Objective Structured Clinical Examination (OSCE) (PLAB PART 2)
PLAB part 2
Centre is now only GMC centre london with a capacity of 13000 exams a year!!
The aim of the OSCE is to test your clinical and communication skills. It is designed so that an examiner can observe you putting these skills into practice.
Overall nature of Exam
When you enter the examination room, you will find a series of booths, known as 'stations'. Each station requires you to undertake a particular task. Some tasks will involve talking to or examining patients, some will involve demonstrating a procedure on an anatomical model. Details of the tasks are explained below under 'Content'.
There will also be two rest stations in the circuit. Sometimes these stations will contain instructions asking you to read or write something about the station you are about to go to or the station you have just left. If there are no instructions, you should remain quietly in the booth until the bell rings signalling the end of that station.
You will be required to perform all tasks. You will be told the number of the station at which you should begin when you enter the examination room. Each task will last five minutes.
Your instructions will be posted outside the station. You should read these instructions carefully to ensure that you follow them exactly. An example might be:
'Mr McKenzie has been referred to you in a rheumatology clinic because he has joint pains. Please take a short history to establish supportive evidence for a differential diagnosis.'
A bell will ring. You may then enter the station. There will be an examiner in each station. However, unlike in the oral examination, you will not be required to have a conversation with the examiner; you should only direct your remarks to him or her if the instructions specifically ask you to do so. You should undertake the task as instructed. A bell will ring after four minutes 30 seconds to warn you that you are nearly out of time. Another bell will ring when the five minutes are up. At this point, you must stop immediately and go and wait outside the next station. If you finish before the end, you must wait inside the station but you should not speak to the examiner or to the patient during this time.
You will wait outside the next station for one minute. During this time you should read the instructions for the task in this station. After one minute a bell will ring. You should then enter the station and undertake the task as instructed.
You should continue in this way until you have completed all the tasks. You will then have finished the OSCE.
Content of the stations
Each station consists of a scenario. An examiner will be present and will observe you at work.
The scenario could be drawn from any medical specialty appropriate to a Senior House Officer (SHO).
Although the tasks you will be instructed to do will involve a number of skills, one skill will predominate.
The skills to be tested are set out below. They will not necessarily be tested in the order given here. Under each skill area you will find some examples. Please note that these are only examples; other topics will be tested.
History taking
Your candidate instructions will set the scene. You will be asked to take a history from an actor pretending to be a patient (a simulated patient). The actor will have been given all the necessary information to be able to answer your questions accurately. You should treat him or her just as you would a real patient.
Examples: abdominal pains, rectal bleeding, amenorrhoea, severe headache, pneumonia
Examination skills
You will be asked to examine a particular part of the body. You may have to examine a simulated or real patient or perform the examination on an anatomical model. Although you should talk to the patient or model as you would to a patient in real life, you should only take a history or give a diagnosis if the instructions require you to do so. You may be asked to explain your actions to the examiner as you go along.
Examples: breast examination, cardiovascular examination, examination of abdomen, hip examination, knee examination
Practical skills/use of equipment
This is to assess some of the practical skills an SHO needs. The stations concerned will normally involve anatomical models rather than patients.
Examples: IV cannulation, cervical smear, suturing, blood pressure
Emergency management
These stations will test whether you know what to do in an emergency situation. You may have to explain what you are doing to the patient or to the examiner. Your instructions will make this clear.
Examples: resuscitation, chest pain, trauma
Communication skills
There will be a communication skills element in most stations. However, in some stations this skill will be the principal skill tested. Areas tested may include interviewing (including appropriate questioning, active listening, explaining clearly, checking understanding) and building rapport (including showing empathy and respect, sensitivity to others' emotions and coping with strong emotions in others).
Examples: instructions for discharge from hospital, explaining treatment, consent for autopsy, ectopic pregnancy explanation
Tuesday, February 9, 2010
Professional and Linguistic assessment exam (PLAB)
PLAB test details for overseas doctors
Professional and Linguistic assessment exam (PLAB)
More Details about PLAB part 1 examination
Skills of PLAB part 1 test.
