Y4 OSCE student feedback PDF

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Y4 OSCE student feedback notes...

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Fourth Year OSCEs – Friday 7th June 2019 STATION 1: AGEING & HEALTH: URINARY RETENTION General examiner feedback to students Generally good performance with good communication skills, and most students had a structured approach. Most students competently interpreted NEWS chart and were familiar with fluid balance charts. The management of the situation was good in most cases. However some students were not knowledgeable regarding some of the relevant medications (even with the aid of the BNF) and many students did not recognise the key diagnosis of urinary retention. Main learning points/concerns 1. Need to develop ability to bring together knowledge and history taking and assessments of charts. 2. Need to improve awareness of commonly used medications and side effects ( 3. Remember that in some stations multiple clinical problems may be present 4. It was obvious to examiners which students were familiar with the NEWS chart and fluid balance chart, and which were not. 18.1% students did not achieve the cut score (pass mark) in this station.

STATION 2: GP: STROKE General examiner feedback to students This was generally thought to be a good station and was well performed by almost all students (and nearly all recognised stroke). Most demonstrated good interaction with patient. However, many students did not read the instructions and thus risked wasting time. Main learning points/concerns 1. 2. 3. 4.

Make sure to treat as any other station (ie ask for name, location, age etc) Take cues from simulated patient. Think your way through the situation practically Do not suggest ringing ambulance until you have completed relevant history (don’t rush to this conclusion prematurely) 5. Remember how important it is to test the concerns of patients and to respond appropriately to patient anxiety. Don’t assume patient knows about strokes. 6. Read the instructions carefully and listen if the examiner redirects you 8% of students did not achieve the cut score (pass mark) in this station.

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STATION 3: PSYCHIATRY: ALCOHOL DEPENDENCE General examiner feedback to students Students generally performed well. Most were very sensitive and empathetic in their approach. Some students lacked a structured approach. Few adequately Main learning points/concerns 1. Remember to read the instructions (many students tried to counsel the patient when this was not necessary). 2. Remember the importance of communication skills in a sensitive situation 3. Certain clinical contexts, such as this, are difficult or embarrassing for some patients – develop your awareness around these issues. 7.2% of students did not achieve the cut score (pass mark) in this station. Station 4: Rest

STATION 5: RADIOLOGY: NG TUBE General examiner feedback to students Most students were good in that they took a systematic approach. Most gave good detail on image quality etc However many students did not seem to be aware of what they were looking for. Some could not locate the NG tube on the CXR and did not seem to be fully aware of how Even when aware of the clinical scenario demonstrated, many did not suggest “nil by mouth”. Main learning points/concerns 1. This is a real situation which arises often in the clinical situation. 2. Ensure patient safety. 3. Demonstrate that you are of students did not achieve the cut score (pass mark) in this station.

STATION 6: POEM: IV FLUIDS General examiner feedback to students Generally well performed and most students demonstrated ability to prescribe safely. It was clear when students had previous experience and familiarity with charts. Main learning points/concerns 1. 2. 3. 4.

Think logically, take your time. Prescribe bags in the volumes available. Gain practical experience prior to the examination. Improve your ability to present a summary of your findings.

8.8% of students did not achieve the cut score (pass mark) in this station. 2

STATION 7: POEM: INTRAVENOUS CANNULATION General examiner feedback to students Generally students did well on this station but many omitted Not all students were adequately aware of safety issues (eg many threw cap away). Students who had greater familiarity with equipment performed better. Many students demonstrated an accomplished and explanatory manner with the patient. Main learning points/concerns 1. 2. 3. 4. 5.

This is a very important topic and requires preparation and pre-exam-practice. Some students Talk to patient-explain procedure and put them at ease. It is a common scenario that Foundation doctors deal with frequently-gain knowledge and experience whenever the opportunity arises. Be prepared and well organised. did not achieve the cut score (pass mark) in this station.

STATION 8: CANCER STUDIES: PALLIATIVE CARE LUNG General examiner feedback to students Most students had a good systematic approach and demonstrated good communication skills. Most were empathetic. However it was also apparent that whilst some students possessed adequate knowledge they found it difficult to explain/communicate sensitively with the SP. Main learning points/concerns 1. 2. 3. 4.

