Psychiatry OSCEs

Module 4


Part 1. Structured approach to the psychiatric OSCE.

Every diet MRCEM Part C/OSCE exam has at least one, and usually more than one, psychiatry station. The psychiatry station is typically much feared by candidates and as a result often poorly performed. This is for two reasons: firstly, in the UK at least, emergency doctors rarely (if ever) carry out psychiatric assessments, this now being the role of psychiatric liaison teams and their equivalents; and second, … … more in purchased course package.
Similar to medical history taking, history taking in psychiatry OSCEs follows a definite structure but differs in emphasis and questions posed. Key areas … … more in purchased course package.
The second stage of the STRUCTURED approach to the psychiatric OSCE is to perform an assessment appropriate to the patient’s presentation, from which a conclusion or diagnosis is drawn and a management plan formulated. After taking the history … … more in purchased course package.
The patient with depression may be quiet, uncommunicative and withdrawn. Gentle, empathic questioning is required to … … more in purchased course package.
The psychiatry station may well have a depressed patient who has self-harmed or attempted suicide and the stratification of the patient’s imminent risk is essential. A common tool to do this is the SAD PERSONS scale which places the … … more in purchased course package.
The mental State exam is used to assess the patient with behavioural disturbance and is designed to identify patients with acute psychotic illness – mania, schizophrenia and drug induced psychosis being the major causes. The psychotic OSCE patient is … … more in purchased course package.
The mini mental state exam (MMSE) assesses cognitive ability and is most commonly used where an elderly patient requires assessment for possible dementia. The full … … more in purchased course package.
A number of alcohol screening tools exist and are in use in different departments. It doesn’t matter which one you use as long as you can use it correctly. Two simple ones are … … more in purchased course package.
Good preparation and structured approach are necessary for success in the psychiatric OSCE. Prepare by reviewing the questions of the psychiatric history and by learning and practicing the various assessment methods … … more in purchased course package.


Part 2. The uncooperative patient

Not infrequently, the patient in the psychiatric OSCE is deliberately uncooperative. The may be virtually silent and give brief, uninformative replies to questions or be floridly psychotic and ignore your questioning all together whilst insisting they are the king of England! Many candidates become unnerved … … more in purchased course package.


Part 3. Example psychiatric assessment videos.

Assessing Capacity

Depression History

Deliberate Self Harm

Mental State Exam



Part 4. Improving your psychiatric assessment skills

Psychiatric OSCE stations are easy to pass with a well rehearsed and … … more in purchased course package.

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