OSCE
Objective structured clinical
examination
• Evaluation of clinical competence through direct observation
• Assess history taking , clinical examination, clinical reasoning,
communication and psychomotor (shows how) skills
• Multiple stations
• Simulated or real patients
OSCE Scenarios
• Students: The following practice OSCE scenarios are provided to help
prepare you for the university exam
• Although these are not the exact stations that you will encounter, the
scenarios are representative of the types of problems that will be tested.
•
• Station 1 - history taking
• Station 2 – clinical examination
• Station 3 – aetcom
• Station 4 – psychomotor skill
• To maximize your learning, we suggest that you:
•
• Practice these scenarios in groups of 3, alternating among Patient,
Student, and Assessor roles.
• Complete and review each scenario individually--it will maximize
your learning if the
• ‘Student’ does not view the other roles before the performance.
• You may wish to print out the patient information, assessor form
and any linked/attached materials for each scenario.
• Limit your time to 5 minutes per scenario. ‘Assessor’ should keep
time and give a 2minute warning.
• Assessor should note questions asked/not asked during the
interviews; consider video or audiotaping to improve recollection and
feedback
• Review and discuss the likely components of the assessor checklist.
• Give each other honest feedback about performance.
Station 1 – history taking
• Leg ulcer
• Soft tissue swelling over the limb
• Gangrene toes
• Varicose veins
• Neck swelling – lymph nodes, salivary gland, benign neck masses
• Parotid swelling
• Oral cavity cancer
• Goiter
• Breast lump
• Jaundice
• Groin swelling
• Scrotal swelling
History of patient presenting with breast Lump
Sr. no Task Marks Marks
allotted obtained
1 Introduce yourself and confirm identity of 1
the patient
2 Chief complaint and lump history (onset 2
duration and progress) with aggravating
and relieving factors
3 Ask for if associated with pain, associated 2
symptoms like nipple discharge, skin
changes, axillary swelling
4 Ask for systemic symptoms , relevant 2
history in other body systems
5 History of Risk Factors. Menstrual and 2
obstetrics history, Family history
6 History of previous breast surgery/ 1
medication/ chronic illness
Total 10
Station 2 clinical examination
• Breast examination, usually using a male simulated patient
• Thyroid examination
• Abdominal examination
• Hernia examination
• Oral cavity examination
• Parotid swelling
Specific tests
• Fluctuation test
• Pulsatility test
• Allen’s test
• Fixity to structures like muscle
• Trendelenburg’s test
• Lymphadenopathy examination – cervical, axillary
• Examinations of the pulses
• Examination of a groin swelling
• Assessment of varicose veins
• Joint examination
Task Marks allotted Marks obtained
Introduce yourself, briefly explain what examination will involve 1
Explain the need for a chaperone , consent to proceed with 1
examination
Hand hygiene , adequately expose the patient for the 1
assessment
Wear gloves, stand on the right side of the patient 1
Inspection of breasts with patients arm by the sides, on their 2
hips, arms above and bending forwards
Palpate each breast with palmer surface of fingers all the 2
regions systematically
Palpate for nipple discharge
Palpate the axillary and supraclavicular lymph nodes 2
Total 10
Station 3 aetcom
• Communication skills – empathetic, non judgemental , non
threatening manner
Scenarios
• Consent taking for hernia surgery
• Consent taking for mastectomy for cancer breast
• Prognosticating the relations of a terminal patient
• Counsel families about treatment and outcome of shock
• Breaking bad news
Task Marks Marks
allotted obtained
Introduces self and confirms identity of the patient 1
Addresses patient by name and provides overview of the 1
interviews purpose
Maintains posture, tone, pace, eye contact that shows care 1
and concern
Opens the discussion by allowing patient/ family to speak 1
(Gathers information)
Communicates clearly and accurate information (shares 1
information), uses everyday language, explains medical terms
Encourages patient/relatives to express himself or herself 1
Attention – shows interest and listens with patience 1
