What is the format of a typical EBEEM Part B OSCE station?
So you understand that the EBEEM part B exam consists or a series of OSCE stations designed to test clinical competencies expected of a senior Emergency Physician, but what does an OSCE actually look like and what are you the candidate expected to do? Ok let’s go back to the beginning and imagine you are in the examination building about to start the Part B OSCE circuit.
Each station consists of a partitioned area inside the examination hall within which the mock clinical scenario is staged. Posted outside is a set of candidate instructions which include introductory information about the mock scenario and – very importantly – the specific task you the candidate is required to perform. For example, a typical set of instructions might read:
Station 1.
Your next patient is a 74yr old woman called Mrs Schmidt. She has presented to the ED complaining of a headache.
Take a history from Mrs Schmidt and then discuss with her your differential diagnosis and management plan.
Outside each station, below the candidate instructions is a pie chart showing the distribution of marks for that station. The pie chart associated with the above station might look like this:
Here it indicates that 50% of the marks for the station are for showing that you can take a thorough history from a patient with a headache, 20% of the marks are for demonstrating clinical knowledge, in this case an appropriate differential diagnosis of this patients headache, 20% of marks are for demonstrating good communication skills and finally 10% for suggesting an appropriate management plan.
It is vital that the candidate reads their instructions carefully and pays attention to the distribution of marks on the pie chart.
The EBEEM part B candidate has five minutes to read the candidate instructions before a bell sounds and they must enter the station. Inside the station, the mock clinical scenario will be laid out with all required equipment and actors/assistants in place and ready for the candidate to interact. Each actor/assistant will have been briefed with written instructions on their role in the scenario. There will also be an examiner with a clipboard and marksheet. It is important to be aware of two things at this point
- 1. There will be no further instructions from the examiner – you must have read the candidate instructions outside the station to know what to do
- 2. You must be pro-active in gaining marks by interacting with and managing the clinical scenario – there will be no prompting or questioning from the examiner or the actors/assistants to help you.
Thus, from the moment they enter the station, candidates must enter ‘role play’ mode and treat the mock situation just as if it were a real life clinical encounter in the ED. Good starting points, depending on the type of scenario, might be to introduce yourself to the patient or address the resuscitation team and ask each member their level of experience in preparation for role allocation or to immediately assess for signs of life on a mannequin representing a collapsed patient. From there the scenario will unfold in a predetermined way and in response to your actions.
Remember also that the OSCE is timed, and it is important to ensure you perform all the tasks requested in the candidates instructions by the end of the ten minutes. This includes reporting back to the examiner your findings or your management plan if required. When the time is up the bell sounds and the examiner will move you on to the next station regardless of whether you are finished or not!