3rd year

Mock OSCE

You are on your GP Placement

Mary Birchall has come into the GP practice. She
recently had an x-ray taken which incidentally
showed several round opacities in the gall
bladder.
Explain these findings to Mary and discuss
possible treatment

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Wash hands, introduction, establish rapport

Check the patients identity and how to address them
Check understanding of the current situation: establish why they are
here and what they already know
Volunteer to explain what the current diagnosis is and what it might
imply: gallstones
Explanation (to be taken as reference, this guide is not
comprehensive; ensure they cover the following points somehow):
- explain what bile is and that gallbladder acts as a reservoir for it
- simply explain the principle of the biliary ducts, e.g. branches of a
tree
- it is the bile, which is normally liquid, which can form stones
- it is quite common and gallstones dont necessarily cause
symptoms
- gallstones only require treatment if they cause symptoms
- treatment can be medical (medication to avoid further stone
formation, dissolution), shock-wave and surgery
Chunk and check; check patients understanding as going along
Invite patient to ask questions, e.g.
- What will surgery imply? Sample answer: different techniques,
depending on the size and site of stone, from more traditional open
surgeries to keyhole approaches
- Side-effects of surgery? Sample answer: abdominal and pain after
eating, particularly following fatty meals.
- How long will I be in hospital for? Sample answer: variable,
depending on surgical technique. Keyhole surgery would be
performed as a day case, for example.
Acknowledge the amount of information provided and that it can be
overwhelming, and remain empathic. Offer follow-up and mention
where they can get more information (eg. leaflets).
Ask if any further doubts, thank the patient.
Wash hands.

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