Wednesday, 4 July 2012

Paper 3Dii: OSCEs (7 minute stations)

Station 1: Lethargic patient
Okay... so from yesterday, i came to the conclusion that I really struggle with communication skill based OSCE stations. When clerking patients on the wards, i tend to speak to them for quite a while, but when i was stuck with just 10 minutes yesterday, and just the 7 minutes today.. i realised it's not smart to waste too much time being nice to the patient, but more importantly to get all the questions in. I managed to make my way to finding out about the patient's social history, before the examiner had to interrupt me and ask me a few questions before the buzzer went. Managed to get a few nods from the examiner before the buzzer sounded and i moved on. 

Station 2: ABG and interpretation
This was a rather straight forward station, with a model arm attached to a bottle of red coloured fluid and to a machine to simulate a pulse in the arm. I managed to take a sample, cleared up my mess, and then went on to interpret the blood gas question which followed. 

Station 3: Rest
I needed this one, was super thirsty at this point!

Station 4: Cardiovascular examination
This station had nothing else to it; simply just do a cardiovascular examination and present! I went into full mode autopilot, almost forgetting to assess the carotid pulses (but managed to do it before i went onto auscultation of the chest). Presented the findings just in time before the buzzer sounded. 

Station 5: PE history
I basically had to take a history and present the findings at my next station. This station went quite well. The patient presented with shortness of breath, and after finding out he has recently returned to the UK on a long haul flight, i just focussed in on a PE history, and that was that. 

Station 6: CXR 
This station should have come at the end of the last station. I went into the station, and the examiner told me i had a lot of time.. and he was right. I presented my history, and then he took out a chest radiograph. He told me i didn't had to present it, and just had to point out the abnormality. The history pretty much gave the answer away, though the CXR had a pretty large wedge shaped infact which was hard to miss.. it looked a little like this.

Station 7: Fundoscopy
This was awful! I did a quick visual examination on the patient, then picked up the opthalmoscope and had to look into the eye of the plastic head, reading off words they've stuck on bits of paper attached to each quadrant of the eye and the macula. I was really struggling to look into the eye, and this was made worse, when i was a little too rough with the plastic model head, and ended up pushing it onto the floor. I had to pick the head up mid-exam, place it back onto the stand and continue looking into the head!

Station 8: Cannulation
 This station was pretty straight forward. It was another plastic arm hooked up to a bag of red coloured fluid.  I inserted the cannula, finished the station, and was then instructed to remove it before the next student arrived. 

Station 9: Thyroid Examination
Another straight forward examination, with a question at the end. Almost forgot to assess for lid lag and opthalmoplegia, but managed to slip them in before i went on to the legs. 

Station 10: Breast Examination
So during the last CCS week, we were taught how to perform a breast examination on real volunteers, and this was basically the exact same thing.

....................... and that's it! OSCES are over for 2012 (i hope!)
Just one more paper to go on Friday, but luckily i have the day off tomorrow to cram for it...not exactly sure how i'm going to cram for a data interpretation exam >.<

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