Get through clinical finals : a toolkit for OSCEs

312 Pages·2006·1.565 MB·English

by  Chan, Michelle, Papanikitas, Andrew, Bahal, Nawal

Get Through
Clinical Finals:
A Toolkit for OSCEs
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Get Through
Clinical Finals:
A Toolkit for OSCEs
Andrew Papanikitas BSc (Hons) MA MBBS
Senior House Officer
Aylesbury General Practice Vocational Training Scheme
Nawal Bahal BSc (Hons) MBBS
Senior House Officer
Anaesthetics and ITU,Oldchurch Hospital,Romford
Michelle Chan BSc (Hons) MBBS
Senior House Officer in Ophthalmology
Royal Free Hospital,London
© 2006 Royal Society of Medicine Press Ltd
Published by the Royal Society of Medicine Press Ltd
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permitted under the UK Copyright, Designs and Patents Act, 1988, no part of this publication
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the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the
publishers at the UK address printed on this page.
The rights of Andrew Papanikitas, Nawal Bahal and Michelle Chan to be identified as authors of
this work have been asserted by them in accordance with the Copyright, Designs and Patents
Act, 1988.
British Library Cataloguing in Publication Data
Acatalogue record for this book is available from the British Library
ISBN 1-85315-615-9
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Contents
Preface vii
Acknowledgements ix
Part 1 Basic framework
1. Introduction 3
Part 2 Skills in communication and ethics
2. Communication skills 13
3. Ethics for OSCEs 21
4. Obtaining consent for a post mortem 27
5. Perioperative advice 31
Part 3 History and counselling skills
6. History taking 37
7. Specific histories 43
8. Psychiatry for OSCEs 53
9. General practice scenarios 67
10. Medications and counselling 75
Part 4 Examination skills
11. Examination of the abdomen 81
12. Arterial examination 87
13. Examination of the breast 93
14. Cardiovascular examination 97
15. Respiratory examination 105
16. Cranial nerve examination 109
17. Dermatological examination 123
18. Examination of the ear 129
19. Gait examination and GALS screening 133
20. Examination of the limbs 137
21. Hip 159
22. Spine 163
23. Lumps 167
24. Examination of the neck/thyroid 171
Get Through Clinical Finals
Part 5 Special situations
25. Gynaecological history 177
26. Sexually transmitted diseases 183
27. Oral contraceptive pill and emergency contraception 187
28. Vaginal examination and cervical smear and swab 193
29. Obstetrics 199
30. Paediatrics 207
Part 6 Practical skills
31. Basic life support and advanced life support 231
32. Prescribing 239
33. Confirmation of death 247
34. Interpret and record a 12-lead ECG 251
35. Body mass index (BMI) 263
36. Arterial blood gases (oxygen therapy) 265
37. Blood transfusion 269
38. Syringe pumps and drivers 273
39. Male catheterization 277
40. Venous cannulation and setting up a drip 281
41. Nasogastric intubation 283
42. Public health and evidence-based medicine 285
Index 293
vi
Preface
There’s no getting away from the fact that finals are tricky. Not difficult
but tricky, like riding a bike or swimming. Once you know how to do it,
it is second nature, but before you do, it can be akin to a miracle.
Many people will tell you how unfair finals can be, about how they
got a distinction in the written only to fail the clinical exam. The truth is
that no other exam reflects adequate preparation better than the clinical
finals.
Our aim when preparing for the finals was to be ready for ‘the
googly’, to use a cricketing term. The result was a comprehensive list of
what we expected, how to approach it, and how to shine. We also
realized just how useful what we learned could be to future students.
Not just a checklist of things to do but things not to do, and how to
assess what is wanted of you.
There exists an obscure area between being a final-year medical
student and becoming a confident House Officer. It involves possessing
and implementing an understanding of not only medicine, surgery and
psychiatry but also ethics, communication and administrative skills,
amongst others. This book is intended to help identify this whole area
and show the reader the common pitfalls and, by combining such
information, how to successfully ‘mind that gap’.
Nawal Bahal
Andrew Papanikitas
Michelle Chan
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Acknowledgements
We would like to thank our parents for support and encouragement, as
well as Miss Andrea Ogden, Miss Niran Bahal and Miss Victoria
Hyslop. We would also like to thank the staff of the Conquest Hospital,
Hastings, including Dr Richard Wray, Dr James Dennison, Dr Martin
Clee, Mr Simon Baer, Mrs Lesley Rudling, Miss Nikki George, as well
as Mr Niall Aston, of Queen Elizabeth Hospital, Woolwich for an
honest practice OSCE; and Dr Joseph Papanikitas, Dr Richard
Freeman, Dr Toby Gillman and Dr Taryn Youngstein for test-driving
the manuscript.
We are indebted to the following for the sometimes harsh but fair
peer-review including Kai Keen Shiu, Giles Kendall, Kin Yee Shiu,
Maxine Tran, Sarita Singh, Arani Nitkunan, Tarek Maani, Litha Pepas,
Suparna Das, Krishnan Venkataraman, Martin Paul and Clementine
Maddock.
Finally, we would like to thank Professor Ronald Marks, Cardiff,
for providing the dermatology pictures and Mr Bob Tapper for the
ophthalmology photos. We are indebted to Alison Campbell and
Hannah Wessely at the RSM Press for their patience and hard work in
developing our manuscript.
Nawal Bahal
Andrew Papanikitas
Michelle Chan