Trial OSCE exam: 'jess M' by ClaireGo

You are taking part in a trial exam created by ClaireGo. There are 9 OSCEs in this exam including 1 double stations (100 minutes).
 

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

Scenario:

You have just completed an unsuccessful resuscitation on an 18 year old woman who was brought to the ED after being struck at high speed by a car whilst crossing the road. She sustained multiple injuries and went into cardiac arrest on arrival in the resuscitation room. She had aggressive resuscitation by a large multidisciplinary trauma team for 35 minutes, including emergency department thoracotomy. A formal debrief for all staff involved is planned for later in the shift, however, one of the nurses has asked you to check on the well being of Janice, a final year medical student who was present during the resuscitation. She was seen to be distressed and has been placed in your office awaiting your further involvement.

Instructions for the candidate

Please go and see Janice and offer her debriefing, support, reassurance and any further follow up she may require.

Domains being examined

  • Medical Expertise
  • Communication
  • Teamwork and Collaboration
  • Leadership and Management
 
The candidate has 3 minutes reading time. This OSCE is expected to run for a maximum of 7 minutes.

For the actor

You are quite distressed/teary. You found the whole resuscitation very confronting. You wonder why the thoractomy was done as it made no difference and seemed very aggressive to you. You are very concerned for the patients family.

You house share with 3 other senior medical students who will be highly supportive. If you feel reassured/comforted by the consultants manner you will open up and share your feelings and past history.

The situation is very personal for you as a close friend died in a car accident 12 months ago and was brought to the same ED in which you are now doing your placement.

For the examiner

None

Domains Assessment Objectives

Medical Expertise
Explanation of role of thoracotomy in blunt trauma.....

Communication
Open and professional approach, supportive

Teamwork and Collaboration
Inclusion of student in team and team debrief if desired

Leadership and Management
Approach to distressed staff member

Other Assessment Notes

Excellent candidates will do all/most of the following:

Offer a reassuring environment for Janice to talk and open up about her feelings
Note that such trauma resuscitations are confronting for all staff, even seasoned ones. “no shame in feeling upset”
Show concern and empathy
Offer further explanation as to why certain actions were performed and answer any questions around these queries.
Offer open ended questions and suffer any uncomfortable silences to enable Janice to open up. (ie don’t rush her)
Confirm that past life experiences will affect our function at work on some occasions and that this should be recognized so it can be dealt with, but it can also improve our ability to offer empathy and care to our patients and their families.
Offer follow up, counselling, further meeting with consultant, student counsellor etc.
Followup if she needs time off today, further days
Followup safe transport home and appropriate supports at home.