Communication
Every OSCE involves communication but in these OSCEs communication is the focus of the assessment.
The domains that are likely to be tested in these stations are: Communication, Medical expertise, Professionalism and Health advocacy.
It is most important with these stations that you take an empathetic approach, use appropriate language, and successfully communicate the important information to the role player (patient/relative/colleague).
The best way to achieve success in these OSCEs is to practise them over and over again. It is obvious which candidates have practised. Practise them in your study group, during your ED shifts and ask FACEMs to observe you and give you feedback. It is useful to have your study group film you doing these stations, as you may identify weaknesses you are not aware of.
Tips for the Communication OSCEs (what examiners are looking for):
Introduce yourself
Establish rapport with patient (including good use of body language and eye contact)
Maintain confidentiality and assure patient/colleague of this
Start with open ended questions
Use appropriate language (e.g. not medical jargon)
Actively listen and resist interrupting early
Respond to prompts and non-verbal cues
Convey understanding and empathy
Logically use second order questioning to focus on and differentiate presenting problem/s or concerns
Avoid premature closure
Repeat back parts of what the role player has said to confirm listening and understanding and try to use shared decision making
Conclude by asking for any further information that the patient wishes to convey
There is a broad range of scenarios that could be assessed. Here is a list to get you started, but there are many more.
Click on the links for examples.
Open Disclosure
- Missed diagnosis
- Adverse event
- Procedure complication
End of life discussion
Challenging Conversations
- Chronic pain - Abdo pain
- Aggressive patient or relative
- Anxious parent
- Complaint
Essential Communication
- DAMA
- Consent
- Discharge advice - e.g. bronchiolitis, head injury
- Informed decision making - e.g. PE workup
- Management explanation e.g. renal colic, snakebite
- Cultural competency
- Debrief
Sensitive Discussions
- Early pregnancy bleeding
- Sexual assault
- NAI
- Domestic violence
Communication with colleagues
- Difficult referral
- Handover
- Phone advice
- Impaired colleague
- Trainee issues – e.g. performance feedback, stressful shift
- Junior Dr adverse event
- Inter-Professional Conflict