My scarf just doesn't fit any more OSCE by Michael

 
You have 3 minutes reading time. This OSCE will run for a maximum of 7 minutes.

Scenario:

Your RMO has asked you to examine one of their patients, a 57-year-old female who has presented after noticing a neck lump.

Your RMO believes this to be a goitre, but is unsure on the examination findings. They have asked you to confirm findings prior to discussing with the specialist.

The attached file is for examiner's use - do not view.

View attached:  Attachment 1

Instructions for the candidate

You are to examine the patient. When complete, you are to describe your findings to the specialist over the phone. If not commenced earlier, this phone call will be suggested after 6 minutes (ie when the 1-minute remaining timer sounds).

Domains being examined

  • Medical Expertise
  • Communication
  • Professionalism
 
The candidate has 3 minutes reading time. This OSCE is expected to run for a maximum of 7 minutes.

For the actor

Be yourself. You are not expected to furnish any history items, but can answer basic questions and interact with the candidate.

For the examiner

Equipment: tendon hammer, cup of water

Vitals: HR 90 BP 160/70 RR 16 SaO2 98% RA T 37.1

Questions to ask as specialist:
- Does the goitre extend retrosternally?
- Are there any signs of hypo or hyperthyroidism?
- Are there any other medical conditions of note?

Domains Assessment Objectives

Medical Expertise
- Thorough and timely thyroid examination
- Accurate diagnosis of hyperthyroidism

Communication
- Clear and polite introduction and instruction to patient
- Clear expression of findings to specialist

Professionalism
- Develop patient rapport

Other Assessment Notes

- Thyroid examination checklist as attached
- Should elicit signs of hyperthyroidism
- Should check phonation for vocal cord function


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