Four groups of skills will be tested in approximately equal proportions:
a. Diagnosis: Given the important facts about a patient (such as age, sex, nature of presenting symptoms, duration of symptoms) you are asked to select the most likely diagnosis from a range of possibilities.
b. Investigations: This may refer to the selection or the interpretation of diagnostic tests. Given the important facts about a patient, you will be asked to select the investigation which is most likely to provide the key to the diagnosis. Alternatively, you may be given the findings of investigations and asked to relate these to a patient's condition or to choose the most appropriate next course of action.
c. Management : Given the important facts about a patient's condition, you will be asked to choose from a range of possibilities the most suitable course of treatment. In the case of medical treatments you will be asked to choose the correct drug therapy and will be expected to know about side effects.
d. Others: These may include:
i. Explanation of disease process: The natural history of disease will be tested with reference to basic physiology and pathology.
ii. Legal/ethical : You are expected to know the major legal and ethical principles set out in the GMC publication Duties of a Doctor.
iii. Practice of evidence based medicine: Questions on diagnosis, investigations and management may draw upon recent evidence published in peer-reviewed journals. In addition, there may be questions on the principles and practice of evidence-based medicine.
iv. Understanding of epidemiology: You may be tested on the principles of epidemiology, and on the prevalence of important diseases in the UK.
v. Health promotion: The prevention of disease through health promotion and knowledge of risk factors.
vi. Awareness of multicultural society: You may be tested on your appreciation of the impact on the practice of medicine of the health beliefs and cultural values of the major cultural groups represented in the UK population.
vii. Application of scientific understanding to medicine
Content of part 1 of PLAB exam (new format since 2004 September)
The content to be tested is, for the most part, defined in terms of patient presentations. Where appropriate, the presentation may be either acute or chronic. Questions in Part 1 will begin with a title which specifies both the skill and the content, for example, The management of varicose veins.
You will be expected to know about conditions that are common or important in the United Kingdom for all of the systems outlined below. Examples of the cases that may be asked about are given under each heading and may appear under more than one heading.
These examples are for illustration and the list is not exhaustive. Other similar conditions might appear in the examination.
a. Accident and emergency medicine (to include trauma and burns)
Examples: Abdominal injuries, abdominal pain, back pain, bites and stings, breathlessness/wheeze, bruising and purpura, burns, chest pain, collapse, coma, convulsions, diabetes, epilepsy, eye problems, fractures, dislocations, head injury, loss of consciousness, non-accidental injury, sprains and strains, testicular pain.
b. Blood (to include coagulation defects)
Examples: Anemia's, bruising and purpura.
c. Cardiovascular system (to include heart and blood vessels and blood pressure)
Examples: Aortic aneurysm, chest pain, deep vein thrombosis (DVT), diagnosis and management of hypertension, heart failure, ischaemic limbs, myocardial infarction, myocardial ischaemic, stroke, varicose veins.
d. Dermatology, allergy, immunology and infectious diseases
Examples: Allergy, fever and rashes, influenza/pneumonia, meningitis, skin cancers.
e. ENT and eyes
Examples: Earache, hearing problems, hoarseness, difficulty in swallowing, glaucoma, ‘red eyes’, sudden visual loss.
f. Female reproductive system (to include obstetrics, gynecology and breast)
Examples: Abortion/sterilization, breast lump, contraception, infertility, menstrual disorders, menopausal symptoms, normal pregnancy, postnatal problems, pregnancy complications, vaginal disorders.
g. Gastrointestinal tract, liver and biliary system, and nutrition
Examples: Abdominal pain, constipation, diarrhea, difficulty in swallowing, digestive disorders, gastrointestinal bleeding, jaundice, rectal bleeding/pain, vomiting, weight problems.
h. Metabolism, endocrinology and diabetes
Examples: Diabetes mellitus, thyroid disorders, weight problems.
i. Nervous system (both medical and surgical)
Examples: Coma, convulsions, dementia, epilepsy, eye problems, headache, loss of consciousness, vertigo.
j. Orthopedics and rheumatology
Examples: Back pain, fractures, dislocations, joint pain/swelling, sprains and strains.
k. Psychiatry (to include substance abuse)
Examples: Alcohol abuse, anxiety, assessing suicidal risk, dementia, depression, drug abuse, overdoses and self harm, panic attacks, postnatal problems.
l. Renal System (to include urinary tract and genitourinary medicine)
Examples: Haematuria, renal and ureteric calculi, renal failure, sexual health, testicular pain, urinary infections.
m. Respiratory system
Examples: Asthma, breathlessness/wheeze, cough, hemoptysis, hoarseness, influenza/pneumonia.
n. Disorders of childhood (to include non-accidental injury and child sexual abuse; fetal medicine; growth and development)
Examples: Abdominal pain, asthma, child development, childhood illnesses, earache, epilepsy, eye problems, fever and rashes, joint pain/swelling, loss of consciousness, meningitis, non-accidental injury, testicular pain, urinary disorders.
o. Disorders of the elderly (to include palliative care)
Examples: Breathlessness, chest pain, constipation, dementia, depression, diabetes, diarrhoea, digestive disorders, headache, hearing problems influenza/pneumonia, jaundice, joint pain/swelling, loss of consciousness, pain relief, terminal care, trauma, urinary disorders, vaginal disorders, varicose veins, vertigo, vomiting.
p. Peri-operative management
Examples: Pain relief, shock,
How to approach the extended matching question examination (part 1 plab-EMQ)
The examination paper will contain 200 questions in the extended matching and SBA (single best answer ) format., divided into a number of themes.
