Joint aspiration OSCE by Naanu Neenu

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


A 45 year old man, John Smith, presents with a unilateral swollen painful knee. There is no history of trauma. You decide that you need to aspirate the knee to rule out septic arthritis. The patient is being seen by a competent third year resident Melissa Harvey. You are going to instruct the resident on how to do the procedure and then guide them through the procedure.

Instructions for the candidate

The patient and Dr. Harvey are present in the next room.

You will interact with the patient but use the model to do the actual procedure.

There will be no interaction with the examiners in the room.

Domains being examined

  • Medical Expertise
  • Communication
  • Teamwork and Collaboration
  • Health Advocacy
  • Scholarship and Teaching
  • Professionalism
The candidate has 3 minutes reading time. This OSCE is expected to run for a maximum of 7 minutes.

For the actor

John Smith is a 45 year old man who has developed a painful swollen knee. He noticed some pain in his left knee yesterday and this morning when he woke it was red, swollen and very painful. He is unable to walk on it.

He has no past medical history and no history of swollen joints. Melissa Harvey is his doctor. She has taken a thorough history and examination. She has also explained what may have caused the swollen knee and that in order to diagnose the disorder they will have to take a sample of fluid from the knee. She has also explained that she has seen this done before but has not done it herself and would like to under the instruction of her consultant.

John Smith is a very easy going man. He has developed trust in Dr. Harvey and is happy for her to do the procedure under instruction.

The focus of this assessment is on the candidate teaching the junior doctor a procedure. You will have minimal interaction with the candidate apart from some specific interactions that are required:

We expect the candidate will explain that Dr. Harvey would like to do the procedure under instruction and ask for consent for that to occur. If this does not occur then you should say “has she ever done this before? Will you be helping her?”
We also expect the candidate to explain the procedure to you or ask Dr. Harvey to do that and obtain consent. If this does not happen then please say “what are you going to do?”
We expect the candidate to always be gentle with you. If they do something that hurts then please let them know

Junior Doctor Instructions

Melissa Harvey is a competent third year resident. She hopes to do surgery as a career. She is currently doing a 3 month rotation in Emergency Medicine and likes the experience. She is well liked, knowledgeable and good practically.

Melissa has not done a knee aspirate before but has seen a few done so has some knowledge of what to do.

You are to follow the instructions of the candidate only. However, when you follow the instructions you are competent at them. If you are unclear on an instruction then please ask to clarify

For the examiner


All equipment needed is supplied.

Use model to do the procedure

Domains Assessment Objectives

Medical Expertise

Relaxed manner
Clear instructions
Explanation of situation to patient

Explains Dr. Harvey has not done this before
That you will be supervising

Teamwork and Collaboration
Active listening

Health Advocacy

Scholarship and Teaching


Other Assessment Notes

Sterile technique
Reasonable procedure technique (at least explained, does not have to be completed in the time)

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