Practical Advice to Excel in the Exam - Ixorainternational

Practical Advice to Excel in the Exam

Practical Advice to Excel in the Exam

Objective Structured Clinical Exams (OSCEs) represent the practical aspect of medical school exams. While they may appear challenging and stressful, consistent practice can lead to success. Here are some valuable tips to help you ace your OSCEs. We trust they’ll ease your concerns and boost your confidence.
What does OSCE stand for?
OSCE, short for Objective Structured Clinical Examination, is a widely used approach to evaluating clinical competency in medical education.

Unlike workplace-based assessments like the mini-CEX, which take place in real clinical settings, an OSCE evaluates performance in simulated clinical environments.
What should you focus on?
It’s essential to understand the specific examinations and procedures required for your assessments.

Consult your university for mark schemes and sample examination formats to ensure you’re prepared.

Prioritise addressing your weak areas and start targeting them early. While practicing skills you’re not confident with may feel challenging, remember that the study period is an opportune time to learn from errors and improve.
Continuous Practice Leads to Excellence
Team up with a fellow medic, friend, or roommate and practice regularly until you feel fluent and confident in your examinations.

Exam anxiety can impact your performance, so it’s wise to be overly prepared rather than underprepared. If finding medics to practice with proves difficult, don’t worry. Your non-medical family members or friends can serve as excellent “patients” and provide valuable feedback on your approach, manner, and their comfort level in the simulated scenarios.

Take advantage of any opportunities your medical school provides to practice with equipment and anatomical models. Often, the same tools are used in real OSCEs!
Timing is Key
Ensure you practice with a timer as time passes swiftly during the actual exam.

Familiarise yourself with the precise timings of each OSCE station at your university. For instance, you might have a full 8 minutes for an examination, but only 6 minutes with 2 additional minutes for questions during a history-taking station.
Offer Valuable Feedback
When practicing with peers, it’s crucial to exchange constructive feedback.

Constructive feedback involves providing supportive suggestions, criticism, or insights in a positive manner. Always offer actionable advice for improvement, focusing on areas such as communication skills, physical examination technique, clinical reasoning, professionalism, and time management.
Providing Constructive Feedback
A structured approach to giving constructive feedback involves following Pendleton’s rules:

1. Begin by having the doctor highlight their successful aspects (“What went well?”).

2. Then, allow the examiner(s) and patient to share their perspectives on the doctor’s positive performance.

3. Prompt the doctor to reflect on potential areas for improvement in their approach or technique (“What would you do differently next time?”).

4. Lastly, the examiner and patient contribute their observations on areas where the doctor could enhance their performance.

Ensure feedback is specific, focusing on behaviours observed during OSCE practice, and provide practical and achievable suggestions for improvement.
Adhere to Dress Guidelines
Present yourself professionally and in alignment with the local dress code. While it may not directly impact your score, it does contribute to making a positive first impression.

Ensure long hair is tied back, sleeves are rolled above the elbows, and any jewellery on the wrists or fingers is removed.
Attention to Detail
Before entering each station, you’ll have reading time to review the scenario. Take a moment to breathe deeply and ensure you read the instructions thoroughly.

Under stress, it’s common to confuse details, such as performing an upper limb instead of a lower limb neurological examination.

Pay close attention to directions like ‘only examine’ or ‘you do not need to…’. Mentally rehearse the steps, considering any modifications from the prompt, and prepare your approach for when the timer begins.
Let’s Get Started…
Remember to commence and conclude each station by washing your hands. Not only is this a fundamental clinical practice, but it also earns you crucial and straightforward marks.

Internalise your opening script until it flows naturally. It should include greeting the patient, introducing yourself, verifying their identity, explaining the procedure/examination, and obtaining their consent to proceed. While these steps may seem simple, they are essential and can earn you valuable points.
Importance of Structure
Establish a systematic order for examinations that you feel comfortable with and can easily recall. For more detailed guidance, contact Ixora.

In history taking, a general structure typically includes:

1. Presenting complaint

2. History of presenting complaint

3. Past medical history

4. Drug history

5. Family history

6. Social history

7. Systemic enquiry

8. Ideas, concerns, and expectations

However, remember that patient responses may alter the sequence during a consultation, as they may not follow our structured approach.

Be attentive to the patient’s responses and adapt accordingly. If a patient shares personal information, respond empathetically rather than strictly adhering to the structure.

Moreover, avoid using filler words like “cool” or “okay great,” as they can detract from your communication’s clarity and professionalism.

Maintain a steady pace during the consultation to facilitate effective listening and rapport-building with the patient. Rushing may hinder accurate assessment by the examiner and inhibit patient rapport development.
Strike the Right Balance in Your Communication
During moments of panic, resist the urge to speak impulsively. When proposing potential diagnoses, focus on listing options that align with the patient’s history and presentation. Typically, three differentials suffice; listing too many or too few may indicate weak clinical reasoning.

When considering diagnostic tests, prioritise bedside investigations before progressing to ordered tests such as blood work or imaging. Concentrate on investigations directly pertinent to the patient’s case, rather than reciting an exhaustive list learned by rote.
Project Confidence
Even if you’re not feeling entirely confident during your OSCE, it’s essential to appear so!

Maintain good posture, smile when appropriate, and speak with clarity and confidence. Displaying excessive apprehension can convey uncertainty and make the patient uneasy as well.
Courtesy is Key
Demonstrate politeness, empathy, and honesty in your interactions with patients. Listen attentively to their concerns and allow them ample opportunity to express themselves. Remember to express gratitude to both the patient and the examiner after the station.

These basic communication skills often carry substantial weight in scoring, so prioritise them accordingly!
Make the Most of Your Time
After completing your examination, use any spare moments wisely. Take a quick scan of the room to identify any unused equipment.

If you recall something you missed, don’t hesitate to revisit it. You have nothing to lose and marks to gain by ensuring thoroughness.
Stay Calm and Learn from Mistakes
Instead of erasing memories of a poor OSCE, consider documenting your errors. Reviewing these mistakes before your next exam can prevent repetition.

Discussing experiences with your peers can also be beneficial. Remember, learning from others’ mistakes is just as valuable as learning from your own.
Prioritise Restful Sleep
The evening before an exam can provoke stress, but aim to unwind and ensure a restful night’s sleep. Being well-rested enhances concentration during the exam.

Avoid cramming the night before, as it often leads to more harm than good. Consistent revision over several days produces better outcomes than last-minute intense studying. Trust in your preparation and maintain confidence until exam day.
Don’t Forget Your ABCs… Especially Glucose
Ensure you eat something before your OSCE or bring food with you. Depending on your university’s regulations, you may need to ‘quarantine’ before and after the OSCE while other students complete their stations. It’s essential to avoid hunger during this time!
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