Each theme has a heading which tells you what the questions are about, in terms both of the clinical problem area (e.g. chronic joint pain) and the skill required (e.g. diagnosis).
Within each theme there are several numbered items, usually between four and six. These are the questions the problems you have to solve. There are examples below.
Begin by reading carefully the instruction which precedes the numbered items. The instruction is very similar throughout the paper and typically reads ‘For each scenario below, choose the SINGLE most discriminating investigation from the above list of options. Each option may be used once, more than once or not at all.’
Consider each of the numbered items and decide what you think the answer is. You should then look for that answer in the list of options (each of which is identified by a letter of the alphabet). If you cannot find the answer you have thought of, you should look for the option which, in your opinion, is the best answer to the problem posed.
For each numbered item, you must choose ONE, and only one, of the options. You may feel that there are several possible answers to an item, but you must choose the one most likely from the option list. If you enter more than one answer on the answer sheet you will gain no mark for the question even though you may have given the right answer along with one or more wrong ones.
In each theme there are more options than items, so not all the options will be used as answers. This is why the instruction says that some options may not be used at all.
A given option may provide the answer to more than one item. For example, there might be two items which contain descriptions of patients, and the most likely diagnosis could be the same in both instances. In this case the option would be used more than once.
You will be awarded one mark for each item answered correctly.
SBA section
From september 2004, SBA s will make 30 % of the paper. An SBA or single best answer or MCQ (multiple choice answer)or BOF (best of five) is one and the same thing. In such questions you have to choose one single most appropriate answer to the given question. AIPPG forums are well known for carrying the latest papers / SBA;s discussions.
These days some questions are picture questions : common ECGs, X Rays and skin problems are commonly asked in such questions.
Marks are not deducted for incorrect answers nor for failure to answer. The total score on the paper is the number of correct answers given. You should, therefore, attempt all items in part one of PLAB examination.
Professional and Linguistic assessment exam (PLAB)
More Details about PLAB part 1 examination
Skills of PLAB part 1 test.
Four groups of skills will be tested in approximately equal proportions:
a. Diagnosis: Given the important facts about a patient (such as age, sex, nature of presenting symptoms, duration of symptoms) you are asked to select the most likely diagnosis from a range of possibilities.
b. Investigations: This may refer to the selection or the interpretation of diagnostic tests. Given the important facts about a patient, you will be asked to select the investigation which is most likely to provide the key to the diagnosis. Alternatively, you may be given the findings of investigations and asked to relate these to a patient's condition or to choose the most appropriate next course of action.
c. Management : Given the important facts about a patient's condition, you will be asked to choose from a range of possibilities the most suitable course of treatment. In the case of medical treatments you will be asked to choose the correct drug therapy and will be expected to know about side effects.
d. Others: These may include:
i. Explanation of disease process: The natural history of disease will be tested with reference to basic physiology and pathology.
ii. Legal/ethical : You are expected to know the major legal and ethical principles set out in the GMC publication Duties of a Doctor.
iii. Practice of evidence based medicine: Questions on diagnosis, investigations and management may draw upon recent evidence published in peer-reviewed journals. In addition, there may be questions on the principles and practice of evidence-based medicine.
iv. Understanding of epidemiology: You may be tested on the principles of epidemiology, and on the prevalence of important diseases in the UK.
v. Health promotion: The prevention of disease through health promotion and knowledge of risk factors.
vi. Awareness of multicultural society: You may be tested on your appreciation of the impact on the practice of medicine of the health beliefs and cultural values of the major cultural groups represented in the UK population.
vii. Application of scientific understanding to medicine
Content of part 1 of PLAB exam (new format since 2004 September)
The content to be tested is, for the most part, defined in terms of patient presentations. Where appropriate, the presentation may be either acute or chronic. Questions in Part 1 will begin with a title which specifies both the skill and the content, for example, The management of varicose veins.
You will be expected to know about conditions that are common or important in the United Kingdom for all of the systems outlined below. Examples of the cases that may be asked about are given under each heading and may appear under more than one heading.
