!"#$ &'() * +,-. !

#
/0
1!2
03
456'78')
,09:';0 <'':8(=>

Stuuents as a cohoit peifoimeu well in the 0SCE. The pass iate was high. 0f the
inuiviuual stations, stuuents stiuggleu the most with the station on lithium toxicity anu
the station on psychosis.

The following aie some specific feeuback fiom examineis on nine stations. The othei
nine stations weie all peifoimeu well anu hau no specific feeuback fiom the examineis.

The feeuback below points to a tenuency foi piematuie closuie in uiagnostic
assessment, aieas of weakness in examination skills, weakness in iecognising anu
assessing a piesentation of psychosis, anu specific knowleuge ueficits.

?(@ #
,0(0A5; !B C5D') EA78 'F(7A;(0A5;
ueneially, stuuents peifoimeu well. Examineis iecogniseu that a compiehensive
examination of the lowei limbs was not possible within the limiteu time. Stuuents who
peifoimeu well weie able to piioiitise the task while still ietaining a systematic
appioach (e.g. not spenu too long on inspection anu methouically looking foi ielevant
signs in a patient with uiabetes).

Examineis commenteu on the following aieas that neeu attention:
a) Non-systematic appioach to examination, e.g. beginning sensoiy examination
with vibiation sense, omission of testing foi light touch.
b) Pooi examination technique, e.g. incoiiect technique foi eliciting ieflexes, pooi
technique foi testing piopiioception, pooi technique foi palpating peiipheial
pulses.
c) Insufficient knowleuge, e.g. confusion between signs of micio- anu macio-
vasculai uisease anu venous uisease.
u) Failuie to iecognise signs, e.g. Chaicot's foot, nail abnoimalities.

,0(0A5; $B G)'(>A;H 8(: ;'D/
This station was geneially peifoimeu well. Examineis commenteu on a ieliance to use
stock stanuaiu statements to uemonstiate empathy, iathei than engaging with the SP by
asking how he was feeling oi exploiing his expeiience (to an extent feasible within the
confines of the station time). Examineis also noteu that some stuuents hau incoiiect
knowleuge about the sequence of managing oesophageal caicinoma.

,0(0A5; IB CA03A97 05FA=A0@
This station was geneially pooily peifoimeu. Examineis noteu that a laige numbei of
stuuents weie not able to iuentify the symptoms anu signs of lithium toxicity. 0f those
who iuentifieu it, many uiu not holu oi cease lithium, which is an essential pait of
management. Stuuents shoulu iemembei that lithium toxicity is a ielatively common
clinical piesentation, anu is a uiagnosis baseu on clinical featuies iathei than seium
level, even though seium level is a useful aiu to uiagnosis anu shoulu be peifoimeu.

,0(0A5; 2B J)'/=)A8A;H KL5/015L')(0A6' (;(EH'/A(M
The piesciibing station was geneially uone well, anu most stuuents iecogniseu that
moiphine is the uiug of choice anu unueistoou the neeu to monitoi foi ovei-
seuation. Some uiu not complete the uiug alleigy panel, anu a veiy small numbei filleu
in the panel as "none known" - this is misleauing anu potentially uangeious since the
patient hau a histoiy of penicillin alleigy. A few stuuents useu oxycouone iathei than
moiphine - this was acceptable but not iueal.

?(@ !
,0(0A5; !B NA/05)@ 5O O(0AH9'
A numbei of stuuents uiu not peifoim well in this station. The main pioblem noteu by
examineis was the piematuie uiagnosis by stuuents, e.g. focusing eaily on malignancy
anu thus failing to auequately consiuei othei uiffeiential uiagnoses.

,0(0A5; IB J/@=35/A/
This station was pooily peifoimeu by stuuents as a whole. Examineis all commenteu on
the failuie of many stuuents to iuentify psychosis, uespite SPs ietuining to theii
uelusions on multiple occasions uuiing the inteiview. Pait of this ielateu to stuuents
missing oi ignoiing cues given by SPs, anu pait of this ielateu to pooi clinical skills in
eliciting psychotic featuies, e.g. only asking about auuitoiy hallucinations in assessment
of psychosis, asking foi psychotic symptoms in such a way that only insightful patients
coulu answei (such as asking if they hau "thought withuiawal" oi if they hau
expeiienceu anything "abnoimal"). Examineis also noteu that few stuuents consiueieu
any aspect of iisk to the patient oi infant in this scenaiio, which possibly ieflecteu the
failuie to iuentify the piesence of psychosis.

Stuuents shoulu also be awaie that SPs aie often sciipteu to pioviue uiffeient veibal anu
non-veibal iesponses uepenuing on the stuuent's empathic engagement anu
questioning style, as patients uo in ieal life. Stuuents theiefoie shoulu not assume that
SPs woulu automatically ieguigitate histoiy when piobeu - the questioning woulu neeu
to be ielevant anu appiopiiately skilleu in oiuei foi histoiy to be eliciteu.

?(@ $
,0(0A5; #B -():A(= 'F(7A;(0A5;
This station was geneially peifoimeu well. Examineis commenteu on the neeu foi
gieatei competence in examination technique, in paiticulai ielating to the manoeuvies
foi auscultating caiuiac muimuis.

,0(0A5; !B J)'15L')(0A6' 8E'':A;H
This station was geneially peifoimeu well. Examineis commenteu that few stuuents
uemonstiateu open questioning in theii histoiy taking, insteau ielying on iapiuly fiiing
questions at the SPs. Examineis also iuentifieu piematuie closuie in uiagnostic
consiueiation, with a iapiu focus on one uiagnosis at the expense of consiueiing othei
uiffeiential uiagnoses.

,0(0A5; *B ,>A; E'/A5;
This station was geneially peifoimeu well. Examineis commenteu that the aiea
iequiiing the most impiovement was uesciiption of the lesion, anu theie was a neeu foi
gieatei familiaiity with uesciiptive teims. Some stuuents also showeu an incoiiect
knowleuge of the maigin foi excisional biopsy.