I’m currently working through my neurology rotation and this week I had my last OSCE of my medical school career. OSCE stands for observed standardized clinical exam and believe it or not, even though this was my very last one, it was still a somewhat stressful experience!
I took Step 2 CS over the summer, which is the mother of all observed standardized exams with 12 patient encounters over the course of a day. Even though I’ve already conquered that, this neurology OSCE was daunting because it forced me to be accountable for actually performing good, complete neurological exams.
Although I learned how to do a neurological exam during my first year of medical school, I always felt that it was a weak point for me since it has so many maneuvers and steps to remember. Most of the time, other clinicians have shown me that it is sufficient to assess how a patient is functioning globally and just take a look at them while they walk into your exam room and while they talk to you. For patients without neurological symptoms this is probably enough, but sometimes you have to do the whole neurological exam – the full, hot order.
I was a bit nervous, but I gave up formally studying for standardized patient encounters a long time ago. So the only thing I did to prepare was to run through and recite the steps of the neuro exam in the order I wanted to do them while I was in the shower on the morning of the exam. Rehearsing in the shower has been a favorite study strategy of mine because it’s a short block of time that’s usually underutilized! I sometimes practice giving answers to interview questions, too.
Apparently my shower recitation helped because I remembered almost every step of the neuro exam! The OSCE felt like it went pretty well, and I’m definitely glad it’s over. Next month, I’ll get to have fun with some role reversal…I’ll be teaching the first and second year students how to work with standardized patients and perform histories and physicals. It will be good to be on the other side of the camera and microphone – watching and grading instead of being in the hot seat!