These examples are for illustration and the list is not exhaustive. Other similar conditions might appear in the examination.
a. Accident and emergency medicine (to include trauma and burns)
Examples: Abdominal injuries, abdominal pain, back pain, bites and stings, breathlessness/wheeze, bruising and purpura, burns, chest pain, collapse, coma, convulsions, diabetes, epilepsy, eye problems, fractures, dislocations, head injury, loss of consciousness, non-accidental injury, sprains and strains, testicular pain.
b. Blood (to include coagulation defects)
Examples: Anemia's, bruising and purpura.
c. Cardiovascular system (to include heart and blood vessels and blood pressure)
Examples: Aortic aneurysm, chest pain, deep vein thrombosis (DVT), diagnosis and management of hypertension, heart failure, ischaemic limbs, myocardial infarction, myocardial ischaemic, stroke, varicose veins.
d. Dermatology, allergy, immunology and infectious diseases
Examples: Allergy, fever and rashes, influenza/pneumonia, meningitis, skin cancers.
e. ENT and eyes
Examples: Earache, hearing problems, hoarseness, difficulty in swallowing, glaucoma, ‘red eyes’, sudden visual loss.
f. Female reproductive system (to include obstetrics, gynecology and breast)
Examples: Abortion/sterilization, breast lump, contraception, infertility, menstrual disorders, menopausal symptoms, normal pregnancy, postnatal problems, pregnancy complications, vaginal disorders.
g. Gastrointestinal tract, liver and biliary system, and nutrition
Examples: Abdominal pain, constipation, diarrhea, difficulty in swallowing, digestive disorders, gastrointestinal bleeding, jaundice, rectal bleeding/pain, vomiting, weight problems.
h. Metabolism, endocrinology and diabetes
Examples: Diabetes mellitus, thyroid disorders, weight problems.
i. Nervous system (both medical and surgical)
Examples: Coma, convulsions, dementia, epilepsy, eye problems, headache, loss of consciousness, vertigo.
j. Orthopedics and rheumatology
Examples: Back pain, fractures, dislocations, joint pain/swelling, sprains and strains.
k. Psychiatry (to include substance abuse)
Examples: Alcohol abuse, anxiety, assessing suicidal risk, dementia, depression, drug abuse, overdoses and self harm, panic attacks, postnatal problems.
l. Renal System (to include urinary tract and genitourinary medicine)
Examples: Haematuria, renal and ureteric calculi, renal failure, sexual health, testicular pain, urinary infections.
m. Respiratory system
Examples: Asthma, breathlessness/wheeze, cough, hemoptysis, hoarseness, influenza/pneumonia.
n. Disorders of childhood (to include non-accidental injury and child sexual abuse; fetal medicine; growth and development)
Examples: Abdominal pain, asthma, child development, childhood illnesses, earache, epilepsy, eye problems, fever and rashes, joint pain/swelling, loss of consciousness, meningitis, non-accidental injury, testicular pain, urinary disorders.
o. Disorders of the elderly (to include palliative care)
Examples: Breathlessness, chest pain, constipation, dementia, depression, diabetes, diarrhoea, digestive disorders, headache, hearing problems influenza/pneumonia, jaundice, joint pain/swelling, loss of consciousness, pain relief, terminal care, trauma, urinary disorders, vaginal disorders, varicose veins, vertigo, vomiting.
p. Peri-operative management
Examples: Pain relief, shock,
How to approach the extended matching question examination (part 1 plab-EMQ)
The examination paper will contain 200 questions in the extended matching and SBA (single best answer ) format., divided into a number of themes.
Each theme has a heading which tells you what the questions are about, in terms both of the clinical problem area (e.g. chronic joint pain) and the skill required (e.g. diagnosis).
Within each theme there are several numbered items, usually between four and six. These are the questions the problems you have to solve. There are examples below.
Begin by reading carefully the instruction which precedes the numbered items. The instruction is very similar throughout the paper and typically reads ‘For each scenario below, choose the SINGLE most discriminating investigation from the above list of options. Each option may be used once, more than once or not at all.’
Consider each of the numbered items and decide what you think the answer is. You should then look for that answer in the list of options (each of which is identified by a letter of the alphabet). If you cannot find the answer you have thought of, you should look for the option which, in your opinion, is the best answer to the problem posed.
For each numbered item, you must choose ONE, and only one, of the options. You may feel that there are several possible answers to an item, but you must choose the one most likely from the option list. If you enter more than one answer on the answer sheet you will gain no mark for the question even though you may have given the right answer along with one or more wrong ones.
In each theme there are more options than items, so not all the options will be used as answers. This is why the instruction says that some options may not be used at all.
A given option may provide the answer to more than one item. For example, there might be two items which contain descriptions of patients, and the most likely diagnosis could be the same in both instances. In this case the option would be used more than once.
You will be awarded one mark for each item answered correctly.
SBA section
From september 2004, SBA s will make 30 % of the paper. An SBA or single best answer or MCQ (multiple choice answer)or BOF (best of five) is one and the same thing. In such questions you have to choose one single most appropriate answer to the given question. AIPPG forums are well known for carrying the latest papers / SBA;s discussions.
These days some questions are picture questions : common ECGs, X Rays and skin problems are commonly asked in such questions.
Marks are not deducted for incorrect answers nor for failure to answer. The total score on the paper is the number of correct answers given. You should, therefore, attempt all items in part one of PLAB examination.
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