OSCE Practice - NZREXinfo

OSCE Station Types

The NZREX Clinical exam consists of 16 OSCE stations across two days. Each station is 10 minutes (2 min reading + 8 min with patient). Here are the main station types:

History Taking

Take a focused history from a simulated patient. Use ICE (Ideas, Concerns, Expectations) and SOCRATES for pain. Cover relevant systems, red flags, and psychosocial aspects.

Physical Examination

Perform a focused examination on a specific system. Remember WIPER (Wash hands, Introduce, Position, Expose, Right patient). Explain each step to the patient.

Counselling / Breaking Bad News

Counsel a patient about a diagnosis, treatment options, or lifestyle changes. Use SPIKES protocol for breaking bad news. Show empathy, use plain language, check understanding.

Emergency Management

Manage an acute scenario (anaphylaxis, cardiac arrest, DKA, etc.). Prioritise ABCDE approach. Demonstrate leadership, call for help, and communicate clearly.

Data Interpretation

Interpret investigation results (ECG, blood results, imaging). Explain findings to the patient and discuss management. Show clinical reasoning.

The 8-Minute Strategy

Time management is critical. Here's how to structure your 8 minutes:

0-1 min

Introduction — Greet, introduce yourself, confirm patient ID, explain purpose, obtain consent

1-4 min

Core task — History, examination, or counselling. Use mnemonics. Be thorough but focused.

4-6 min

Wrap-up — Summarise findings, address concerns, discuss management plan

6-7 min

Safety net — Red flags, when to return, follow-up plan. Check understanding.

7-8 min

Close — Ask "Is there anything else?", thank the patient, confirm next steps

Top OSCE Tips

1. Always introduce yourself — Even under pressure, the introduction marks professionalism.

2. Read the prompt carefully — The 2-minute reading time is crucial. Identify the task type and key points.

3. Use the patient's name — Personalise the interaction. It builds rapport.

4. Show empathy — Acknowledge emotions. Even a brief "I'm sorry to hear that" goes a long way.

5. Avoid jargon — Plain language is actively scored. Say "heart attack" not "MI".

6. Don't forget safety netting — Always tell the patient when to come back or seek urgent help.

7. Check understanding — Use teach-back: "Can you tell me what we've discussed?"

8. Practice with timers — Time pressure is the biggest stressor. Practice under exam conditions.

Common OSCE Mistakes

Poor time management — Running out of time before completing the task

Not reading the instructions — Missing key requirements from the station prompt

Silent examination — Not explaining what you're doing during physical examination

Being paternalistic — Not involving the patient in decision-making

Not washing hands — Infection control is a basic expectation in every station

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Key Mnemonic

WIPER for every station:
W — Wash hands
I — Introduce yourself
P — Position/Privacy
E — Expose appropriately
R — Right patient