OSCE Learning

History

Taking a history

• The Medical History
• Exploring symptoms
• Systems review
• Paediatric history
• Alcohol History
• Attempted suicide history
• Gynaecological history
• Sexual health history
• Subfertility history
• Collateral history for Delirium / Dementia
• Psychiatric history
• Obstetric history

Common presenting complaints

1. Common generalised histories
2. Common cerebral histories
3. Common chest histories
4. Common abdominal histories
5. Common urinary histories
6. Common gynaecological histories
7. Common obstetric histories
8. Common orthopaedic and rheumatological histories
9. Common psychological histories
10. Common paediatric histories

History taking skills

1. History communication skills
2. Presenting histories

Examination

Cardiorespirtory

1. Cardiac examination
2. Cardiac condition signs
3. Cardiac murmurs – systolic
4. Cardiac murmurs – diasystolic
5. Respiratory examination
6. Respiratory condition signs
7. Peripheral arterial examination
8. DVT Examination

Abdominal

1. Abdominal Examination
2. Abdominal conditions signs
3. Digital rectal examination
4. Inguinal hernia examination
5. Testicular examination
6. Varicose veins focussed examination
7. Renal examination

Endocrine

1. Thyroid examination
2. Diabetic foot examination
3. Cushing’s syndrome focussed examination
4. Acromegaly focussed examination

Neurology

1. Lower limb neurological examination
2. Upper limb neurological examination
3. Cranial nerves examination
4. Neurological differential diagnosis
5. Neurological hand examination
6. Examination of speech
7. Parkinson’s disease focussed examination
8. Cerebellar disease focussed examination

Orthopaedic

1. Shoulder examination
2. Elbow examination
3. Hand and wrist examination
4. Spine examination
5. Hip examination
6. Knee examination
7. Foot and ankle examination

Obstetrics and gynaecology

1. Pelvic examination
2. Pregnant abdomen examination

Paediatrics

1. Newborn check examination
2. Key tips for communicating with and examining children
3. General child assessment
4. Paediatric respiratory examination
5. Paediatric cardiac examination
6. Paediatric abdominal examination
7. Child developmental assessment

Other

1. Dermatological skin examination
2. Visual system examination
3. Lymph node examination
4. Neck examination
5. Breast examination
6. Hydration status examination
7. Nutritional status examination
8. Ear examination
9. Presenting in OSCE examinations

Vivas

Cardiovascular

1. Valve replacements
2. Pacemakers
3. Varicose veins
4. Peripheral arterial disease
5. Heart failure

Respiratory

1. Pulmonary fibrosis
2. Chronic obstructive pulmonary disease (COPD)
3. Bronchiectasis
4. Pneumonectomy / Lobectomy

Surgical

1. Thoracic scars
2. Abdominal scars

Abdominal

1. Renal replacement therapy
2. Arteriovenous fistula
3. Tenckhoff catheter
4. Renal transplant
5. Stomas
6. Causes of hepatosplenomegaly
7. Inguinal hernias
8. Chronic liver disease

Endrocrine

1. Goitres
2. Cushing’s syndrome
3. Acromegaly

Orthopaedic and rheumatology

1. Dupuytren’s contracture
2. Carpal tunnel syndrome
3. Osteoarthritis
4. Gout
5. Rheumatoid arthritis
6. Ankylosing spondylitis
7. Systemic sclerosis (Scleroderma)
8. Paget’s disease
9. Marfan syndrome

Neurology

1. Parkinson’s disease
2. Multiple sclerosis
3. Stroke

Dermatology

1. Neurofibromatosis
2. Eczema
3. Psoriasis
4. Dermatology photos
5. Basal cell carcinoma
6. Seborrhoeic keratosis (seborrhoea wart)
7. Vitiligo
8. Foot ulcers

Other

1. Abnormal fundoycopic appearances
2. Digital clubbing
3. Mechanisms of labour
4. Visual field defects

ABCDE

Life support

1. Adult basic life support
2. Adult advanced life support

ABCDE

1. ABCDE management of a critically ill patient
2. Acute presentation assessment
3. Suggested approach to common acute presentations

Common acute presentations

1. Differential diagnosis: Shortness of breath
2. Differential diagnosis: Acute chest pain
3. Differential diagnosis: Acute abdominal pain
4. Differential diagnosis: Acute headache
5. Differential diagnosis: Collapse / fall

