OSCE Day 1: 10 minute stations
I don't exactly look forward to OSCEs, but i always end up enjoying them each year; I suppose they're a pretty fun exam to sit ^^... even though at times, I wish the floor would open up and take me away from a cringey moment.
Station 1: Lower limb motor and sensory exam
I've practised this examination quite a bit, so i was pretty chuffed when the buzzer sounded and i turned around and saw the station instructions. I went behind the curtains and went into auto-pilot, finishing the exam with 3 minutes to spare to present my examination, and answer the examiner's questions on diabetic neuropathy.
Station 2: Non-compliant patient
This was my first ever communication skills station, and I was terrible. I asked the patient at the start to score how confident he was feeling about making a change, and he goes 8/10.... I was a bit taken back, as he already seemed quite determined to make a change, and there didn't seem to be much scope for me to "motivate" him with. ...... not sure if i passed this station.. (thankfully i think we're aloud to fail a few stations).
Station 3: Resus/ IV drip / 02 therapy
I turned behind the curtain and was faced with a plastic dummy. I was sort of confused on what I had to do for this station, but the really nice examiner sort of guided me through. So it was basically ABCDE.. with the examiner firing questions as i went along. Airway was patent, Resp rate was raised, Sats low... i had to administer oxygen... this was when i had to decide on the oxygen mask to use and the litres of oxygen to set it to. The patient was hypotensive, so I set up a drip for a fluid challenge. It's pretty hard to do a GCS or AVPU on a dummy, so we just spoke about that, and wrapped up the station discussing SBAR.
Station 4: Rest!
Station 5: Respiratory Exam and peak flow
This was another station i've practised quite a few times, so i went into my routine, finishing off the exam with approximately 2 minutes left to quickly teach the patient how to use the peak flow machine, take 3 readings and assess on the chart whether his peak flow was normal or not. This was probably the best station of the day, as the examiner and patient were both very smiley and encouraging, and actually seemed happy to be there.
Station 6: Fainting patient
Arghhhhhhhhhhh this was another communication skills station i messed up!! I honestly struggle at making differential diagnoses on the spot under pressure; and i really had no idea what the underlying cause was >.<
Station 7: Abdominal examination/ RIF pain / Management
So.. I struggled with what to do with the patient in pain. I've always been taught to not cause the patient any pain, and the actor (very convincingly) had a right inguinal fossa pain and i just didn't know if i was meant to do deep palpation in the area or not...and when it came to management.. all surgery just went out of my head. I muttered what I could make up, and had to move onto my next station.
Station 8: Discharging a patient
This was the only communication skill station that went relatively well. The patient was to be discharged with 4 new medications, and i had to explain the drugs, their side effects, and how to take them to the patient. The actress was really nice, and as the one minute left buzzer went, the actress guided me into telling her about lifestyle changes she could make, and before the final buzzer went, i slid the Ideas, Concerns and Expectations (ICE) in .
Day 1 of OSCES over... day 2 tomorrow!