Preparing for the OSCE station format
Candidates are encouraged to review the common mistakes web page made on exams featuring Objective Structured Clinical Examination (OSCE) stations.
Additionally, here are the answers to some frequently asked questions that we receive from candidates preparing for the OSCE station format.
1. What if the time allowed is too short — can I get extra time?
You should have ample time to complete the task(s) at each station as the stations were designed to fit the allotted time. The tasks have been reviewed by many physicians and were deemed appropriate for the time limit. Even if the time limit is particularly challenging for a specific station, all candidates face the same challenge. However, most candidates finish most stations well within the time limit.
If you are running out of time at each station, then you may be too slow, for any one of several reasons. Your physical examinations may be too generic and thorough relative to the patient problem or you may be asking far more questions than is necessary. Remember that your approach should be based on the clinical problem and its possible causes. Re-assess your style. Avoid using too many “yes – no” questions, making the patient move around unnecessarily, explaining too much and missing verbal or physical cues from the patient.
2. Should I worry if I finish a station early?
Finishing early does not necessarily indicate a problem. Many stations can be completed in less than the time allotted. However, if you have done all the most important things, consider what else might help you understand or confirm the patient’s problem. If you forgot something, go ahead and do it, even if you have been sitting quietly for the past few moments.
3. What are some effective strategies for studying?
Form study groups:
- Forming a study group may be very helpful. Identify which objectives are most important for each group member to review (e.g., management of chest pain, assessment of vomiting in a child). Do not let the most competent members in a group spend all their time helping others. It is unfair and often hurts the performance of your most competent members. They also need to be challenged.
- Consider having each member generate common patient presentations that they understand well. Each person can then present their patient problems to the group and quiz individuals within the group about how they would assess and manage these problems. Be critical. Challenge each other. What other diagnoses should you think about? How would you differentiate between them? What investigations are essential? Why? What should you assess on your physical examination? What else should you assess?
Create a study plan:
- Identify the objectives that you most need to study and focus on common or critical patient presentations. Be honest in assessing your own knowledge and ability.
- Create differential diagnoses, identify key features that will lead you to establish or confirm your differential diagnoses, create checklists, and identify key orders for investigation and management plans for each one. If you realize there is a knowledge deficit in a particular area, then go back to learning the basics.
4. Are there any books about the OSCEs?
The Medical Council of Canada (MCC) does not endorse any specific reference books on OSCE stations. References that may be helpful should cover key principles of doctor-patient communication as well as address common ethical and legal issues. They should also be based on a focused approach to presenting problems. When choosing a reference, keep in mind that some references may be aimed at preparing for undergraduate assessments or entry into a training program and therefore may use examples of cases or scoring instruments that are not representative of those used in the examination.
The MCC has compiled a list of reference books and online reference materials that its test committees have used to validate examination questions and content. This list may be useful to candidates who are studying for the examination.
5. What examination-taking strategies might help me?
The following suggestions may help you cope with the OSCE format:
- Use the notebook provided at the examination registration when reading the instructions. If you are stressed and likely to get confused, consider noting the task first (shown at the bottom of the instruction page) and then reading the patient information. Note what you need to know or do. The instructions are also available in the station if you want to check the patient information again.
- Have back-up strategies in case you feel lost about a patient problem. Fall back on basic clinical interviewing and physical examination skills. Find out what you can, as best you can. Be willing to think a moment about what you want to do next.
- Ignore the examiner’s pencil. Some checklists are longer than others and some items can only be completed after you leave. How often the examiner’s pencil is moving is not a reliable indicator as to how well you are doing. Concentrate on the patient.
6. Should candidates take a preparatory course to prepare for the OSCE format?
There are no approved preparatory courses. Some medical faculties offer programs and these may be the most helpful. There may also be a commercial preparatory course available in your city.
Comments from candidates who have taken a commercial course suggest that they vary widely in their helpfulness. In most cases, a preparatory course will give you an opportunity to become familiar with the OSCE format.
The emphasis of some preparatory courses appears to be on examination-taking skills, not on assessing your clinical knowledge, skills and judgment. If you have weaknesses in your clinical competence, a preparatory course is unlikely to help you.