Read student instructions and use these to guide you. Listen to the patient’s questions. Avoid technical jargon. Do not forget to identify yourself and the patient.

6.4% of students did not achieve the cut score (pass mark) in this station.

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Fourth year OSCEs – Tuesday 11th June 2019 STATION 1: O&G: PLACENTA General examiner feedback to students Many students performed sub-optimally on this station. History taking was sometimes lacking in structure. Ultimately the majority of students reached the correct diagnosis however. Main learning points/concerns 1. This is an obstetric emergency-be aware of this. 2. Students must ask about fetal movements-remember that there are two patients here, the mother and the baby. 15.3% students did not achieve the cut score (pass mark) in this station.

STATION 2: GP: BLOOD PRESSURE General examiner feedback to students Students were generally good and demonstrated good levels of knowledge and were empathetic. There were weaknesses in performance however, including some students spending

Main learning points/concerns 1. 2. 3. 4.

Be sure to adopt a systematic approach to history taking. Try to ascertain the patient’s concerns. Try to involve the patient in decision-making and devise a clear action plan. Be aware of NICE guidelines re

10.4% of students did not achieve the cut score (pass mark) in this station.

STATION 3: PSYCHIATRY: General examiner feedback to students Generally students performed well. Most were sensitive and empathetic and most were aware of details of MHO. There was however frequently a lack of awareness of how patients are brought to hospital. Many students ’ Main learning points/concerns 1. Some students were not clear on the objective of the station and spent excess time on the history when they had been instructed to focus on answering questions. Focus on the question posed. 2. Avoid jargon. 3. Sedation before a patient arrives in hospital is not the norm. 4. Understanding the theory is obviously important but be sure you can also explain how to put into practice. 5. Be decisive and clear about process. Opening comments are very important. State clearly who you are and the purpose of the consultation. 11.6% of students did not achieve the cut score (pass mark) in this station.

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STATION 4: REST

STATION 5: HoC: CROUP General examiner feedback to students There was a generally high standard, with good management plans and safe practice. The however. Many students students had a structured approach to assessing and presenting an acutely unwell child.

Not all

Main learning points/concerns 1. Ensure patient safety, and safety netting. 2. Say what you see, not what you expect to see. 3. Talk through what you see as clearly as possible (to assist the examiner) 4. 14.1% of students did not achieve the cut score (pass mark) in this station.

STATION 6: O&G: PMB General examiner feedback to students From most students a very good performance. Almost all students undertook a reasonable assessment of the patient and had a systematic approach. Some students were more haphazard in their approach however. Most students adopted a sympathetic approach (and when this did not happen examiners thought that anxiety may have been the cause). A number of students missed associated symptoms (eg weight loss). Main learning points/concerns 1. Focus on time-keeping-there was 2. Ensure you learn to listen to the patient. Think about how you ask questions-do not make assumptions. 3. Don’t forget to ask about smear history; sexual history; past obstetric history. 6% of students did not achieve the cut score (pass mark) in this station.

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STATION 7: FRACTURES: LONG LEG PLASTER/COMPARTMENT SYNDROME General examiner feedback to students In general the examiners were impressed and thought that the students showed a good and consistent approach. There was often evidence of a systematic approach, and evidence of additional reading but this did not apply to all students. Main learning points/concerns 1. In any station emphasise urgency when necessary-as it is here. 2. Ensure you are competent in completing a thorough examination of a limb (eg when examining for a pulse ensure do so in right place). 4.4% of students did not achieve the cut score (pass mark) in this station

STATION 8: HoC: GROWTH CHARTS General examiner feedback to students Very good overall performance. Technical approach generally good ( ). It was very obvious when a student had completed the task before, and indeed handled a baby before. Not all students were able to suggest an good at interpreting growth chart.

. Not all students

Main learning points/concerns 1. 2. 3. 4. 5.

Remember to adopt professional behaviour-think about introduction and rapport. Say what you see on the chart. Remember to verbalise to examiner. Avoid jargon. Practice measuring head circumference.

15.3% of students did not achieve the cut score (pass mark) in this station.

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