OSCE Examination

Dr. Ahmed Gado, M.D.

Consultant Gastroenterologist
Misr International Hospital, Giza, Egypt.
Member of the Egyptian Fellowship Board of Medicine
Member of the Scientific Committee, Egyptian Med. Board
Member of the American Society of GI Endoscopy (ASGE)
Member of the British Society of Gastroenterology (BSG)
Reviewer, International Editor, Gastrointestinal End. (USA)
 OSCE

Objective Structured Clinical Examination

 Objective

All candidates are assessed using exactly the

same stations with the same marking scheme
 Structured

Structured stations

Stations have a very specific task:

• History taking
• Clinical examination
 Clinical examination

In an OSCE, clinical skills are tested rather

than pure theoretical knowledge.
Criteria of good
performance
Criteria of good performance

We’ve already decided

how good we want you
to be
 Criteria of good performance

Performance: Organized and systematic way

in thinking, asking questions and doing
examination

Findings: Eliciting proper symptoms and

identifying correct physical signs
Criteria of good performance

History taking case

 History taking

1. Introduction
2. Symptoms: analysis of symptoms
3. Symptoms: associated and related symptoms
4. Confirm patient’s knowledge and understanding
5. Detect patient’s concerns
6. Treats patient respectfully and sensitively
7. Questions by examiner [summary, diagnosis, DD
and management]
 Fixed standards
[Free marks]

1. Introduction
2. Symptoms: analysis of symptoms
3. Symptoms: associated and related symptoms
4. Confirm patient’s knowledge and understanding
5. Detect patient’s concerns
6. Treats patient respectfully and sensitively
7. Questions by examiner [summary, diagnosis, DD
and management]
 History taking

Introduction

- Introduce yourself [name, hospital]

- Aim and gain consent [history or examination]
- The patient information [name, age, occupation]
 History taking
Symptoms

- Analysis of the symptoms

- Associated and related symptoms (etiology, risk factors,
complications if any, alarm symptoms)
History taking of a patient with epigastric pain
since one month
Analysis of the symptoms:
Pain character [type, location, onset, timing, duration,
severity, radiation, precipitating and alleviating factors]

Associated and related symptoms

Vomiting, diarrhea, constipation, jaundice, GI bleeding
(hematemesis and melena) and malignancy (anorexia,
fatigue and weight loss)

Risk factors: Smoking, alcohol intake, Drugs intake

(aspirin, NSAIDs), previous medications and
investigations
 History taking

Patients` knowledge and concerns

- Do you want to ask anything

- Do you have any worries or fears
 History taking

Treat the patient respectfully and sensitively

- Ask permission to take history

- Thank the patient at the end
Criteria of good performance

Clinical examination case

 Clinical examination

1. Introduction
2. General examination
3. Local examination
4. Local examination
5. Treat the patient respectfully and ensures comfort,
safety and dignity
6. Questions by examiner [summary, diagnosis, DD
and management]
 Fixed standards
[Free marks]

1. Introduction
2. General examination
3. Local examination
4. Local examination
5. Treat the patient respectfully and ensures comfort,
safety and dignity
6. Questions by examiner [summary, diagnosis, DD
and management]
 Focused clinical examination
Introduction

- Introduce yourself [name, hospital]

- Aim and gain consent [history or examination]
- The patient information [name, age, occupation]
- Wash your hands
Focused clinical examination

General examination: Focus on signs related to

the case

Local examination: As usual

 Focused clinical examination of the
respiratory system

General examination and focus on:

- Clubbing
- Respiratory failure (cyanosis, flappy tremors)
- Corpulmonale
- Examination of lymph nodes

Local examination:
- Trachea, inspection, palpation, percussion, auscultation
 Focused clinical examination of the
abdomen

General examination and focus on:

- Stigmata of liver disease

Local examination:
- Inspection, light palpation, deep palpation, percussion,
auscultation
 Focused clinical examination of lower limbs to
asses the cause of weakness in the right side

General examination and focus on:

- Pulse, blood pressure
- Carotid (thrill or bruit)
- Heart [apical pulse and murmurs]

Local examination:
- Inspection, motor, sensory, reflexes, gait
- Ask permission to examine upper limb and cranial nerves
[examiner will say no]
 Focused clinical examination of the
cardiovascular system

General examination and focus on:

- Pulse, blood pressure
- Heart failure signs [right and left]
- Cyanosis
- Stigmata of infective endocarditis [sub conjunctival hge,
clubbing, splinter hemorrhage, nail fold infarct, osler`s
nodes, peripheral pulse]

Local examination:
- Inspection, palpation, percussion, auscultation, maneuver’s
to accentuate murmurs
 Focused clinical examination

Treat the patient respectfully and ensures

comfort, safety and dignity

- Ask permission to examine and explain

- Expose - Ensures comfort and dignity
- Thank the patient and tell them they can get dressed
How can I pass the
OSCE examination?
Train yourself on the way
of examination in OSCE
Best wishes