How did OSCEhome.com created the Systematic Approach to the OSCEs and clinical patients encounters. www.oscehome.com. Preparing for Objective Structured Clinical Examination (OSCEs) or Clinical Skills Assessment; USMLE Step 2 CS, MCCQE II, NAC, SAT, PLAB part 2, OSCEs for medical students or International / Foreign Medical Graduates? Would you be interested in help for your Medical OSCE Exam?

1. A Step By Step Guide
To Mastering the OSCEs
and Patient Encounters
How did we create the
Systematic Approach?
Dr Al Imari, MD
www.OSCEhome.com

2. OSCEhome Systematic Approach
 Patients visit doctors complaining of a
symptom, not a disease.
 It is all about the differential diagnosis of
symptoms and signs.
 This is the main focus of physicians
during patients’ interviews, right?
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3. OSCEhome Systematic Approach
 OSCE stations, as well as real life
patients’ interviews, have limited time.
 Physicians have no choice but to be
focused and to organize the interview in
a time efficient manner.
 On the other hand, physicians have to
be vigilant not to miss anything!
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4. OSCEhome Systematic Approach
 Obviously, there is a need for some sort of an
approach that will fulfil both patients and
physicians goals.
 An approach that will explore all the patients’
presenting issues in a limited time frame.
 An approach that will protect both the patients
and physicians.
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5. OSCEhome Systematic Approach
 How did we at OSCEhome formulated the
OSCEhome Systematic Approach ?
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6. OSCEhome Systematic Approach
 We started by preparing a list of all signs
and symptoms a physician faces.
 We wrote one sign or symptom on a
separate sheet of paper.
 Then for each symptom or sign we wrote
all the possible differentials.
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7. OSCEhome Systematic Approach
 Then, we draw a table, assigned a column for
each differential and wrote that symptom/sign
presentation details, quality, duration, relation to
other symptoms/signs, and red flags.. Etc..
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Symptom / sign
DDx 1 DDX 2 DDx 3 DDx 4
…..
…..
…..
…..
…..
…..
…..
…..
…..
…..
…..
…..

8. OSCEhome Systematic Approach
 Then for every detail, we wrote questions
to ask for or points to examine.
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Symptom / sign
DDx 1 DDX 2 DDx 3 DDx 4
….. Do you
….. Is it
….. How is
….. Do you
….. Is it
….. How is
….. Do you
….. Is it
….. How is
….. Do you
….. Is it
….. How is

9. OSCEhome Systematic Approach
 Obviously, there are now, many identical
questions or points to examine concerning this
symptom among all these differential diseases.
 We started to merge the diseases’ columns into
one set of questions. When the same question
is required for several diseases, we placed
these diseases’ names between brackets after
the question to help us later with the clinical
decision making process.
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10. OSCEhome Systematic Approach
 Then we arranged these questions and points to
examine in a logical easy flowing flowchart.
 We have noticed that there are some details that
are not required if you are just screening for a
symptom and not thoroughly gathering details
about it. So, we divided the to ask/do list into
two files, we placed the must ask/do important
ones up in the list for screening, and the rest at
the bottom for detailed data gathering sub-file,
and just in case we run out of time.
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11. OSCEhome Systematic ApproachOSCEhome Systematic Approach
 What about communication skills? It a major
issue to ensure an easy going interview
professional organized interview and to achieve
a mutual understanding and respect.
 We rephrased the questions to meet
communication skills guidelines. e.g. English
language issues, open ended questions, non-
leading questions, respective manner ..etc.
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12. OSCEhome Systematic Approach
 Now, we have all the needed questions to ask
and points to examine concerning that symptom
on a separate sheet of paper.
 We placed the sheet in a separate file, labelled
it with the symptom/sign name.
 Then, we repeated the same process for all
other signs and symptoms.
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13. OSCEhome Systematic Approach
 Again, there are now, many identical
questions or points to examine among all
these symptom/signs.
 We started to gather identical questions
or points to examine into a separate file
box and crossed it out on that symptom/
sign sheet. e.g questions about
medications, past illnesses, social, ..etc.
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14. OSCEhome Systematic Approach
 Now, we have three sets of box files;
1. Chief complaint data gathering box file,
2. Specific symptom/sign box files, and
3. Standard questions box file.
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15. OSCEhome Systematic Approach
 Remember, in real practice, as well as
during OSCE stations, our time is
limited.
 So, we carefully went into each of these
box files and rearranged the questions
and points to examine for maximum time
efficiency.
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16. OSCEhome Systematic Approach
 So we came up with a tree of a step by
step history taking and physical file
boxes.
 During the patient interview, you go
through the file boxes one by one.
 You only open the box files you need.
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17. OSCEhome Systematic Approach
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18. OSCEhome Systematic Approach
 Let us take an example. A patient
presented with cough.
1. Introductions box: 5 sentences to say.
2. Chief Complaint: 10 question to ask.
3. HPI: 15 questions to ask.
4. Respiratory question box: 10 questions to ask.
5. Standard questions box: 14 questions to ask.
6. Wrap up box: Sentences for 8 points to explain.
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19. OSCEhome Systematic Approach
 Most of the patients’ answers will be
“NO”. How long then, will it take you to
ask all these questions and wrap up the
case?
 FIVE minutes! And you have COVERED
all the guidelines and checklists.
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20. OSCEhome Systematic Approach
 We created similar flowcharts for the
physical examination, counselling, and
ER stations that, with practice, will take
you just 5 minutes to perform.
 ONE flow chart of 7 steps with 23 history
taking and 24 physical examinations
boxes to choose one depending on the
case !
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21. OSCEhome Systematic Approach
 Don’t you agree, it is much more easier
to memorize than 488+ checklists!
 Rest assured that all the guidelines and
checks in ANY checklist are fulfilled,
including communication skills.
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22. OSCEhome Systematic Approach
 You won’t forget anything to ask, do, or
explain. No need to anxious and
nervous.
 You will be on a relaxed autopilot mode!
Letting you focusing on the clinical
decision process and communication
skills.
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23. OSCEhome Systematic Approach
 The systematic approach took three of
us a full year to finalize and eight years
so far to tweak.
 Don’t you agree, it is worth a try? It is
yours in just few minutes.
 Save your time and effort and get your
copy now at www.OSCEhome.com ...
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24. A Step By Step Guide to The Mastering
The OSCEs and Patient Encounters
www.OSCEhome.com