Candidate Tutorial Handbook (with videos)- Part II(OSCE)
The accompanying video tutorial has 10 clips or vignettes without any text or introductions. This handbook highlights particular features of the video, which has been prepared to familiarize candidates with the examination process and what they and others are expected to do during the examination.
These vignettes are used to make some important points. Some of these situations have occurred in OSCEs where candidates did not understand what to expect or what was expected of them. Some are serious and some are intentionally humourous. They are presented to illustrate some important things - most of all, to use the expertise that you have already gained and top it off with some garden-variety common sense!
Carefully read the Qualifying Examination Information booklet or the same information on the PEBC web site, to ensure that you are fully informed about the examination.
Now start the video and play one vignette at a time, referring to the notes for each vignette.
Note: If you don't have Windows Media Player, you can download a free version by clicking here.
1. Nancy arriving for the exam with a load of books
Click here to play the first video vignette.
Point: Some candidates arrive with a load of books and other reference materials. They cannot be used in the examination and must be checked in on arrival. You will not be permitted to use your own references so please leave your books at home; appropriate references are provided in the stations. You may use only the materials provided.
A note booklet will be provided to you when you arrive at the examination, so that you can take notes when you need to do so. You will be required to keep it intact, return it and sign for it before leaving.
2. Nancy interacting with the examiner
Click here to play the second video vignette.
Point: Examiners are all practicing pharmacists. Some have also been practice-based instructors for students. During the exam, even if you recognize anyone, you are not to interact with them socially. Candidates and examiners must focus only on the tasks they are required to perform and avoid distraction. This will allow the exam results to be fair and accurate.
3. Nancy asking SP (standardized patient) "How did I do?"
Click here to play the third video vignette.
Point: SPs cannot provide feedback in this exam, nor should they be expected to depart from their role as a patient. Even if you know some of the personnel in the exam, this is not the time to interact with them socially as it can be disruptive for both of you.
4. Orienting the candidates just before the exam
Click here to play the fourth video vignette.
Points:
• You will receive information about the time and place of the examination on your PEBC Identification/Card of Admission.
• You will receive a different ID/admission card for each part - check to be sure that you have the right one for each part.
• Part I and Part II will take place in different locations.
• You must be on time as late-comers cannot be admitted. All candidates must start and end at the same time.
When you arrive:
• You must sign the register and turn in any personal belongings for safe-keeping
• You will be given an identification (ID) badge which you must wear throughout the examination and hand back in before leaving
• You will also receive a sheet of bar code labels and a note booklet for use during the examination.
• Once you have registered at the site, exam staff will brief you on the particulars of your exam site - and will be there to help you as necessary.
5. Hall scene #1 - candidates outside their stations.
Click here to play the fifth video vignette.
Point: On the wall outside each station you will find your instructions, describing what you are expected to do. Read these instructions very carefully. A copy of the instructions will also be placed inside the station for your reference.
Some instructions are very specific, e.g. "A cancer patient who has been using morphine sustained release tablets is experiencing increasing levels of pain. He is now being started on morphine oral solution and is anxious about using too much morphine. Please assist him when he consults you for advice."
Others are more general, e.g. "A patient will be coming to seek your advice. Respond as you would in practice." In this case, the patient will briefly describe the problem, and you may need to probe for additional information about the nature of the problem and any related information. Be sure to:
• listen carefully to the patient's opening line;
• clarify anything you don't understand;
• observe their appearance and behaviour and
• interview/counsel the patient as appropriate.
If the station is "quiet" or non-interactive, specific instructions will be provided. Those instructions will also be printed on the exam paper placed in the station for your use.
When the start signal is given, go into the station. When you enter the station, give one bar code label to the assessor. The assessor will then attach your label to the scoring sheet on which your performance is recorded, ensuring that you receive credit for your own performance.
If the station is "quiet" or non-interactive, take your exam sheet from the desk or table. Place one bar code label on the paper as indicated and begin.
For a Sample Station handout (in .pdf form) click here.
If you do not have Adobe Acrobat Reader, click here to download a free version.
6. Hall scene #2 - SPs get up from their chairs and go into the stations.
Click here to play the sixth video vignette.