Managing cardiorespiratory emergencies

1. Acute asthma & COPD exacerbation management
2. Pulmonary embolism management
3. Acute coronary syndrome management
4. Arrhythmia management
5. Acute pulmonary oedema management
6. Anaphylaxis management

Managing abdominal emergencies

1. Managing abdominal emergencies
2. Upper GI bleed management

Managing endocrine emergencies

1. Management of diabetic emergencies

Managing neurological emergencies

1. Stroke and TIA management
2. Seizure management

Managing trauma

1. Wound management
2. Ligament injury
3. Fracture management

Managing other emergencies

1. Sepsis management
2. Post-operative complications
3. Anaphylaxis management
4. Rapid tranquilisation of agitated patient at risk to self/others

Procedures

Neddle-to-skin

1. Peripheral venepuncture
2. Attaining a venous blood sample for blood culture
3. Peripheral venous cannulation
4. Arterial blood gas sampling
5. Suturing technique

Drug administration

1. Intravenous infusion
2. Intravenous injection
3. Intramuscular injection
4. Subcutaneous injection
5. Intradermal injection
6. Blood transfusion
7. Administering nebulised medication

Swabs and smears

1. Cervical smear
2. Gynaecological swabs
3. ENT and skin/wound swabs

Tubes

1. Urethral catheterisation
2. Nasogastric tube insertion
3. Airway devices

Bedside tests

1. Performing an ECG
2. Urine tests
3. Blood pressure measurement
4. Peak flow measurement
5. Capillary glucose measurement

Surgical

1. Surgical scrub

Advanced Procedures

• Chest Drain Insertion (Seldinger Technique)

Interpretations

Paper traces

1. ECG interpretation
2. Spirometry
3. Partogram interpretation

Imaging

1. Chest radiograph interpretation
2. Abdominal radiograph interpretation
3. Musculoskeletal radiograph interpretation

Blood

1. ABG interpretation
2. Interpretation of the full blood count
3. Interpretation of urea and electrolytes
4. Interpretation of liver function tests
5. Interpretation of coagulation screen

Urine

1. Urinalysis

Prescribing

Oxygen

1. Oxygen therapy

Intravenous fluids

1. Adult intravenous fluids

Nutrition

1. Adult nutrition

Management

1. Commonly prescribed drugs in hospital
2. Commonly prescribed drugs in community
3. Common infective organisms
4. Anticoagulants
5. Insulin prescribing
6. Antibiotics
7. Continuous drug infusions – advanced

Calculation

1. Drug units and calculations

Prescriptions

1. Hospital inpatient prescriptions
2. Outpatient prescriptions

Drug monitoring

1. Monitoring narrow therapeutic range drugs

Adverse drug reactions

1. Common side effects
2. Drugs and renal impairment
3. Drug interactions

Communication

Explaining

1. How to counsel/explain to patients
2. Discussion about surgery
3. Inhaler technique
4. Common medications requiring counselling
5. Childhood vaccinations
6. Explaining scope procedures

Counselling

1. Contraception counselling
2. Emergency contraception
3. Basic genetic counselling
4. Birthing options
5. Hormone replacement therapy
6. Common medications requiring counselling

Ethics and law stations

1. Confidentiality
2. Assessing capacity
3. Consenting a patient for a procedure
4. Advance decision to refuse treatment (‘living will’)
5. Lasting power of attorney
6. DVLA reporting
7. Safeguarding
8. Domestic violence

Difficult encounters

1. Breaking bad news
2. Dealing with strong emotions
3. Psychosocial concerns
4. End of life and TREATMENT escalation discussions

Communication with medical professionals

1. Presenting histories
2. Receiving a handover
3. Making a referral

Documentaiton

1. Venous thromboembolism assessment
2. Discharge summary
3. Death certification
4. SOAP note
5. Ward round documentation

Reviewing patients

The consultation

1. SOAP note
2. Ward round documentation

Clerking patients

1. Admission clerking
2. Pre-operative assessment

Reviewing inpatients

1. Post-operative general surgical patient review
2. Medical patient review
3. Falls risk assessment
4. Diabetic care review
5. Common on-call scenarios