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OSCE Pitfalls-30 Mistakes to Avoid
OSCE Pitfalls-30 Mistakes to Avoid : Avoid These 10 Traps in Clinical Assessment (1 of 3)
1. Rote Behaviour
The Mistake : Candidates act like robots, reciting scripts without engaging the patient.
Why It Matters : Examiners look for real interaction and empathy. Acting rehearsed looks insincere.
How to Avoid It :
- Listen and adapt to what the patient says
- Use frameworks (SOCRATES, ICE), but don’t sound robotic.
- Practise with varied partners to develop flexibility.
Example : In a chest pain station, a patient mentions being scared after their father’s heart attack. Candidate ignores it and continues scripted questions. Examiner notes ‘no empathy.’ Better: acknowledge the concern and reassure before continuing.
2. Overusing Confidentiality Statements
The Mistake : Telling every patient ‘everything is confidential.
Why It Matters : Sounds artificial unless contextually needed.
How to Avoid It :
- Use it only in psychiatric or sexual health contexts.
- Phrase naturally : ‘What you share stays between us unless there’s risk of harm.
Example : Saying it to someone with a cough looks odd. Saying it to a hesitant patient with depression builds trust.
3. Asking Permission for Routine Questions
The Mistake : May I ask you a personal question?’ before smoking/alcohol questions.
Why It Matters : Over-formal and time-wasting.
How to Avoid It :
- Ask directly: ‘Do you smoke?’
- Use lead-in phrases only for sensitive questions.
Example : Candidate asks permission before every lifestyle question and runs out of time. Better: ‘I’d like to ask about lifestyle factors such as smoking and alcohol. Do you smoke?’
4. Over-apologising Before Questions
The Mistake : ‘Is it OK if I ask you some questions?’
Why It Matters : Makes you look hesitant.
How to Avoid It :
- Be confident and clear.
- Replace with : ‘I’ll ask a few questions to understand your symptoms better.’
Example : Candidate wastes 15 seconds apologising. Better: confirm patient’s name and start history.
5. Referring Patients to the Internet
The Mistake : Advising ‘check online’ for explanations.
Why It Matters : Examiners want your advice.
How to Avoid It :
- Explain in layman’s terms.
- Offer leaflets if available.
- Mention seniors only if appropriate.
Example : Candidate tells COPD patient to Google inhaler technique. Examiner marks unsafe. Better: demonstrate inhaler use yourself.
6. Misreading Station Instructions
The Mistake : Rushing instructions and doing the wrong task.
Why It Matters : You lose marks even if your performance is good.
How to Avoid It :
- Read twice.
- Highlight key words mentally.
- Ask to re-check inside if unsure.
Example : Candidate explains diagnosis to patient when instructions said ‘tell the examiner.’
7. Making Up Results
The Mistake : Inventing test results not provided.
Why It Matters : Unsafe and dishonest.
How to Avoid It :
- Stick to given data.
- Admit limits and suggest investigations.
Example : Candidate says ‘CT scan was normal’ when no CT was mentioned. Better: ‘I would arrange a CT scan to confirm.’
8. Offering Analgesia Prematurely
The Mistake : Giving painkillers before completing assessment.
Why It Matters : Distracts from the exam purpose.
How to Avoid It :
- Clarify task goal.
- Focus on eliciting details first.
Example : Candidate prescribes ibuprofen in a shoulder pain station instead of checking provoking movements.
9. Getting the Patient’s Name Wrong
The Mistake : Mixing up names.
Why It Matters : Breaks rapport instantly.
How to Avoid It :
- Always confirm at the start.
- Repeat back to fix it in memory.
Example : ‘Hello Mrs. Patel’ — patient: ‘My name is Mrs. Green.’ Examiner notes poor rapport.
10. Confusing Child Details
The Mistake : Using wrong pronouns or calling a child ‘baby.’
Why It Matters : Shows poor attention to instructions.
How to Avoid It :
- Check age and sex carefully.
- Adapt questions to developmental stage.
Example : Asking ‘How is she at school?’ when it’s a male baby with cough.