General Approach
This may involve teaching a junior or a patient. It may be an actual physical skill such as teaching a junior to perform joint aspiration; how to perform a systems exam; or how to interpret something such as an ECG .
Adopting a generic approach will help maximise your marks even if you are a little rusty on the knowledge side of things. A large proportion of the marks are given to how you approach the teaching of the topic rather than the minutiae of the skills.
There are two main areas candidates tend to run into trouble with in these stations. The first is timing, and the second relates to how you maximise the educational experience for the learner.
For these reasons, some candidates will include the following easy to achieve marks in their opening:
- Identifying any learning objectives from the learner.
- Ascertaining previous prior experience.
- Signposting to further resources.
- Stating you would get the learner to practice the skill after it has been demonstrated.
Introduction
“Hello, my name is Dr Smith I am one of the Senior Doctors working in the Emergency Department today.”
“What is your name, and what level/grade are you?”
“I just want to make sure the patient and department is safe before we begin.”
“I understand you wanted to learn about…? Is that correct?”
Establish previous experience/Signposting
Ascertain level/what they want
“So, before we start…”
“In terms of previous experience…”
- What do you…
- What would be…
- Do you have…
“As we only have a short amount of time…”
- online resources are…
- would you like to meet to discuss further…
“So before we start…”
- “What do you already know about this procedure/skill?”
- “What would be most useful for you to cover?”
- “Do you have anything specific you would like to concentrate on?”
Learning objectives
“From what you have said shall we focus on?..”
“Feel free to ask questions as we go along.”
“We will go through the skill in a staged process (scenario dependent)”:
- I will do the skill/procedure; talking it through as we go.
- Then if you feel happy you can do it with me supporting you.
Explain procedure and obtain consent
To the examiner: “I would ensure I have spoken to the patient to ensure they were happy with the learner being present.”
State to the learner you would:
- Explain the procedure to the patient
- Obtain their consent (see Chapter 4)
Preparation
Confirm
- Correct patient
- Adequate analgesia currently
- Site
- Appropriate investigations have been reviewed (e.g. chest x-ray or chest drain)
- Calculate any drug doses needed (e.g. local anaesthetic)
- Require monitoring is attached
Prepare
- patient position
- required equipment
Perform skill/procedure
- Use a staged approach as appropriate
- Support learner/correct technique as you go
- Ensure you mention any:
- Investigations needed post procedure (e.g CSF analysis post LP; CxR post chest drain)
- Discharge advice if patient going home
Close
“So in summary we have looked at…”
“The learning objectives we considered were…”
“Do you have any other questions about what we have covered before we close?..”
Potential stations
Any of the procedures in Chapter 9 or examinations listed in Chapters 6 and 7 in may be designed to be assessed as a teaching station. In the virtually run OSCEs candidates have been asked to demonstrate or talk through how you would perform a procedure or an examination. Below is a list of other possible topics, it is divided into topics that lend themselves either to be aimed at teaching a colleague or a patient.
Teach a Colleague
Procedure
Interpretation – Fluid analysis
Interpretation – Radiology
Teach a Patient