(understands patient perspective)
Empathy- shows compassion with values , validates 1
emotional responses
Reaches agreement about acceptability of diagnostic or 1
therapeutic plans
Asks patient for any unresolved issues and closes interview 1
Scenario 4 – psychomotor skill
• Shows how in a simulated environment
• Simple interrupted suture
• Wound dressing
• Basic bandaging- figure of 8
• Abcess drainage
Task Marks allotted Marks
obtained
1.Explain the patient or relative regarding need of procedure and record informed consent 1
2. Clean the wound and surrounding area with appropriate antiseptic solution. wear well fitting 1
gloves maintain asepsis
3. Local anesthesia is given/ tested/ confirmed. confirm the armamentarium required for 1
suturing
4. Hold the needle holder in dominant hand properly ( thumb and ring finger with index finger as 1
stabilizer
Hold toothed forceps in non dominant hand
5. Load the needle on the needle holder at the tip of the jaws of the needle holder at 2/3 rd from 1
the point of the needle
6*. Needle enters the skin perpendicular to skin . Bites are symmetrical .Passes through full 1
thickness of skin allow the curve of needle
7*. Square knot placed so as to just appose the wound edges with edges everted in a simple 1
interrupted suture
8. Suture material is cut with scissors, supporting the scissors with non dominant hand at 1
appropriate length (1cm)
9. Wound is cleaned with local antibiotic ointment and proper dressing done 1
10. Patient explained about post operative care 1
Total 10
Task Marks Allotted Marks
Obtaine
d
1
1. Take full informed written consent
2. Give test dose of lignocaine - read in 15 mins prior to administration of LA 1
3. Hand hygiene, wear sterile gloves 1
4. Prepare and drape parts. 1
5. Administer local anesthesia; wait 3-5 mins for action. Aspirate and check needle position prior to 1
each injection.
1
6*. Aspirate pus from abscess with wide bore needle to confirm and collect for culture
1
7. Make an incision using No.11 blade (stab knife) at the pointing part, or the most dependent part of
abscess as per case, till pus drains.
8*. Using a sinus forceps extend incision, break all loculi and drain abscess cavity with finger. Curette 1
out the pyogenic membrane.
9. Irrigate abscess cavity with hydrogen peroxide, betadine and saline. Maintain and confirm 1
hemostasis.
10. Pack the cavity with betadine soaked gauze and dress with dressing pads and elastic compression 1
adhesive tape.
Total 10
Task Marks Allotted Marks Obtained
1. Introduce Yourself And Explain Procedure 1
2. Wound Assessment
*Inspect Wound – classify wound based on mode of injury and contamination 1
Observe The Wound For Size, Depth, And Location and document it.
Check For Signs Of Infection, Such As Redness, Warmth, Or Discharge 1
Evaluate Surrounding Skin Check For Swelling, Erythema, Or Other Skin Changes
Around The Wound, Palpate Surrounding Tissue For Tenderness Or Induration
3. Wound Cleansing
Perform Hand Hygiene And Don Sterile Gloves, 1
Use Sterile Saline Or Antiseptic Solution To Cleanse From The Center Outwards 1
Use a gauze with antiseptic solution like povidone iodine to dress the wound 1
Apply a absorbent dressing material over it to adequately cover the wound without 1
overlapping too much
Apply tape or a roller bandage without excessive tightness 1
4. Post-Procedure Care Patient Communication Provide Guidance On When To 1
Change The Dressing And Signs Of Complications
5. Equipment Disposal Dispose Of Used Materials In Appropriate Waste Containers 1
Task Marks Allotted Marks
Obtained
1. Introduce Yourself And Explain Procedure 1
2. Hand hygiene and wear sterile gloves 1
3. Begin the bandage with two circular turns 1
4. Carry the bandages above the joint, around it, and then below it making 1
a figure of eight
5*. Continue above and below the joint, overlapping the previous turn by 1
2/3rd the width of the bandage
6. Terminate the bandage above the joint with two circular turns 1
7. Secure end appropriately 1
8. Ensure finger tips or toe tips exposed for observation 1
9*. Assess that the bandage is not to tight by noting pulse, skin color, 1
finger or toe movements
10. Explain post procedure care and patient communication 1
Total 10
