Plabcoach
OSCE Pitfalls-30 Mistakes to Avoid
OSCE Pitfalls-30 Mistakes to Avoid : The Final 10 OSCE Mistakes to Master (3 of 3)
21. Poor Examination Technique
The Mistake : Performing clumsy or incomplete exams.
Why It Matters : Examiners notice instantly and mark down unsafe practice.
How to Avoid It :
- Practise examination routines repeatedly.
- Understand why each step is performed, not just mimic textbooks.
Example : Candidate palpates abdomen without explaining or observing patient’s response. Examiner notes lack of patient safety awareness. Better: ‘I’ll gently press on your tummy—please let me know if it hurts.’ Then observe carefully.
22. Awkward Phrasing of Names
The Mistake : Asking ‘How may I address you?’
Why It Matters : Sounds stiff and unnatural.
How to Avoid It :
- ‘What would you like me to call you?’
Example : Candidate: ‘How may I address you?’ Patient replies: ‘By my name?’ Examiner marks awkward. Better: ‘What would you like me to call you—John or Mr. Smith?’
23. Misusing Titles
The Mistake : Calling patient ‘Mr John’ instead of just John.
Why It Matters : Shows poor listening and cultural insensitivity.
How to Avoid It :
- Respect the exact way patient wants to be addressed.
Example : Patient says, ‘Call me John.’ Candidate replies, ‘Okay Mr John.’ Examiner notes poor rapport. Better: ‘Thanks John, can you tell me when the pain started?’
24. Over-simplifying Anatomy
The Mistake : Using childish terms like ‘water pipe’ for penis.
Why It Matters : Sounds unprofessional and confuses patients.
How to Avoid It :
- Use standard medical terms (bladder, ovary, vein).
- Simplify only if patient shows lack of understanding.
Example : Candidate: ‘Your water bag has a problem.’ Patient looks puzzled. Examiner notes unprofessional. Better: ‘Your bladder—the organ that stores urine—seems to be affected.’
25. Wasting Time in Practical Skills
The Mistake : Narrating endlessly instead of demonstrating.
Why It Matters : Marks are for the skill itself, not narration.
How to Avoid It :
- Focus on performance.
- Explain briefly only when required by station.
Example : Candidate spends 4 minutes explaining suturing while barely stitching. Runs out of time. Better: demonstrate suturing calmly, with short explanations when needed.
26. Disorganised Consultation
The Mistake : Jumping randomly between topics without logic.
Why It Matters : Appears unsafe and confuses the patient.
How to Avoid It :
- Use structured frameworks (SOCRATES, ICE, IPPA).
- Practise a logical consultation flow.
Example : Candidate jumps: ‘Do you smoke? Any chest pain? How’s your bowel?’ Patient looks lost. Examiner notes scattergun. Better: In cough history, start with onset, triggers, associated symptoms, then lifestyle.
27. Dumping Random Differentials
The Mistake : Listing every possible diagnosis in random order.
Why It Matters : Shows lack of clinical judgment.
How to Avoid It :
- Give 2–3 logical differentials in order of likelihood.
- Justify briefly why they are considered.
Example : Candidate: ‘Could be IBS, cancer, gallstones, appendicitis…’ Examiner marks unsafe. Better: ‘Most likely appendicitis given right iliac tenderness. Alternatives include gastroenteritis or ovarian pathology.’
28. Not Finishing the Station
The Mistake : Running out of time due to nerves or poor pacing.
Why It Matters : Incomplete stations lead to automatic lost marks.
How to Avoid It :
- Divide time logically: 2 mins intro, 5 mins history/exam, 2 mins closure.
- Practise stations under timed conditions.
Example : Candidate spends 7 minutes on history, no exam performed. Examiner notes unsafe. Better: pace consultation, even if history is slightly shorter.
29. Spending Too Long on Inspection
The Mistake : Over-focusing on inspection while neglecting other steps.
Why It Matters : Leads to incomplete examination.
How to Avoid It :
- Spend ~1 minute on inspection then move to palpation, percussion, auscultation.
Example : Candidate spends 5 minutes staring at chest scars in respiratory exam, never auscultates. Examiner marks incomplete. Better: inspect briefly, then auscultate for wheeze or crackles.
30. Staying After Time is Up
The Mistake : Continuing after the bell.
Why It Matters : No marks gained and wastes prep time for next station.
How to Avoid It :
- Stop immediately when time is called.
- Use walking time to read next station instructions.
Example : Bell rings, candidate keeps explaining BP check. Examiner interrupts: ‘Time is up.’ Candidate flustered. Better: stop immediately, thank patient, and prepare for next station.