Core Clinical Skills for MRCEM OSCEs


Module 1


 

Part 1. The core clinical skills for OSCEs.

When many candidates come to the MRCEM Part C/OSCE exam thinking that it is all about resuscitation moulage and procedures, an 18-station circuit of souped up ALS and ATLS scenarios and consequently focus their preparation on moulage and simulation skills. While resuscitation and procedures do certainly feature in several stations, as a view of the exam as a whole it couldn’t be more wrong! … … more in purchased course package.

 

Part 2. Communications skills.

In the MRCEM Part C/OSCE exam it is vital to realise that, while there are certain stations designed to specifically test communications skills, every station has a communications skills element and that there are communications skills marks on most if not all marksheets. Thus, if there is one factor above all others that makes the difference between passing and failing the MRCEM Part C/OSCE exam it is a candidate’s communications skills. This is perhaps … … more in purchased course package.
From over 10 years of teaching communications skill at OSCE courses, here is a list of our 15 general tips for ensuring good communication in OSCEs (and real life). Try to master these basic communications skills and then practice them on all patients you see from now on. When you are confident in these basic skills, move on to the more advanced communications skills teaching in next months module: 1) SPEAK CLEARLY AND CONFIDENTLY. This is of paramount importance. You must … … more in purchased course package.
As emergency physicians, we are constantly assessing patients and giving presumptive diagnoses on a daily basis. As is the reality of the ED, many of our patients will have poor outcomes and unwelcome diagnoses. Good communication, empathy and timing will always remain the core of delivering any news, good or bad. In the OSCE setting, there are … … more in purchased course package.
Conflict is sadly part of our daily work, and negotiation skills are essential for working in the ED. The MRCEM OSCE will present a spectrum of cases that may either have elements of conflict management within them, (eg the ATLS stations with problematic referrals) or even complete stations that … … more in purchased course package.
The following comments are made by an actor with many years experience of role modeling patients for OSCE examinations and who gives the following tips from the other side of the OSCE table”! Remember that … … more in purchased course package.

 

Intro to communication skills

Breaking Bad News

Angry Relative

 

 

Part 3. History taking.

The majority of clinicians will agree that history taking and examination are the most essentials skills in clinical medicine. A basic generic template exists throughout the world when approaching history taking, however, and those that choose to cut corners in either real life or the OSCE setting, will surely miss key information and … … more in purchased course package.
As with adult history taking, the majority of clinicians will agree that history taking and examination are the quintessential skills of paediatric medicine. Though significant anxiety exists amongst the majority of emergency physicians when thinking about taking a paediatric history, it is important to remember that … … more in purchased course package.
In history taking stations where the presenting complaint is pain – chest pain, abdominal pain, headache, earache – any pain, the examiner will be looking for the candidate to take a thorough history of the patient’s pain. A good mnemonic for remembering the sequence of questions to be asked in a systematic pain history is ‘SOCRATES’ … … more in purchased course package.
Sexual History Taking a sexual history is becoming more commonplace in the OSCE setting, as the College feel that many candidates still seem to struggle with asking the blunt but essential questions required. The OSCE actors are all well prepared, and are certainly not going to be shocked by the lines of questioning you need to pursue. Sadly numerous candidates fail … … more in purchased course package.

 

Open and Closed Questions

Chest Pain History

Abdomen Pain History

Haematuria History

 

 
Part 4. Clinical examination.

The physical examination is a common OSCE station in the MRCEM Part C/OSCE exam, with almost all exam circuits including one or more examination stations. In most cases, they are straightforward stations to pass provided you follow the … … more in purchased course package.

 

Cardiovascular Exam

Respiratory Exam

Abdomen Exam

 
Neurology Upper Limb Exam

Neurology Lower Limb Exam

Neurology Cranial Exam

Neurology Cerebellar Exam

Thyroid Exam

Vascular Exam

 

 

The MRCEM OSCE exam is guaranteed to present you with at least one, if not more orthopaedic examinations. These patients are common place within the ED, however, the candidate must be strict in remembering that the more ’focused’ examination utilised at work may fall short of what is expected in the OCSE. As with the physical examinations, many candidates will have different approaches to conducting the examination. It is, however, essential to remember that … … more in purchased course package.

 

Shoulder Exam

Elbow Exam

Hip Exam

Knee Exam

Hand Exam

Maxillofacial Exam

 

 

The gynaecology examination is an increasingly common examination in the OSCE setting now that pelvic models are readily available which allow for realistic gynaecological examination. Using such models OSCE scenarios testing candidates examination and management of patients presenting with pelvic pain, vaginal discharge, pelvic masses, PV bleeding and lost condoms are all possible. The MRCEM OSCE candidate must therefore be able to: … … more in purchased course package.

 

Part 5. Developing your core clinical skills for MRCEM Osces.

I hope by now you have understood the central importance of the core clinical skills – history taking, examination and communication to the MRCEM Part C/OSCE examination and have read through and watched the teaching material on this page. The question is where do you go from here? The answer of course is … … more in purchased course package.

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