2014 Candidate Orientation Presentation - Certification Examination in Family Medicine

The OSCE Format of the
Clinical skills component of the
Certification Examination in family medicine:
Pre-exam orientation for candidates

The Certification Examination in family medicine
The Certification Examination in family medicine is
comprised of two components: a written examination
and a 12-station clinical skills examination.
• The clinical skills examination is comprised of eight
10-minute objective structured clinical examinations
(OSCEs) and four simulated office orals (SOOs)
each 15 minutes in length.
• OSCEs take place on Saturday and SOOs on
Sunday.
Certification Examination in Family Medicine, OSCE portion

Introduction
Meet Dr. Campbell and Dr. Fournier. They will be
taking the OSCE portion of the clinical skills
component of the Certification Examination in family
medicine today. Let’s follow them as they go through
the OSCE.

What to bring
The list of items to bring to the OSCE is included in the
Candidate Information Sheet that will be sent to you by
mail prior to the examination.
Items to bring to the exam Items to leave at home
Entrance card (will be sent to you by
mail)
Your lunch
Lab coat Pencils/paper
Reflex hammer Electronic devices
Stethoscope Large bags or purses
Watch (there might not be clocks in the
exam rooms)

Coat check
A coat check will be provided at the site to store your
personal items during the examination and
sequestering period.
However, as storage space will be limited, we ask that
you please leave all large bags and handbags at
home.

Candidate registration
Dr. Fournier has arrived at the examination site. Once
he has registered, exam staff will hand him an ID
badge, a pencil and a notebook before directing him to
the orientation room.

Candidate orientation
During the candidate orientation on examination day,
the facilitator will give a brief presentation and answer
your questions.

In her notebook, Dr. Campbell will find bar code labels
and blank pages.
I can use my notebook
throughout the examination for
reference and note taking. The
notebook will not be graded.
I won’t tear out any pages
because I have to hand in my
notebook INTACT at the end of
each examination day. This
includes the label backing
sheet.
Each notebook contains a few
extra labels. If I lose one or two,
I don’t need to worry.
Candidate notebook

Overview of the OSCE
01
02
03
04
05
06
07
08
09
10
The Saturday session
of the examination is
comprised of ten 10-
minute stations:
• eight patient-
encounter stations
(in blue);
• two rest stations (in
yellow).

Start station
Exam staff will be there to guide me
and answer my questions during the
examination.
My start station will be written on the
Candidate Information Sheet I will
have received in the mail and on my
ID badge.
I will start at this station number and
will then go through the remaining
stations in numeric order.
01
02
03
04
05
06
07
08
09
10

Timing of OSCE stations
• You will have two minutes to read the
candidate instructions posted by the door
before the buzzer sounds, prompting you to
enter the room.
• You will then have 10 minutes in the room.
– A warning buzzer will sound at nine minutes.
– A second buzzer will signal the end of the station. At
this point, you will have to leave the room.
• You will then get two minutes to read the
instructions for the next station, and so on.
10-minute stations

Candidate instructions
In any given station, you may
be asked to do one or more of
the following tasks:
– perform a physical
examination;
– obtain a history;
– manage an acute patient
problem;
– respond to a patient’s
concerns;
– counsel the patient and/or a
colleague.
Before entering the
room, I will read my
instructions carefully
in order to determine
what my task is for
the station.
The instructions will
also be available in
the room.

Joseph Trans, 40 years old, presents himself to your office with a
two-hour history of abdominal pain.
IN THE NEXT 10 MINUTES:
• CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION.
As you proceed, EXPLAIN TO THE EXAMINER what you are doing
and DESCRIBE ANY FINDINGS.
GIVE ONE LABEL TO THE EXAMINER.
My task here is to conduct a physical examination.
Therefore, I won’t ask history questions to the patient.
I’ll treat the standardized patient as a real patient because
I will only get credit for tasks I complete satisfactorily.
More sample stations are available.
Sample

Bar code labels
As I walk into the room, I hand one bar
code label to the examiner.

Oral questions
In some stations, the examiner will ask me one to three brief questions
after the warning buzzer. In these stations, I will not be able to continue
interacting with the patient after the warning buzzer, even after I have
finished answering the examiner’s question(s). (If there are no oral
questions for a station, I will have the full 10 minutes to interact with the
patient.)
The oral questions are related to the patient I just saw and are about
matters like diagnoses, management decisions, or ethical or legal issues.
The candidate instructions will clearly state whether there are oral
questions for a station.

