Explanation of Categories for OSCE Feedback
Each clinical skills category is highlighted below with what that category covers and what constitutes good practice. In addition, there are notes on how you may approach improving your performance in that category. You can use this in combination with your station mark and individual comments to help you find out where and how you can improve.
For any enquiries, please contact osce@abdn.ac.uk
- CLINICAL COMMUNICATION
- CLINICAL EXAMINATION
- PROCEDURES
- CLINICAL REASONING
- CLINICAL MANAGEMENT
- PROFESSIONAL BEHAVIOUR
- SAFE PRACTICE
- CLINICAL KNOWLEDGE
- PATIENT CENTRED PRACTICE
- TIMING & STUCTURE: CLINICAL TEAM
-
CLINICAL COMMUNICATION
Communication information gathering
This refers to the communication skills required to gather information in a consultation. This includes use of open and closed questions, active listening, picking up patient cues and signposting during history taking.
Practice taking medical histories, recognising when to use open and closed questions. Refer to the Calgary Cambridge guide on information gathering. Also practice showing how you are listening to the patient and watch and listen to them as you are gathering information.
Communication information giving
This refers to the communication skills required to provide information, explain and plan. This includes making your explanation understandable and easy to remember. Avoiding use of medication jargon. It also means involving the patient in discussions about diagnosis investigations and treatment.
Practice explaining medical terms in understandable language. Take learning opportunities to engage with patients on attachments during explanation and planning. Refer to the Calgary Cambridge guide on explanation and planning.
Communication skills during examination or procedure
This refers to communicating with the patient during an examination or procedure. This includes explaining the explanation/procedure to the patient, providing clear instructions, communication with patient during the examination / procedure.
When you are practising clinical examinations / procedures also practice communicating to the patient before during and after the examination / procedure.
-
CLINICAL EXAMINATION
Clinical examination process
This refers to how well you know and follow the correct examination process. That is you know WHAT to do during an examination. This includes knowing the correct examination steps and having a structured and methodical approach.
Using reference materials, videos and workbooks to learn and practice the clinical examination steps.
Clinical examination technique
This refers to how well you conduct the examination. That is you show HOW to do the examination well. This includes having the correct examination technique and doing this fluently. It also means eliciting any clinical signs correctly and adapting examination for patient (e.g. pain or disability).
Practice clinical examination - use opportunities on wards, with peers, friends / family etc. Be deliberate about looking for clinical signs even if you think there will not be. Do not just "go through the motions".
-
PROCEDURES
Clinical procedures process
This refers to how well you know and follow the correct procedure process. That is you know WHAT to do during procedure. This includes knowing the correct procedure steps and having a structured and methodical approach.
Using reference materials, videos and workbooks to learn and practice the clinical procedure steps.
Clinical procedures technique
This refers to how well you conduct the procedure. That is you show HOW to do the procedure well. This includes having the correct procedure technique and doing this fluently. It also means getting to correct result from the procedure adapting the procedure for patient (e.g. pain or disability).
Practice clinical procedure - use opportunities on wards, attend revision days, approach the clinical skills team. Do not just "go through the motions" aim to practice them as you would with a real patient.
-
CLINICAL REASONING
This is a skill that develops over the course of your MBChB. This refers to how you apply your clinical knowledge with the history, examination and investigation finds to deduce likely diagnoses, relevant investigations, and management plan. This includes asking relevant questions and structuring your history to the patient\'s presentation, suggesting and being able to explain reasoning behind appropriate diagnoses, investigations, and management. It also involves the interpretation of clinical signs and clinical data and investigations in context of patient presentation.
Practice relating medical conditions to how a patient may present and what clinical signs and investigations results you may expect. At the end of history taking and examination consider likely diagnoses and ask / examine further to help gather more evidence. For more senior years, you may develop the skill to do this during history taking / examination so you can adapt according. Use case-based learning material to help familiarise with patient presentations and patient journey. Spending time on outpatient wards, with patients and observing clinicians can greatly improve clinical reasoning.
-
CLINICAL MANAGEMENT
This relates to how you assess and manage clinical conditions. This is especially in the emergency. This includes undertaking clinical observations / ABCDE assessment, demonstrating prioritisation and appropriately seeking help.
Practice ABCDE assessment, interpreting NEWS charts and observations, enquire with tutors / clinicians how they prioritise, observe doctors in clinical practice.
-
PROFESSIONAL BEHAVIOUR
Professionalism
This relates to your professional approach to the patient, colleagues and staff (e.g. examiners). This includes introducing yourself, being courteous and non-judgemental, avoiding any bias or prejudice as well a professional manner.
Reflect on your behaviour and demeanour and review and seek feedback from others. Consider if you have any biases, prejudices or attitudes that may affect your interactions. Observe how others conduct themselves in the clinical and teaching environment.
-
SAFE PRACTICE
This refers to aspects that may affect patient safety. This includes missing an important, serious or life-threatening condition, by an inadequate history (red flags), examination. It also includes inappropriate or inadequate investigation or management plans. Patient safety also includes infection control measures and appropriate patient checks such as verifying identity.
Practice infection control measures. Consider what symptoms / signs / results would alert you to serious disease. Whenever you are with a patient consider are there any immediate risks, what is the worse condition this could be or that could happen in this situation. Are you comfortable that you have covered these possibilities?
-
CLINICAL KNOWLEDGE
Whilst the OSCE is a skills based assessment. The students will need some clinical knowledge to undertake clinical skills safely and appropriately. This includes: Information gathering - gathers appropriate information; Explanation & planning - provides correct & appropriate information; Detects abnormalities in clinical data and investigations.
You need to improve your clinical knowledge base, in the same way as you would for the knowledge (SBA) examinations.
-
PATIENT CENTRED PRACTICE
This refers to how much you consider and focus on the patient. This includes addressing any discomfort / distress, listening to and building a rapport with the patient, being empathic, maintaining patient dignity, respecting the patient. seeking their perspective and involving them in the proceedings.
Even with models or manikins always treat them as you would a real patient. When practice consultations or examinations asks others to observe this aspect of your practice. Consider how would you like a close family member to be treated if they were the patient?
-
TIMING & STRUCTURE: CLINICAL TEAM
Timing & Structure
This refers to how you…
- Consult in a time effective structured and logical manner
- Examine in a time effective structured and logical manner
- Conduct procedures in time effective structured and logical manner
Practice your consultations, examinations and procedures under timed conditions. Use appropriate reading / guidance / workbooks / checklists to help to practice structuring.
Clinical Team
Effective Teamworking skills with good communication, delegation and assigning of tasks – this is generally not assessed in OSCEs