OSCE Introduction & Completion

Question 1

What is the acronym used to help remember how to begin an examination and what does it stand for?

Answer 1

WIPE:
W-ash Hands
I-ntroductions
P-atient details and Position
E-xplanation

Question 2

What else should briefly be discussed in an opening?

Answer 2

Confidentiality

Question 3

What position should the bed, and therefore the patient, be in for the various exams?

Answer 3

Cardio- 45 degrees
Resp- 45 degrees
Abdo- flat/supine with hands by yourself (easier to begin sat upright/45 degrees then lay flat when examination of the abdomen itself begins)
Cranial Nerve- sat upright legs off bed 
Upper Limb- sat upright legs off bed
Lower Limb- 45 degrees legs on bed

Question 4

In practice, what is an appropriate order to begin an examination?

Answer 4

1. Introduction
2. Explain
3. Conset
4. Wash Hands & Patient Details (simultaneously)
5. Position
6. Exposure
7. Questions (ask and receive-pain etc.)

Question 5

What are the patient exposures required for each of the exams and how should they be explained to the patient?

Answer 5

For the purpose of this examination, I would ask that you would be exposed from…
Cardio- waist upwards
Resp- waist upwards
Abdo- Nipple to the knee (practically waist upwards)
Upper limb- whole arm
Lower limb- Waist downwards
Cranial Nerve- neck and upwards
The examiner will act as a chaperone. Do you need any assistance?

Question 6

How should you complete an exam?

Answer 6

1. Thank the patient
2. Summarise finings to the patient and then the examiner
3. Offer to help them get dressed
4. Wash hands
5. Request further examinations (at least 2)