Year II OSCE Part A - Information

Many of the posts on the Year II OSCE Part A from last year still apply to preparing for this year.  A couple of changes -- the session has been moved into early January to allow for more time to reflect and prepare between OSCE part A and part B (April).  We're also encouraging you to take some time to consider the Cultural Communications appendix of the Communication and Medical Interviewing Skills benchmark.

Here are a few older posts that give you some great info about the Year II OSCE and what to expect:

Wait, are we being graded on this?

Written Ethics OSCE sample case

How to "Verbalize"

Dr. Losh's letter about the Year II OSCE

Year II OSCE Part A

Dr David Losh will be speaking to the 2nd year class on Nov 12th about the upcoming Year II OSCEs and how to prepare for them.  Part A is a 4-station OSCE in January 2010 (6th-22nd) and Part B will consist of a 6-station OSCE March 31 - April 15, 2010.

Much of the material posted for the Year II OSCE in 2009 still applies to this year -- we'll be sharing the information again and linking relevant posts.  In the meantime, if you have specific questions, send them to Jennie Struijk @ janim@uw.edu and we'll try to answer them for the class on this blog.

And now for something completely different...

The students at Washington University Medical School put together this cute little rap:

"SP Baby"

Save the Date: Year IV Remedial OSCE Oct 22, 2009

While most students will do very well on the upcoming Year IV OSCE, those who have trouble across a number of stations or skills will be asked to return to Seattle for a Remedial OSCE in October on Thursday the 22nd.

We suggest that you NOT schedule out of town residency interviews or other important activities on or about October 22 on the remote chance that you will be required to re-test on that date.

If you have any questions about the Remedial OSCE or Year IV OSCE in general, please email Jennie Struijk. We look forward to seeing you this summer!

Year IV OSCE dates and making changes

Confirmations of Year IV OSCE dates are currently being mailed out to students. If you decide you wish to change your OSCE date, we ask that you arrange to swap dates with a classmate, and then email: osce@u.washington.edu (be sure to also CC your classmate) to let us know of the swap.

For your convenience in determining swap requests the dates are listed again below:

The 2009 Year IV OSCE will be offered on July 8, 9, 10, 13, 14, and 15, and on August 5, 6, 7, 10, 11 and 12, 2009. Each day begins at 8:15 and will end prior to 1:00pm.

Year IV OSCE Format and Suggestions from Dr. Losh

Re: Senior OSCEs

Dear Senior Medical Students,

We would like to give you some information about the up-coming Senior OSCE that you will be taking in July or August. Several folks have asked “How should I study for the OSCEs?” So here is a short run-down of why the exams are being given, how they work, and how to prepare.

Successful completion of the Senior OSCEs is a requirement prior to graduation from the UW School of Medicine. This requirement derives from the underlying principle that each medical student graduating from the UW, regardless of his or her planned career track, shall demonstrate competence in a variety of basic clinical skills prior to graduation. The OSCEs may also help you practice some of the skills you will need when you take the USMLE Step 2 Clinical Skills Examination (CSE) that is currently a requirement for licensure.

Most of you will pass the exam. However, those who do not pass, will be expected to take a set of remedial OSCEs on October 22, 2009. Therefore you should NOT schedule out of town residency interviews or other important activities on or about October 22 on the remote chance that you will be required to re-test on that date.

The Senior OSCEs are a little different than the Second-year OSCEs that you have already taken. The 2^nd year OSCEs asked you to demonstrate a specific physical examination technique or limited part of an interview. The Senior OSCEs are designed to see if you can make a reasonable differential diagnosis and plan from the information you obtain by interviewing and examining the patient. You will have more time for each station but a number of stations will require you to interview the patient, do an appropriate examination for the specific problem, write up your findings and come up with a differential diagnosis and plan.

Here is a general outline of how the OSCEs will work this year:

1. Each student will rotate through 10 stations dealing with common clinical scenarios. Some of the stations will be with standardized patients, and some of the stations are cases that are done on either a computer, a mannequin, or involve short written answers to clinical scenarios. Each case with a standardized patient will involve 14 minutes in interviewing or examining the patient and nine (9) minutes in either receiving feedback from an observer, or in writing up your findings.

