OSCE: General Information
What is an OSCE?
OSCE stands for “Observed Structured Clinical Examination.” OSCEs are very helpful in medical education because they allow a student to practice and demonstrate clinical skills in a standardized medical scenario.
Students have the opportunity to demonstrate competency in communication, history taking, physical examination, clinical reasoning, medical knowledge, and integration of these skills. It is meant to be a fair and accurate way to assess competence, as well as identify areas that need more work and practice.
OSCE stations may include:
- Clinical interactions (in-person or virtual) with standardized patients: counseling, examination, history taking
- Examination of mannequins and interpretation of findings
- Computerized cases
- Test Interpretation
- Order writing
Why Have OSCEs?
Every LCME-accredited medical school in the United States is required to use OSCEs to assess students’ clinical skills and the effectiveness of the curriculum. The goals of the UWSOM OSCEs are to:
- Assess whether students are achieving required clinical skills as they move through the curriculum towards residency.
- Give students feedback on clinical skills to allow for continual improvement.
- Identify strengths and weaknesses in the curriculum.
How do OSCEs work at UWSOM?
There are three OSCEs at UWSOM; Two during the Foundations Phase and one following the Patient Care Phase.
Timing
The Foundations Phase OSCE is given in two parts and testing dates will be assigned by College:
- Foundations Part 1: Spring of year 1 of the Foundations Phase (Term 2)
- Foundations Part 2: Fall of year 2 of the Foundations Phase (Term 3)
Content
The Foundations OSCE are primarily based on the Foundations of Clinical Medicine (FCM) textbook/pressbook. Any content that has been covered by all regional campuses may be included in the Foundations OSCEs. Learning objectives that may be tested fall under:
- Patient communication and interviewing skills
- Physical examination benchmarks
- Clinical reasoning
- Content from clinical skills workshops
Format
A typical Foundations OSCE station with a standardized patient will include 2 minutes to read instructions and 11 minutes with the patient. Some stations may be shorter depending on the nature of the case.
Carefully read the instructions, and then focus on taking care of the patient as you would in a real patient encounter.
- You may be asked to take a history from a patient. In addition to exploring the chief concern, you should ask about other medical problems, past medical history, medications, allergies, and pertinent family or social issues. Here is an example of student instructions for a history station.
- You may be asked to perform a specific physical diagnosis task in accordance with what you have been taught in FCM. Read the instructions carefully; do not spend time collecting history for a patient if it is not required for the station. Here is an example of student instructions for a physical exam station.
- There are other formats that you may encounter: you may be asked to examine a mannequin, answer questions about a case, or work through a computer simulation.
Timing
The Patient Care OSCE is held in the mornings in May/June of the Patient Care Phase following completion of the required clerkships. Information about registration for exam dates will be sent to the class email list prior to the exam.
Travel
The Patient Care OSCE is held in Seattle, which means that if you are outside of Seattle you will have to travel for this exam. For more information about exam travel, go to the WWAMI Student Travel page or email gowwami@uw.edu.
Content
The Patient Care OSCEs rely on the FCM benchmarks and workshops, as well as principles identified in the learning objectives of the required clerkships. All of the following skills will be part of the examination:
- Communication skills
- Medical interviewing
- Physical examination
- Diagnosis
- Management
- Patient notes
Format
Patient Care OSCE stations differ from Foundations OSCE stations in that they ask students to integrate history and examination skills with development and documentation of a logical differential diagnosis and plan.
Patient Care OSCEs may include:
- History and physical exams with standardized patients
- Examination of mannequins
- Computerized cases
- Telemedicine cases
- Test Interpretation
- Order writing
- Patient education/counseling
A typical Patient Care OSCE station is 25 minutes long, with 2 minutes to read instructions, 14 minutes with the patient, and 9 minutes for write-up or break.
For standardized patient encounters, observers (trained standardized patients or clinicians) are evaluating your history and examination skills as well as your communication skills.
Check the Sample Patient Care OSCE Patient Note to learn more about the general format for write-ups.
What do accommodations look like for the OSCE?
Because the exam focuses on assessing students’ clinical skills, most of the activities that take place during an OSCE are ones for which students do not typically have accommodations. Students who receive extra time on examinations will receive extra time on the OSCE for any written portions of the exam. If you have a disability that requires additional accommodations for the OSCE, please reach out to Disability Resources for Students (DRS) at uwdrs@uw.edu. The process of arranging OSCE accommodations can take at least 4-6 weeks to review and approve, so please reach out to DRS as soon as possible prior to your exam.
How does grading and remediation work for the OSCE?
For standardized patient encounters, observers (trained standardized patients or clinicians) are assessing your history and examination skills as well as your communication skills. Written components may also contribute to the final grade for some stations.
Students and their College Mentors will be notified of the results after all students have completed the exam. For each station, you will receive a score of Meets Expectations (ME) or Needs Development (ND). Students who receive a specific number of ND scores on individual stations will receive an overall score of Needs Development for the entire exam. Successfully completing the Foundations 2 and Patient Care OSCEs is a graduation requirement, so those students who need further development will undergo a remedial exam after meeting with their College Mentor and/or Clinical Skills Learning Specialist to review their test materials. If a student fails the Remediation OSCE, the case is remanded to the Student Progress Committee for deliberation and recommendation. OSCE results are not recorded in the MSPE.