Trial OSCE exam: 'talk talk talk' by Naanu Neenu
You have 3 minutes reading time. This OSCE will run for a maximum of 7 minutes.
You have just successfully resuscitated Jason, a 53yo man who was brought in by ambulance with chest pain and suffered a VF arrest on arrival. He had immediate CPR and received 3 defibrillations and 1 dose each of adrenaline and amiodarone. His post-resuscitation ECG showed infero-lateral STEMI and he has been intubated and transferred to the cath lab for PCI.
Instructions for the candidate
You are the consultant who has just lead the resuscitation. Jason's partner has just arrived and is in the relatives room. You are to inform Jason's partner of what has happened, gain background history and discuss Jason's management and prognosis.
Domains being examined
- Medical Expertise
For the actor
Actor may be male or female. You are Jason's partner of the last 10 years.
You were informed that Jason had developed chest pain at work and was taken by ambulance to the hospital. Jason has been working in a very stressful job at present. You are highly anxious and want to see him.
He is normally reasonably well. He has been stressed recently at work and not sleeping well. He has not mentioned chest pains before. He has no prior heart problems. He has Type 2 Diabetes and is on a tablet. He was noted recently to have high blood pressure and borderline high cholesterol, and has been advised on lifestyle changes, leading to him buying a bike recently (but has not used it much; waste of money, really). He has no allergies. He drinks minimal alcohol, smokes cigarettes (10/day, more recently with stress) and uses no alternative medicines nor illicit substances.
You have been with Jason for 10 years. Jason has 2 daughters who live interstate and his mother lives here.
"Can I see him?"
"Is he going to die?"
"What happened to him?"
"What are they doing to him?"
"When are they doing it?"
"What's going to happen afterwards?"
For the examiner
Domains Assessment Objectives
- Medical Expertise
- Explanation of resuscitation efforts
Explanation of STEMI pathogenesis, risks & benefits of PCI and PCI procedure
Explain likely prognosis and ongoing management
- Appropriate language without jargon
Clear, concise and specific
Active listening, opportunities to ask questions, appropriate pauses, ensures understanding
- Respectful and non-judgemental
Ensures identity and status of partner, ensures confidentiality