O'Neill BSc(Hons) / Evans MBChB / Evans Macleod's Clinical OSCEs - E-book

Macleod's Clinical OSCEs - E-book
1. Auflage 2014
ISBN: 978-0-7020-5482-2
Verlag: Elsevier HealthScience EN
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 479 Seiten

This new book for medical students contains over 60 of the most commonly encountered OSCE stations in medicine and surgery. The OSCEs are arranged according to type of skill; for example history-taking, ethics and communication, physical examination. This is an accessible book for students under pressure who are revising for a clinical OSCE. It provides simple advice, tips about preparation, and will be easily understood. It provides sample OSCE station questions and simulated patient scripts (with answers) for practice at home.Provides sample OSCE station questions and simulated patient scripts (with answers) for practice at home. Will give an insight into how to 'Get inside the examiners head' to help the student do better in the OSCE station. Highlights 'red flag' situations and explains the underlying importance of these topics. Includes advice both on how to excel and on common errors at each OSCE station. Several of the OSCE stations give details of how more advanced students would be expected to perform at higher levels. Includes online access to sample marking sheets.

Autoren/Hrsg.

O'Neill BSc(Hons), MBChB

Evans MBChB, Mrcgp

Evans, Alexandra

Pattison BSc, MBChB

Pattison, Tim

Tolhurst-Cleaver MA (Cantab), MB BChir

Tolhurst-Cleaver, Meriel

Tolhurst-Cleaver MBChB, MRCP(Lon)

