Obs-Gyn OSCE:

General introduction:
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Who you are, who the patient is, why they are here, whether they have had one before
What the procedure will involve, what the reason for testing is
On period? Prior discomfort?

Explaining procedure:
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Unclothed bottom half. Pillow available for under head and bottom
Heels to bottom, knees fall outwards
Examine the outside: vulva, labia, opening
Place lubricated and sterile speculum in the vagina
Take sample from the cervix using brush
Examine the walls of vagina while removing speculum
Explain:
o Sample goes to laboratory which keeps registry for purpose of reminders, and
anonymous samples for research
o Side effects: some spotting, some discomfort, should not be worse than period.
Should not be painful.
o Explanation performed without medical or offensive terminology
o Stop words
Ask to empty bladder, undress and cover up
Clean hands, organise equipment
o Slides, spray
o Speculum, lube
o Gloves
o Open equipment
Sterilise hands

Procedure:
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Patient appropriately positioned and exposed

Examine vulva, labial folds and entroitus
Closed, lubed speculum to the entroitus, they breathe in, on breathing out insert.
Most of the way in start to open and confirm location, allow cervix to fall into opening
and observe.
If not in location, close, reposition and open again.
Stabilise with one hand, take sample with other hand and smear onto slides
Slowly withdraw speculum from vagina, observing walls.
Allow woman to cover up, once instruments placed away then withdraw behind curtain
and allow to dress.

Questions:
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Relevance and follow-up of:

o CIN1: Not cancerous. Likely viral or change
o CIN2:
o CIN3: