my very first osce..:p

Yeay!!im done with my very first OSCE..i was soo nervousss!but i wud rate it just level with med skul interview n anatomy spotter xm though.

OSCE: Objective Structured Clinical Examination
There are 6 stations altogether. Here are some xperience i cud share bout the xm..it was fun + challenging + nerve-wracking..!!Simulated patients r used..they r the locals from all around nottingham area. We were allocated 5 mins in each station to finish what ever task given..they'll automatically stop us if we exceed the allocated time. After time's up, bell is rung n we need to move to the next station. So practically we cud only "breathe" if we finish the station in less than 5 mins. I started off with the 3rd station. Other areas we learnt but didnt come out in the exam includes Cardio xamination, Resp xamination, JVP, infant CPR, First aid, hand hygiene, and Peak Flow Rate.

Station 1: History Taking
We were asked to take the medical history of the simulated patient. Thank God the time's up right after I shook the patient's hand after thanking her for the interview. Here goes the summary of my interview..(might miss here n there but basically the points r there)
Me : Hi, I'm Fiqa. Im a first yr med student. I need to take your med history today. is it alrite for u?
Patient : Yeah sure.
Me : Alrite good, may i have your name please. (...n then all bout the demographic info eg age, status n jod)
Me : So what seems to be the problem today?
Patient : Owh i've got this chest pain really.
Me : Can u tell me more about the pain?
Patient : (honestly i 4got wut she said when i asked her this but wut im sure bout was her answr wasnt the one i was hoping for n her answer was rather short for an open question i gave)
Me : How long has it been like this?
Patient : Well it started off about 3 months ago when i was on a holiday walking with my family.
Me : Wut is the worse pain u ever experienced compared to this chest pain u're having?
Patient : Owh i think this is the worse.
Me : Owh so if u were to rate the pain from the scale 1 to 10...
Patient : Perhaps 7..
(bla..bla..bla..)
Me : May i know wut's ur expectation of today's consultation really?
Patient : I wud love to if the doctor cud run some test to find out wut's happening with me.
(bla..bla..bla)
Me : So before i summarise wut u've told me earlier, do u hav anything else to let me know?
Patient : Yea, im quite concern n afraid if this could be an angina...(she did add some more but cudnt bring myself to remember them all)
(then i summarised everything she told me....lastly thanked her)

Things i miss!!: To ask bout any radiation, to ask if she's smoking n bout her drinking as well...!
Comment frm the examiner: I've got almost everything i need to know, but because i hav the kind of info i want in my head, so sometimes i stumbled, making it less easier 4 patient to understand my questions

Station 2 : Medical Records
Here we ought to convert all the info frm our previous history taking station into a nice medical records with appropriate format and layout.

Station 3 : Medical Ethics
Here we were given a case study and then we ought to give our opinion on the issue involved using the appropriate ethical principle and other factors to come out with our own sort of solution. My case study was about a bus driver who's having an angina is asking for a "stronger medication" n ask me as the GP to not telling his medical problem to the bus company.
Comment frm examiner : I got the principles right n complete (the principles i elaborated on were breech of confidentiality under respect patients' autonomy n non-maleficence etc), but perhaps about the other factors involved in the situation i can add about religous n cultural belief n legislation (i only mentioned bout financial situation, nature of the job n few more i cudnt remember)

Station 4: Peripheral Arterial Pulses
Alhamdulillah i was able to identify all the peripheral pulses in time.
Radial : Medial to radius at wrist
Brachial : Medial to biceps tendon in cubital fossa
Carotid : Lateral to larynx medial to medial border of SCM
Superficial Temporal : Anterior to ear
Femoral : Inferior to inguinal ligament at the mid-inguinal point (between ASIS n pubic symphisis)
Posterior tibial : Posterior to medial malleolus at the medial border of calcaneal tendon
Dorsalis Pedis : Lateral to Extensor hallucis longus tendon (He claimed i wasnt actually feel the pulse here coz he said i felt it rather lower down coz it supposed to be at the peak of the dorsum, gosh!i really felt it!i even counted 1,2, 3 to confirm!he said he didnt feel the pulse when he put his 2 fingers at the area where i claimed i felt the pulse!i did argue with him bout this..of coz i need to defend myself but at last i just said like "yeaa..okay..alrite..ic2" tanda malas nk layan so i wudnt seem as being uncommentable or inadvisable.)
His question : What might it suggest if there's no pulse? (something like that)
My answer : Meaning there's an obstruction of the artery..like thrombosis
His question : In what condition does that's more likely to occur?
My answer : Like when the patient has high cholesterol level
His question : And...? (shoot..why does he has to say 'and'!..tau dak org gelabah dah ni!)
My answer : erm..and high glucose level..i.e diabetes (And the bell rang..Phweuuhh!)

Station 5: Blood Pressure Measurement
I think i did pretty well..dont know why i got the patient's bp perfectly normal i.e 120/80..either the patient is perfectly normal or my reading is not precise.
Ive mentioned my deflation time was 2 mmHg per heart beat but the examiner said i deflated it faster than that..well maybe..i dnt know
His question : What other problem that high bp causes? (If im not mistaken, that was wut i heard..haha gelabah smpai terlupe nk confirm kn ape soalan die)
My answer : Erm..high bp wud cause heart problem...
His question : Why is that?
My answer : Because high bp will put put more strain on the heart..meaning the heart needs to work extra harder to pump the blood out which might result in hypertrophy.
His question : So what's the disease?
My answer : Err...heart problem..?? (His making "the face" as a signal 4 "u're getting there dear...")..emm..congestive heart failure (gosh wut am i thinking..yes dat's wut i think!!)
His "answer": Well, perhaps it's like coronary heart disease...(tp mengapakah???owh im so confused!!didnt get the chance to ask him y coz the time's up alredi...)

Station 6 : Adult CPR
Basically just requires me to do an adult CPR on a dummy after being given a situation. Everything ran smoothly, but it's just that my ventilation to the patient wasnt "effective" enuf..but thank God there's still a few seconds left so the examiner asked me to repeat the procedure n Alhamdulillah it was sooo very effective that time around..hahaha Really like the examiner..sgt lenient.

Pretty long eh?hehe..so grateful the osce's over..now jst need to face wut ever result it turns out to be..(",) xm result will be available on the nle on 20th june..anyhow, sy di msia sudeyh!!hehe..
HAPPY SUMMER HOLIDAY!!