Medical equipment
If a station requires the use of medical equipment other
than a stethoscope and a reflex hammer, it will be
provided in the room.

Patient management stations
During the examination, you might be asked to
manage a patient problem.
In these stations, a standardized health professional,
such as a nurse, might be present in the room.
I will direct the nurse to order any tests
or perform any procedures I believe are
appropriate for this patient.
I may be evaluated on my interaction
with the nurse.
If a standardized health professional is
present in the room, the candidate
instructions will clearly state so.
Download a
video clip of a
candidate in this
type of station

Physician examiners
• Examiners observe and assess your
performance with pre-set score sheets.
• A second observer may be present to
observe protocols and to ensure exam
quality.
• In physical examination stations:
• Tell the examiner what you are doing and
briefly describe your findings.
• You must demonstrate your clinical skills.
You will only get credit for tasks
completed to the examiner’s satisfaction.

Examiner interventions
Examiners may intervene:
• by asking you to reread the instructions;
• to protect the standardized patient;
• to stop you from doing genital or rectal
examinations.
– If such examinations are needed,
clearly inform the examiner that
you would perform them.
• By reporting findings if they are
available. If no findings are reported
to you, please trust the findings from
your examination of the standardized
patient.
Download a
video example
of an examiner
intervening

Standardized patients (SPs)
SPs are trained to simulate patients’ signs and
symptoms in a reliable and consistent manner.
Treat them as you would treat actual
patients and accept their simulated
findings as real.
You may be scored on
the way you interact with
them.

Rest stations
• Rest stations may be included in the examination for
each session.
• During these stations, there are no patients, no
questions and no evaluations.
• Please sit quietly. You can take this time to rest
before your next station.
I might sit through a few rest
stations during the examination.

Sequestering
For security reasons, candidates may be required to
remain on site for up to three hours before or after the
examination session.
• You will not have access to your personal
belongings or telephones during this time.
Any breach of the rules or lack
of co-operation on my part
could invalidate my examination
results and prevent access to
future examinations.

Sign out
Before leaving after each exam day, follow the
instructions of the exam staff:
• hand in your notebook (leave all pages intact,
including the backing sheet from your bar code
labels and any unused labels);
• hand in your ID badge;
• sign out on the sheet.

Confidentiality reminder
During the application process, we agreed to use examination
materials solely for the purpose of completing the examination
and to not disseminate or reveal to others the examination
materials or content.
That means you CANNOT discuss or disclose
exam content (including patient portrayals and
findings, oral questions, etc.) at ANY TIME, in
ANY WAY even after the examination is over.
Examples of this include comparing patient
responses with your colleagues, sharing content
with future exam candidates, and posting case
information online.
Any breach in confidentiality of exam materials
may lead to disciplinary and legal measures,
including invalidating your results and
preventing you from participating in future
examinations.

What do I do if…
You can use the washrooms:
• before you start the examination;
• while in sequestering.
If you have an urgent need at other times,
please inform exam staff.
I have to go to the bathroom?

What do I do if…
Consult the exam staff as soon as
possible.
The staff members are there to help you and
are aware of the protocols to follow.
It is imperative that you remain calm and
co-operative.
I lose my notebook and/or my bar code labels?
I feel ill?
I don’t know where to go?

Helpful tips
• Read your instructions carefully.
• Complete the specified task(s).
Joseph Trans, 40 years old, presents himself to your office
with a two-hour history of abdominal pain.
IN THE NEXT 10 MINUTES:
•CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION.
As you proceed, EXPLAIN TO THE EXAMINER what you are
doing and DESCRIBE ANY FINDINGS.
GIVE ONE LABEL TO THE EXAMINER.

Helpful tips
Inside the station
• Demonstrate your clinical skills. You will not get credit
for simply SAYING you would do something (with the
exception of genital and rectal examinations).
• You will only receive credit for
tasks completed satisfactorily.
• Treat the SPs as you would treat
real patients.

Useful links
The College of Family Physicians of Canada
www.cfpc.ca
The Certification Examination in family medicine
http://www.cfpc.ca/fmexam/

Questions?
And remember, exam staff will be
available throughout the day to answer
your questions and guide you to your
stations.
Please take the time to
review the information in
this presentation and on
the cfpc.ca website. If
you have any questions
on the examination
day, you can ask the
facilitator during your
Candidate Orientation.
For other enquiries
prior to or following the
examination, please
contact the CFPC.

2014 Candidate Orientation Presentation - Certification Examination in Family Medicine

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2014 Candidate Orientation Presentation - Certification Examination in Family Medicine