You might have heard of the term OSCEs, and known it to be a form of examination at medical school. You may have even heard that OSCEs are similar in format to MMIs! In this article, I will explain what OSCEs are and discuss how I felt about my first ever OSCE!
An Objective Structured Clinical Examination (OSCE) at medical school is an exam used to test a student’s clinical capability. As opposed to the written exams at medical school that test knowledge gained from lectures and tutorials, OSCEs test practical skills. Just like the MMIs that applicants undergo at the interview stage for medical school, the OSCE also consists of various stations.
Essentially, OSCEs assess all the practical skills learnt at medical school - the skills you must possess, in order to be a safe and competent doctor once you graduate.
Each station in an OSCE is 7 minutes long, in addition to 2 minutes reading time and a minute for switching between stations. Every medical school is different, but this is a rough guide to the timings. Another thing to note is that the format of each station may differ i.e. there may be a role play station (this is usually the case with history taking stations) or a question and answer station with the examiner.
At my medical school, Aston, the skills we learnt this year were the following: taking blood pressure, measuring pulse rate and oxygen saturation, measuring temperature, history taking and the diagnostic process. Therefore, our first year OSCEs consisted of four stations that tested some of these skills.
The skill that was the overarching focus for this year was that of history taking. We learnt two important mnemonics that became the basis of our approach when taking patient history. They were: SQITARS and ICE.
Site i.e. where the pain is.
Quality i.e. what type of pain it is, for example, whether it is a dull or stabbing pain.
Intensity on a scale of 1 to 10, 10 being the most severe pain to be felt, for example, if your leg was to be cut off without anaesthetics.
Time of onset of pain, and how long it has been going on for.
Aggravating factors i.e. things or activities that make the pain worse.
Relieving factors i.e. things or activities that make the pain better.
Secondary symptoms alongside the pain.
Ideas that the patient has about their illness.
Concerns that the patient has.
Expectations that the patient has from the consultation.
Alongside using these mnemonics as our guide to history taking and making sure to get answers to all these questions from our patients within seven minutes, we were taught the importance of listening attentively, paying attention to a patients’ verbal and non-verbal cues, as well as showing empathy to our patients.
As for my personal experience of my first ever OSCE, I thought it was a great learning opportunity. The biggest lesson I learnt was that of the importance of practising timed history taking. It’s all well and good making sure to ask all the right questions (this is a huge task in itself, especially if you’re new to history taking and are nervous!) but you must also learn to ask these questions within 7 minutes. Now I know for next time to practice taking a history in 6 minutes, allowing myself a minute extra for some flexibility.
OSCEs are designed to test how competent you are at the clinical and practical elements of dealing with patients, because, as we all know, there is more to being a doctor than just knowledge and intellect. The majority of medical schools use OSCEs as an assessment tool which may seem very daunting, however, with practice, you will become more familiar and confident in completing them.
Author: Sana Khan
Editor: Allegra Wisking
