Summary of Common Conditions Seen in OSCEs

Make sure you know common/important referral criteria outlined by NICE (2005).

Hints and Tips for the Exam

Performing a handover using the widely accepted and universally recognised ‘SBAR’ – situation, background, assessment, recommendation – framework is an OSCE station that is increasingly being tested in finals. This station requires a systematic approach and tests your abilities in several different areas:

• Knowledge: You will usually be given a significant amount of background information about the patient you are handing over in the station. However, you will usually be instructed to formulate your own management plan based on your interpretation of the clinical information you are given. This requires skill in data interpretation as well as factual knowledge of how common conditions are managed.
  
• Communication: Your ability to communicate effectively with a colleague is being tested. Remember that this is different from communicating with a patient because you will be required to use medical ‘jargon’. If you follow the SBAR framework, you will find it easier to impart meaningful information in a precise manner. Like all communication skill stations, do NOT forget to check whether your colleague has any questions. In addition, it is also important to remember to discuss whether your colleague agrees with the management plan and has any additions to make.
  
• Safety: Your ability to gauge the urgency of a clinical situation is being tested. Beware that the actor to whom you are handing over may have been instructed to deliberately avoid taking an urgent handover. If this is the case, do not panic or backtrack – this situation is deliberately being simulated to test your ability to justify why you think a situation is urgent.

You will get several opportunities on all your clinical attachments to observer handovers being performed:

• Attend the morning handover meeting before the ward round: Listen carefully to how the night on-call team communicate information about new admissions to your team members. Attending the evening handover will serve the same purpose. Close to your exams, it may be worthwhile noting down some of the patients’ clinical details and practising handing these over to each other with your colleagues. You can then check how closely your recommendation matches the management plan implemented by the team.
  
• Look out for opportunities during GP attachments: Patients are commonly referred to secondary care by GPs, and you can benefit from observing your tutors do this. Some tutors may also allow you to practise referring patients by telephone yourself under supervision, so take such opportunities when they present.
  
• Arrange to shadow the acute team on-call radiologist at your teaching hospital: You will be able to observe several patients being referred to the radiology department for urgent imaging. Focus particularly on how the referring doctors justify why their patients urgently require imaging.
  
• Practise with your colleagues in your study groups: You can formulate scenarios among yourselves, or use the ones you have observed during your attachments, to test each other.

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