Tolhurst-Cleaver, Serena

Leseproben

1 Introduction to the OSCE
1.0 Introduction to the book   3 1.1 What is an OSCE?   4 1.2 How to get the most from this book   5 1.3 General tips for OSCE candidates   8 1.4 Specimen OSCEs   10 1.5 Sample mark-sheet and summary of learning sheet   11 1.0 Introduction to the book This book is designed to give you an approach to each type of OSCE station that you are likely to encounter but does not contain every possible OSCE scenario. It is not just a collection of facts or lists but is a workbook to help you prepare effectively. Often the approach to a station is as important as the underlying knowledge. Use this book later on in your revision so you can have it as a guide to practice in conditions as close to your examination as possible. We suggest not using this book in the initial revision stages or simply reading it cover to cover, as it does not contain all of the required knowledge. Other books in the Macleod’s Clinical Examination series will be more useful in the early revision stages, such as Macleod’s Clinical Examination or Macleod’s Clinical Diagnosis. This introduction gives you some hints and tips for the OSCE as well as how to use the book within a revision programme. You should use it to practise real-time stations in groups so you can learn from each other under examination conditions. For ease, we have divided station types into six chapters, • Chapter 2: History taking • Chapter 3: Examination skills • Chapter 4: Practical skills • Chapter 5: Communication, ethics and explanation • Chapter 6: Prescribing and handover • Chapter 7: Acutely unwell patients Each chapter contains a broad range of scenarios that could be tested in OSCEs. Each scenario follows the same template that highlights important points. Some of these are about how to approach the station; some relate to clinical knowledge and expertise. We have included hazard warnings for key points in the station and also a guide on how to excel or common mistakes that are made. We have included online mark-sheets and other material to structure and guide your learning. Each station is graded as below, but many have station extensions that make the station more (or less) complex. You can also think of your own variations to each station. Obviously the OSCE that you take will depend on your level of experience, with more complex stations coming later in your career. Basic stations—These are designed for candidates who are taking their first OSCE, usually at the start of clinical practice. They are often based on one particular skill, such as performing an examination or a practical procedure. Intermediate stations—These are designed for candidates who are further on in their training and may combine some diagnostic and clinical reasoning skills or data interpretation and explanation. Advanced stations—These are likely to come at the end of medical school or in postgraduate exams. They include focused examinations, often combining a number of skills to be close to a real clinical experience. Candidates who have spent extensive time with patients are more likely to perform well. Timing is always crucial in these complex situations. We realise that exams can be very stressful, but would encourage you to use this book with friends to help each other. The best way to pass the OCSE is to practise the OSCE. In the words of Arnold Palmer, ‘The more I practice, the luckier I get.’ 1.1 What is an OSCE? An OSCE is an Objective Structured Clinical Examination, which has been in common use for over twenty years. OSCEs are becoming increasingly sophisticated and more like real clinical situations, rather than a test of a particular skill (Fig. 1.1.1). They often contain an element of different skills, such as taking a history, interpreting a relevant result and then explaining to the patient. Figure 1.1.1 Clinical skills lab OSCEs were developed to reduce the variability in marking candidates. In an ideal assessment, the variability in scores should all come from the difference in the competence of the students. Unfortunately, in clinical examinations much of the variability can come from other factors. The OSCE reduces the variability by decreasing some of these factors. Usually, the OSCE takes the form of a ‘circus’ with a number of ‘stations’. Each station lasts a fixed time and then the student rotates. In this way, all students perform the same task and are asked the same questions by the same examiner(s) at each station. The exam often has between 10 and 20 stations, with each lasting between 5 and 15 minutes and the exam usually taking 1–2 hours. Each medical school or postgraduate body will design their OSCE differently and you should make sure that you know the following: • What disciplines are being tested? • How many stations are there? • How long is each station? • What are the different types of station? • Is this a formative OSCE (designed to improve your performance) or a summative OSCE (i.e., counts towards your overall result – pass/fail)? We have included some example OSCEs in Section 1.4 that you can use for a complete practice examination cycle. 1.2 How to get the most from this book You should work through stations with your peers under conditions as close to the examination as possible. We suggest that you practise in groups of two or three (Fig. 1.2.1) and the more realistic you make the session, the more you are going to benefit. You may want to complete one station at a time or use a template (see Appendix) to set up a practice OSCE. You could run a mock OSCE or mini-OSCE with the use of a clinical skills lab and enough volunteers to play all the roles. Figure 1.2.1 Reflection and feedback on performance Once you have worked through one of the example stations, then we suggest altering it to have a different diagnosis, clinical condition or explanation of a procedure. This way you will be able to practise the same skills, but use different clinical information. In this way you will get the most use out of this book. We have summarised this below in Fig. 1.2.2. Figure 1.2.2 How to get the most out of the book Roles
The candidate should read only the candidate information. One of you should be the examiner and use the mark-sheets that are provided (on the website). Ideally a third person should be present to assume the role of the patient where this is required. While some stations do not need this (for example, in Chapter 6) you will gain most benefit from the combined feedback of two individuals and your own self-assessment. It is also useful when playing the examiner to watch the candidate and note what is a good performance and what could be improved. Remember you all learn from each other. Timing
Run through the station in real time. The examiner should have a stopwatch as it is essential to time the stations as this is a common problem in OSCEs. If your OSCE has standard timings then use these for every station. Mark-sheet completion
The person playing the examiner should complete the mark-sheet, which is then used for reflection and feedback. The mark-sheets allow you to record specific feedback to review later. An example mark-sheet is included at the end of this chapter with all others available online at http://coursewareobjects.elsevier.com/objects/elr/ExpertConsult/Oneill/macleod1e/PDFs/. The mark-sheet for your examination may be different, but ours will serve as a guide. When playing the examiner, try to learn from this—what makes you think that a candidate is doing well or badly? What do candidates do to make this easier or more difficult to judge? Share these points as they provide insight into examination technique. Reflection on feedback and performance
To get the most from the book, you must reflect and get feedback on your performance. There are several models of feedback, but the important principle is that the individual thinks about their performance rather than just being told what they have done right or wrong. This encourages deeper learning and will help with performance in examinations and beyond. The best feedback is as specific as possible. Write down actual quotes of...