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    Family Medicine OSCE Dr. Rebeca Hoilett

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    Fatma El Fares
    This document provides guidance on communication skills and sample scenarios for a family medicine OSCE exam. It outlines the importance of verbal and non-verbal communication as well as active listening skills. Sample scenarios covered include breaking bad news about abnormal test results, counseling for HIV pre-testing, smoking cessation advice, and dealing with difficult patients/relatives. The document recommends a structured approach for patient encounters that addresses the chief concern, assesses risks or previous attempts, provides explanations, allows for questions, establishes a management plan and follow up. Checklists are used to evaluate performance in the OSCE exams.

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    Family Medicine OSCE Dr. Rebeca Hoilett

    Uploaded by

    Fatma El Fares
    41 views20 pages
    This document provides guidance on communication skills and sample scenarios for a family medicine OSCE exam. It outlines the importance of verbal and non-verbal communication as well as active listening skills. Sample scenarios covered include breaking bad news about abnormal test results, counseling for HIV pre-testing, smoking cessation advice, and dealing with difficult patients/relatives. The document recommends a structured approach for patient encounters that addresses the chief concern, assesses risks or previous attempts, provides explanations, allows for questions, establishes a management plan and follow up. Checklists are used to evaluate performance in the OSCE exams.

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    Osce

    Original Title

    Family-Medicine-OSCE-Dr.-Rebeca-Hoilett

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    This document provides guidance on communication skills and sample scenarios for a family medicine OSCE exam. It outlines the importance of verbal and non-verbal communication as well as active listening skills. Sample scenarios covered include breaking bad news about abnormal test results, counseling for HIV pre-testing, smoking cessation advice, and dealing with difficult patients/relatives. The document recommends a structured approach for patient encounters that addresses the chief concern, assesses risks or previous attempts, provides explanations, allows for questions, establishes a management plan and follow up. Checklists are used to evaluate performance in the OSCE exams.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    41 views20 pages

    Family Medicine OSCE Dr. Rebeca Hoilett

    Uploaded by

    Fatma El Fares
    This document provides guidance on communication skills and sample scenarios for a family medicine OSCE exam. It outlines the importance of verbal and non-verbal communication as well as active listening skills. Sample scenarios covered include breaking bad news about abnormal test results, counseling for HIV pre-testing, smoking cessation advice, and dealing with difficult patients/relatives. The document recommends a structured approach for patient encounters that addresses the chief concern, assesses risks or previous attempts, provides explanations, allows for questions, establishes a management plan and follow up. Checklists are used to evaluate performance in the OSCE exams.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 20

    Family Medicine Osce

    Station
    Dr Rebekah Hoilett Duncan
    MBBS, Dip Fam. Med. Distn
    Communication and the Health
    Professional
     Verbal Communication – Effective use of language
    skills to explain and present ideas clearly without the
    use of jargon; appropriate use of open and closed
    ended questions.
     Non-verbal Communication – body language, facial
    expression, gestures, pictures.
     Listening Skills – cues, silence (pause), interrupts
    inappropriately, attentive to answers and concerns.
    Critical use of Communication
    Skills include:
     Explaining diagnosis, investigation and treatment.
     Breaking bad news.
     Seeking informed consent.
     Advice on lifestyle, health promotion or risk factors.
     Difficult or anxious patients or relatives
    Family Medicine and the Osce
    Scenarios which you encounter daily:
     Breaking bad news – abnormal pap smear, abnormal
    mammogram.
     Counselling – HIV pre-test, birth control.
     Lifestyle/Health promotion – Smoking cessation,
    screening tests.
     Difficult Patients/Relatives – Medical ethics,
    Confidentiality, Consent
    Checklist/Marking Scheme
     Points earned according to checklist.
     If checklist item not mentioned or not dealt with
    appropriately point cannot be given.
     Read scenario appropriately and stay focused on given
    objective, eg smoking cessation, don’t ramble on about
    stages of lung cancer etc.
     Nothing new, what you do daily with each patient
    encounter…….Relax !
    Structure
     The structure of the patient encounter should be
    tailored towards the scenario as well as to the
    individual patient however certain aspects are basic,
    allowing quick and easy earning of points.
     Greet patient appropriately.
     Introduce yourself and ascertain patients name,
    maintain good rapport throughout the encounter.
     Establish reason for visit.
    Structure Cont’d
     Patients understanding of test/procedure, disease,
    previous attempts at lifestyle modifications. (Also
    illicit fears/concerns and pass experiences if any).
     Risk assessment where appropriate – eg. Smoking
    cessation- length of years smoking, number of
    cigarettes smoked daily, other drugs; HIV pre-test -
    sexual practices and other potential at risk practices.

     Important not to be abrupt when breaking bad news.


    Structure Cont’d
     Manner in which news is given if breaking bad news.
    Build up to the result, eg. “As you know we took a
    biopsy (reason for visit already established), and the
    results are not as we hoped, (PAUSE…..pausing and
    waiting allows patient to reflect and formulate
    questions which may lead the consultation)
    Unfortunately/I’m sorry to tell you its …..
    Structure Cont’d
     Establish support system.
     Illicit patients understanding eg may ask patient to
    summarize what they have understood.
     Allow questions and answer, if unable to answer do not
    be afraid to say you will find out.
     Address concerns
     Management plan when appropriate (eg. Next steps
    etc. start date to smoking cessation)
    Structure Cont’d
     Do not reassure inappropriately.
     Summarize the patient encounter, including what was
    discussed, understanding, items to follow up on.
     Set an early follow up appointment.
     Make yourself accessible to discuss with patient and
    patients support system IF it is the patients wish.
     Thank your patient.
    Practice Scenarios
     Counselling – HIV Pre-test
     Health Promotion/Lifestyle Modification – Smoking
    Cessation
     Breaking Bad News – Abnormal pap smear or
    mammogram
     Difficult Patient/Relative
    HIV Pre-Test
    HIV Pre-Test Cont’d
    HIV Pre-Test Cont’d

    http://bcs.wiley.com/he-bcs/Books?action=mininav&bcsId=7645&itemId=0470659416&assetId=304427&resourceId=29970&newwindow=true
    Smoking Cessation

    http://academicdepartments.musc.edu/fm_ruralclerkship/curriculum/osle.htm
    Breaking Bad News

    http://www.radcliffehealth.com/sites/radcliffehealth.com/files/books/samplechapter/6584/21-app4-1b575c60rdz.pdf
    Difficult Patient
     Scenario - Joan Lavis is the mother of your 17 year old
    patient, Sandra Lavis, she came to your office asking to
    see you. Please talk to her in the next 5/ 10/15 minutes.
    (Confidentiality/ Demanding/ in this scenario you
    will discover that the mother found an appointment
    card in her daughter pocket while doing the laundry.
    She demands and insists to know the reason of her
    daughter's visit. Note: no reason was given for the visit
    in the stem question).
    Difficult Patient Cont’d
     Approach
    - Explain Doctor/Patient Relationship ethically
    bound in confidentiality.
    - Competence established.
    - Suggest mother and daughter speak, other factors,
    lack of trust.
    - Offer group session.
    - Maintain professionalism, calm demeanour.
    References/Links
     http://bcs.wiley.com/he-
    bcs/Books?action=mininav&bcsId=7645&itemId=0470
    659416&assetId=304427&resourceId=29970&newwind
    ow=true
     http://www.radcliffehealth.com/sites/radcliffeheal
    th.com/files/books/samplechapter/6584/21-app4-
    1b575c60rdz.pdf
     http://academicdepartments.musc.edu/fm_ruralcl
    erkship/curriculum/osle.htm
    Questions ???

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