Top Reasons Why People Fail the OSCE exam
1. You haven’t solved the main drug related problem. This a major reason for failing OSCE. There is usually one major problem, but you have to gather information to solve the problem. Sometimes the problems are subtle and not easy to find.
2. You have put a patient at harm or risk. If you make a recommendation to a patient or doctor and the recommendation puts the patient at risk, you will most likely fail. For example, if a patient complains of stomach pains and you recommend ibuprofen, you’d probably fail since the patient might have a bleeding ulcer.
3. You have given wrong information. If you have given an incorrect dose or an incorrect recommendation you might fail. If you catch yourself making a wrong recommendation, correct yourself and save yourself.
4. You have not completed all the steps of pharmaceutical care. Make sure you know all the steps of pharmaceutical care. If you miss a step, you will lose marks. Do not forget to document your interaction (just tell the patient that you are keeping a record of the interaction). Do not forget the follow up with the patient.
5. You could not be understood by the evaluator. It could be because your English was not understood or you were too quiet. Make sure your patient can understand you. Do not use technical language. Make sure your spoken and written English is well understood.
6. You wasted too much time looking into the references. This is a very common mistake. Students will search the CPS for 5 minutes and run out of time without finding what they were looking for. Make certain you can find the information quickly in the references. The CPS is a difficult book to find information. Know how to use it!
7. Your interview was incomplete and missing some valuable information. You might have missed family history or the fact the patient was not using their medication. The patient might have cognitive impairment and you did not acknowledge it.
8. You did not use your time wisely. You only have 7 minutes and time passes very quickly especially when you are nervous. Make sure you listed for the 2 minute warning bell. When you hear the 2 minute warning, it is time to wrap up and summarize everything.
9. You haven’t used the ‘clues’ in the station to help you solve the problem. I always tell students that there are several clues in a station. The best clue is the patient. Ask questions to help you solve the problem. If there is a medication record on the table, use it. The medication record can tell you a lot of useful information. If there is a pamphlet on the table, it is there for a reason. Use it if needed.
10. You did not know your OTC ingredients well enough. Make sure you know your OTC ingredients and when to recommend them. You will most certainly get an OTC station where you have to make a recommendation. Make sure you know the ingredients and when to recommend and when not to recommend.
11. You did not use your PROFESSIONAL JUDGEMENT. This is often the most difficult for some people to use. You must make tricky decisions. Not all situations are black and white. Make sure you use your judgement. That is why you are a professional!
12. You could not control your nervousness. This is also a major problem. Learn to control your stress levels. Practice deep breathing continuously during OSCE day. Everyone will be nervous. If you mess up an OSCE station, forget it and move on. Do not think about it during the day.
Everyone always asks me what I should study for PEBC MCQ (Part 1). One of the observations I have made over the last 15 years of teaching pharmacy students, is that IPGs have excellent drug knowledge.
What you have to do is put that drug knowledge into a clinical perspective or PATIENT CARE perspective.
In other words, it is not enough to know the half life of a particular drug or what side effects to encounter. What you should be able to do is make recommendations like: What is the drug of choice in a patient with otitis media but is allergic to penicillin?
Or what drug would you use to treat hypertension in a patient that also has angina?
Or what would you do if you have a diabetic patient whose blood sugars are not controlled?
You have to learn how to solve problems not just regurgitate drug facts.
Here are some good references and some comments:
1. Therapeutic Choices 6th ed. is a good start HOWEVER the information is very limited and top level only. Do not use this as your only book.
2. Rx Files is an excellent comparative summary of drugs and their uses. It is very useful with easy to find information.
3. Patient Self Care is NOT a great book, but you’ll have to know OTC products in Canada. I suggest studying from it.
4. Make sure you know the Pharmaceutical Care Model. This is essential. A good reference is Pharmaceutical Care Practice by Cipolle, Strand and Morley.
5. One of my favourites for the OSCE: Communication Skills in Pharmacy Practice 5th ed.
6. The CPS is a TERRIBLE book but you MUST know how to use it. The font is tiny, the paper thin and it is difficult to find information. BUT you must know how to find information since this may be the only reference you have in an OSCE station. Borrow one from a library. Don’t buy one. Test yourself on finding information.
7. There are some Clinical Practice Guidelines published in www.cma.ca Many ‘purists’ do not like to use Clinical Practice Guidelines, but they are an excellent way to find out how diseases are treated in Canada.
If you use an American reference, remember the units of measurement may be different. For example, blood sugar and cholesterol units are different.
There are some other references listed in www.pebc.ca but use your judgement.
I hope that helps you.