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:

A 37yo man has been brought to your emergency department after being knocked off his bike by a car at low speed. You are approached by a medical student who has been assessing him to assist with cervical spine clearance.

Instructions for the candidate

You are the consultant on in your urban district ED. You are to assess the patient for clinical cervical spine clearance and explain this procedure to the medical student.

Domains being examined

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

For the actor

Patient:

You are a fit & well man, no medical problems or medications. You were knocked off your bike by an inattentive driver. You were wearing your helmet and had no loss of consciousness. You have a number of grazes to your arms and legs and a sore left hand. You developed neck pain in the few minutes after the accident. You mobilised initially, but were encouraged by the ambulance crew to lie down and a hard collar was applied.

You have no weakness, loss of sensation or midline cervical spine tenderness. You have good head control.

Med student:

You have no idea about clinical clearance of the cervical spine. You can ask:

"How do you decide who gets imaging?"
"What criteria do you use for clinical clearance?"
"Are there other guidelines?"
"Are these criteria suitable for clinical clearance in all patients?"

After clinical clearance, ask:

"How do you decide which imaging type to use?"

For the examiner

Require: hard collar for patient

Domains Assessment Objectives

Medical Expertise
Clearance of the cervical spine in trauma

Communication
Clear explanation to patient and student

Scholarship and Teaching
Good teaching technique

Other Assessment Notes

Introductions, hand hygiene
Analgesia for patient

1. Assessment
- Safe approach and clear explanation of rationale
- Consider other injuries, etc

2. Clinical guidelines
- Use of validated guidelines for clinical clearance (eg NEXUS, Canadian c-spine rules)
- Identify applicable and non-applicable populations

3. Imaging choice
- With rationale (age, radiation dose, likelihood good images)

4. Communication

Bonus points:
- limitations of guidelines
- comparison of different criteria