Clarity how clearly

Quantity how muchStyle the way they speak

Mood

Lasting, pervasive state

'Like the climate

Ascertained by what the person says

AffectCurrent state, changes and shifts around

'Like the weather

Observable

Considered by: quality, range, reactivity, modulation,

appropriateness

Thought

Stream ascertained through speech. Pressured,

slow.

Form Words, sentences, paragraphs etc. Flightof ideas, formal thought disorder.

Content phobias, obsessions, compulsions,

delusions etc.

Thought alienation not perceived as ones own

thoughts.

PerceptionHallucinations

Illusions

Misinterpretations

Passivity phenomena (something is being forced

upon the person by an external agent).

Disordered self-awareness (depersonalisation)

CognitionEg orientation to

time and place


12/13

BP

Ear exam

Eye exam (these 2 will be a bit limited without proper

equipment...)

MSBack and spine

MSShoulder, elbow and wrist

MS Hip, knee and foot

Neuro upper limb

Neuro lower limb (these 2 could be combined as there is a lot of

overlap?)

General motor/sensory exam


13/13

Documents

Year 1 OSCE