Objective structured clinical exams (OSCEs) assess key skills required of a pharmacist, usually in a simulated environment. They can seem stressful at first, but once you are familiar with common station types and have practised, you’ll feel much more confident.
We’ve put together some tips for approaching and passing OSCEs for pharmacy students. Hopefully, these will reassure you and help with your exams!
What do you need to know?
Different universities will have different types of OSCE stations, and these may also vary depending on which year of your programme you are in. Your university should provide some information about what you will be assessed on and may provide mark schemes to guide your revision.
It’s important to know exactly what types of stations you could be assessed on so you can focus your revision.
How to revise for OSCEs
One of the best ways to revise for OSCEs is with a friend/flatmate. It may feel awkward at first, but the more you practise with others, the more natural it will feel in the exam. Practising in this way can help you become comfortable taking brief histories and explaining things using patient-friendly language.
It can also be a good opportunity to ask for some honest feedback so you can identify areas you need to focus on.
Practice stations can be helpful. Geeky Medics now has dedicated OSCE stations for student pharmacists, available for use with a friend or individually.
Timing
OSCE stations can feel very tight for time. Check with your university how long you will have at each station in your real exams, and get used to practising with a timer.
Timings for different types of stations may differ, and there may also be a few minutes of questions at the end.
Feedback
When practising with friends, part of the process is giving and receiving constructive feedback.
One method commonly used to give constructive feedback is Pendleton’s rules.
Pendleton’s rules
Start with the person doing the station and ask them to state what they think went well.
- Next, the examiner/patient should state what they think went well
- Ask the person doing the station to reflect on what areas they think could be improved: “What might you do differently next time?”
- The examiner/patient should provide constructive feedback on areas for improvement
Feedback should be specific and provide clear, actionable areas for improvement.
On the day
Make sure you know where you need to be and when. OSCEs are often taken as a ‘circuit’ of several stations, one after the other. Your university should provide you with information about how many stations you will be sitting in a row and your specific start time.
You might have to report to a ‘holding room’ before the start of your exam for a briefing. Knowing how things will run on the day can help ease exam nerves.
Try to eat something beforehand, and check your university’s rules on whether you are allowed to bring water between stations.
What to wear
Check your university dress code, as you are usually expected to dress professionally for your OSCEs. Wear something smart that you feel comfortable in.
Remember to remove any watches and jewellery, roll up your sleeves and tie back long hair.
Outside the station
You will usually be given some reading time outside each station with a short brief about the scenario you are about to enter.
Take your time to read the instructions carefully, ideally more than once, to make sure you fully understand what is expected of you. When you are nervous, it can be easy to assume what the station is, so pay attention to the details.
If you have any more time after you have read the brief carefully, it can be helpful to run through the steps you will take once the station begins.
Once the station begins
Most different station types will require you to introduce yourself at the start. Practise this until it almost becomes automatic. Include your name and role, and verify the patient’s identity. This may seem basic, but you’ll get marks for it, and it is important to know how to open a patient interaction properly.
Depending on the scenario, you may also need to wash your hands or use alcohol gel at the start and end of the station. If there is gel provided, this is a good clue that you should be using it, but your university may provide guidance in advance of which stations this would be expected in.
History stations
In many stations, you will be required to take a brief history. This may be in a community setting, where a patient is asking about a specific product or presenting with symptoms and seeking advice.
Whatever the setting, it is important to develop your own structure that covers all the information in a logical order.
WWHAM questions
WWHAM questions can be used for a simple over-the-counter query:
- Who is the medicine for?
- What are the symptoms?
- How long have the symptoms been present?
- Action taken so far/anything already tried?
- Medication/medical conditions the patient already has
Don’t forget to ask about any other over-the-counter medications or herbal remedies, as well as prescribed medications, and always ask about drug allergies.
OSCEs assess your communication skills as well as your clinical knowledge, so avoid jargon and use patient-friendly language. Even though these are simulated scenarios, the patients and examiners are real people, so be polite, empathetic and remember to thank them at the end.
Actively listen to the patient and be prepared to adapt your structure to respond to the information they provide.
If you feel you need more support with communication skills, there is a dedicated page of communication skills guides available.
Written stations
Some stations may not involve a patient and instead require you to write answers before discussing them with an examiner.
This could include calculations, performing a clinical or accuracy check, or data interpretation. You might have access to a BNF in these stations, so it is important to familiarise yourself with the paper copy and know where to find key information.
Data interpretation
You may have a station where you are given some information and asked to interpret it. You may also be asked to explain this information to a patient. This can include drug levels, medication excipients or identifying common interactions.
Knowing what your university expects of you can help focus your revision. The BNF is a useful resource for checking interactions and often has reference ranges for drug levels, so you may not need to memorise these.
Calculations
Some universities have a separate calculations paper, but some courses include brief calculations in OSCE stations. Check if this is something you could be asked to do. You can prepare for these stations by practising simple pharmaceutical calculations under time pressure.
Don’t let the idea of having to do maths alarm you. It could be something as straightforward as calculating how many tablets are required to complete a course of prednisolone.
Mistakes can happen
Don’t panic if you feel like one station has gone wrong; take a deep breath and get ready for the next one. The examiner at the next station has no idea what happened at any of the other stations, so treat each station like a fresh start.
Once you’ve finished all of the stations, take some time to reflect on anything you think you can learn from for your next set of exams.
Remember, OSCEs are just one part of your journey to becoming a pharmacist. With practice and preparation, you’ll do well. Good luck!
Reviewer
Lauren Grainger
Senior pharmacist
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