2. Some of the Standardized Patient cases will require you to write out your findings which will be graded later by trained UW physician graders. The write-up cases will use forms similar to those used in the CSE. (The write-ups are done on one page and are divided into 3 sections: 1) Findings (History and Physical findings), 2) Differential Diagnosis with the most likely diagnosis listed first, and 3) The Plan including diagnostic needs and/or therapy.)

3. If you finish your patient interview or examination early, you will be allowed to start your write-up early.

4. On the Standardized Patient cases that do not require a write-up, you will receive some immediate feedback from the standardized patient and/or a volunteer physician or other observer.

5. We anticipate that the results of the OSCEs should be available in late September or early October.

How should you prepare for the OSCEs?

Like the real practice of medicine, there is no way to study specifically for the exact clinical cases that may confront you each day. However, there are several things you can do that will prepare you to do well in the OSCEs.

• Get enough sleep the night before and arrive on time, relaxed and mentally prepared. Rushing to make it to the OSCEs after a hard night on call is not an advisable way to take the exam.

• Be sure to bring your own clinical equipment – that way you will know you have (and know how to use) whatever you need for each station. The minimum recommended is your own stethoscope oto-ophthalmoscope. General clinic supplies will be provided, as will any “less common” equipment you might need. You will not be able to use any reference cards or texts during the exam.
• Remember: Most of the material for the OSCEs is linked to the ICM II Benchmarks and the goals and objectives and other material you covered in your Clinical Clerkships.

• When you take a history from ambulatory patient, don’t forget to include the basic elements of a history: HPI, current other health problems, PMH, current meds including OTCs and CAM, allergies, smoking & drug/substance use, dietary habits, family history, and social history.

• When you need to do a focused physical examination, run through the portions of the physical exam you learned in ICM II that you feel a reasonable clinician should obtain in a patient presenting with the particular problem. For example, a patient presenting with chest pain (in addition to auscultation of the heart) might also require vital signs, a general description of their appearance, (cyanosis, respiratory distress, sweating), auscultation of the lungs, palpation of the chest, a check of their pulses and evaluation of the vascular system including palpation and auscultation of the abdomen for aneurysm or bruits.

• Basic patient-centered communication skills and professionalism issues will be measured, so don’t forget to greet the patient, confirm their identity, introduce yourself, and establish the patient’s agenda. Its always a good idea to find out what the patient feels is causing their symptoms or problem. Try to use an effective combination of non-judgmental open and closed ended questions. At the end, smooth closure can often be accomplished by a brief summary and letting the patient know what you would like to do next.
  

• The material covered may rely on your knowledge of pediatric through adult problems and may rely on special skills interviews as well as general examinations.

Most of you will do quite well on this examination. A very large effort is being made by staff and volunteers to make the examination clinically relevant and helpful for you. We hope that it will actually be fun and that the feedback you receive will be helpful and informative. We also hope it will help give you practice and confidence as you prepare for your CSEs.

David Losh, M.D., Members of the UW OSCE Work Group

Professor, Med. Director of OSCEs

Dept. of Family Medicine

Question about OSCEs and Transcripts

We love it when people contact us about "rumors" -- it's a great way for us to clarify things and, we hope, reduce uncertainty and anxiety for students.

Today's question: There have been a few rumors in class that the spring but not the winter osce will be depicted somehow on our transcripts. Can you clarify?

Dr Losh's reply:

"Yep, that's just a rumor. Students have to successfully complete the 2nd year OSCE requirement before they are allowed to proceed to the clinical clerkships, but to my knowlege there is no statement regarding the 2nd year OSCE on the transcript.

If s student gets 2 or more "needs development" ratings on these last 6 cases, they must meet with their College Mentor for constructive feedback, to analyze the results, and to determine if any further remedial work is needed. That process must be completed before the student is allowed to start the clinical clerkships.

Hope that helps clarify things."