Preparing for an OSCE – 5 tips to help you face your fears

An OSCE exam is a typical type of examination (first described in 1975) that is often used in health sciences (e.g. medicine, physical therapy, nursing, pharmacy, dentistry) to test clinical skill(s) performance and competence (knowledge, skills and attitudes) such as communication, clinical examination, medical procedures/prescription, clinical decision making, clinical thinking/reasoning, exercise prescription, joint mobilization/manipulation techniques and/or interpretation of clinical outcome results. The OSCE is now a universally-accepted standard exam in higher education assessment. A mere mention of the word ‘OSCE’ can send students into a frenzy of fear, but understanding its components can help.

Defining the OSCE

OSCE stands for Objective Structured Clinical Examination. To better understand the format, consider the following breakdown of the acronym:

The OSCE examination was developed in 1975 by Ronald Harden, Professor of Medical Education (Emeritus) at the University of Dundee. It was first outlined by Professor Harden in a journal article in The British Medical Journal (BMJ) called Assessment of clinical competence using objective structured examination.

How an OSCE is Implemented

When setting up an OSCE the following aspects must be considered: The number of stations to be used across the examination to create an OSCE circuit whereby a number of 15 – 18 stations is considered as ‘objective’. Students then rotate through a series of timed stations in sequential order. At each station, students will have to work on a different clinical scenario. For example, a 44 year old man presents himself with a complaint of headaches. Obtain a complete history of this complaint.

Candidates or students are given information about the upcoming scenario before they enter a station and are allowed 2 minutes to prepare for the assessment. The length of the station varies and depending on the institution running the OSCE, the station can last any length between 5 minutes and 15 minutes and even sometimes longer. Each station often assesses multiple aspects of a student’s clinical competence across communication, clinical examination, medical procedures/prescription, exercise prescription, joint mobilization/manipulation techniques and interpretation of results.

Top Tips for Preparation

1. Learn from previous OSCEs – but don’t let them define your next one

Always remember: Try not to let your performance in previous OSCEs or practical exams have a bearing on how your next OSCE plays out. Don’t let your mind trick you into thinking you’re at risk of making mistakes you’ve made in the past. Put previous OSCE performances in the past and think of your next OSCE as a brand new invite to master the practical clinical exam format. If things didn’t go to plan in the past, your next OSCE is a clean slate and an opportunity to demonstrate your skills.

Remember ‘three of a kind’ from last OSCE:

• 1. What went well (3 ONLY)
• 2. What could I have done better (3 ONLY!)

The latter is called reflective-feedback. If you’ve already participated in an OSCE in the past, you may have learned lessons or received feedback on where you could have improved. Feedback has been proven to be a huge tool for learning and it can help you to find specific pointers on areas that you can look to improve on when you engage in a similar scenario in the future.

2. Rehearse, rehearse, rehearse

An OSCE is essentially a performance. Like an actor in a play who strives for perfection by going over a scene time and time again until the words come out without thinking, an OSCE scenario can be played out at home with friend, family or other students playing the parts of patient actors. The most convincing and well-prepared students can expect to do well in their OSCEs and rehearsing different stations at home should be an integral part of your preparation. You can even ask someone to be a mock examiner to really replicate the situation.

3. Believe you are a healthcare professional

Of course you’re not officially a doctor or a qualified medic until you pass your final exams and graduate but getting into the mindset of a doctor can help with your performance. Many know that if they are to qualify as professionals, the scenarios that are encountered in an OSCE will become a daily occurrence in their roles. Each station should look to challenge students to apply their clinical knowledge and skills as they work through each scenario encountered.