First OSCE: done and dusted?

Today I had my first ever OSCE. That stands for “Objective Structured Clinical Examination” and is basically a practical exam for medical students. I don’t think I was this nervous for my final Matric exams. Of course I wasn’t, back then I was an A+ student.

As our first OSCE, we didn’t have real patients and it was probably the easiest OSCE we will ever encounter. Each student does eight stations in the Clinical Skills Lab. I did:

1. Sterile hand washing technique and urine dipstick analysis: this would not have been bad if I had dried my hands properly. I then struggled for probably a minute to put on the gloves for the urine analysis – did I mention we only get five minutes per station?
2. Emergency medical care of a child: with no ambu-bag, i.e. the breaths were mouth-to-mouth; something we hadn’t actually practised and so I don’t think the dummy’s chest actually rose – in which case I don’t get the mark for rescue breaths.
3. Apex beat auscultation: The examiner wouldn’t let me go after I answered all the questions and demonstrated how to palpate for the apex beat and parasternal heave. I finally realised I had forgotten to mention that in the case of apex displacement I would check if the trachea was central. Oops. I also didn’t mention that I could feel the apex beat more strongly if I had the patient do some mild exercise. Truth be told I didn’t study that part.
4. Abdominal examination for ascites and palpation for the kidneys: I did well in this one, but I forgot to sanitize my hands. Hopefully the rubric didn’t mention it – sometimes they don’t, I’ve seen examples. Afterthought: CRAP. Why do I suddenly think the lady asked me to feel for the SPLEEN?
5. Integrated Management of Childhood Illness (IMCI) Assessment: This is an approach I actually get, and a lot of the friends I have spoken to don’t. I think I may have made a stupid mistake though. I blame it on a poorly re-reproduced growth chart.
6. Clinical identification of slides: my pictures were moderate, I think I got all of them right.
7. Consultation with a patient who has severe chest pain.
8. Questions about aforementioned patient: I knew we would be asked a genogram, and yet I forgot to ask the ages and genders of the patient’s children. Damnit!

I felt good about the OSCE, but the later it gets the more scared I get. This year has been terrible for me academically. Truth be told I can deal with poor marks for theoretical assessments, but I want my clinical skills to be impeccable. I couldn’t live with myself if I were a doctor of poor clinical skills. Then I might as well not be studying this course.

So now onto further studying. I hope that I can somehow remain focussed enough to continue studying properly till the end of exams.