Point: In the interactive stations, the SP will enter about 15-20 seconds after you do - giving you a few moments to hand your bar code sticker to the assessor and see what materials and references are available in that station for you to use if you wish. The SP will stay in the station as long as the interaction is continuing and will go back out to the hall when the interaction is completed (or when the end-of-station signal is given, whichever happens first). Be assured that they will not leave before you have concluded the interaction.
7. Nancy asking an SP "Are you a man... or a woman?"
Click here to play the seventh video vignette.
Points:
• Simulations and role-playing are not easy for everyone. Assume that you are working with the actual client, materials and equipment as provided in the station... nothing more, nothing less.
• If your client is a standardized patient, regard him or her as your actual patient - same gender, age, physical appearance, mannerisms, etc. Observe them, listen to them and interact with them as you would in real life... they are highly trained to portray their situation realistically and consistently - both verbally and nonverbally... observe their appearance and actions.
• If your client is a physician or other health professional, use the same approach that you would take in practice.
• You may or may not have a patient profile or record to review. If you need to know something that is not presented by the client or on a profile, question the client as you would in practice - the client will answer!
8. Nancy at an imaginary keyboard, using an imaginary telephone
Click here to play the eighth video vignette.
Point: You are not expected to go beyond the task or demands of the station, such as to enter data on a profile, provide full pharmaceutical care services in 7 minutes, or call a physician on the telephone. Just follow the instructions and listen to the clients' requests and comments. Stay focused on what is asked of you.
Before viewing the last two vignettes:
Refer to general scoring guidelines for Communication, Outcome and Performance in the Examination Results section of the web site.
Go to the Qualifying Examination Sample Stations section on the web site and review the structure of the Sample Stations:
• the station objective/s
• competency/ies assessed
• candidate's instructions
• the scenario involving a standardized patient showing their opening line and patient profile information (a patient profile is provided in some stations but not all)
• other types of information that can be obtained by interviewing the patient
• station-specific scoring guidelines for the assessor,
• materials and references available,
• checklists of expected responses and
• the scoring scales for Communication, Outcome and Performance.
Stations have been carefully designed and selected to represent patients' problems that occur in hospital and community settings. The physical surroundings in the exam are not exactly as you might see them where you work, but the items you need to work with are provided.
The last two vignettes show the two Sample Stations "in action". They are shown in an ambulatory setting - but could just as easily occur in an outpatient clinic, palliative care unit, or in hospital. In the first (morphine) station the patient is concentrating more on how the two products are to be used together, and is seeking reassurance of the appropriateness, effectiveness and safety of the new regimen.
The patient profile in this station would have the new prescription information. In this station you would not be expected to call the doctor, because the objective is to respond to the patient's concerns and needs directly. In other stations, you may be instructed that the physician may be contacted and how to do so. Part of the response could be to refer the patient to the physician if the pain is not adequately controlled and/or if side effects are intolerable.
The two examples shown in the next two vignettes demonstrate fully acceptable performances. Watch them now!
9. Cancer Pain
Click here to play the ninth video vignette
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Click here to play the ninth video vignette
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The candidate does attend and respond to the patient's concerns and provides clear and logical information on the effective use of the two products together. See more information in the Sample Stations section.
10. Travellers Diarrhea
Click here to play the tenth video vignette
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Click here to play the tenth video vignette
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In this case there is no patient profile, therefore it is important to interview the patient to obtain all relevant information before recommending therapy, to avoid causing any additional drug related problems.
Read the station Objective just below the title in the Sample Stations section. Then read the competencies assessed. As you watch the video you will notice that the candidate did fulfill the station Objective and did demonstrate each of the elements listed on under Competencies 1 and 4.
Remember:
The OSCE stations are focused and relatively uncomplicated, and have been thoroughly pretested to ensure that they provide a fair assessment.
The best preparation for Part II is to take full advantage of your practical training and to become familiar with the references listed on page 75 of the Candidate Information booklet or go to the Pharmaceutical References section of the web site.
Frequently asked questions
1. What if I know one of my assessors?
Set this aside and refrain from conversation with the assessor; focus on the task at hand. Assessors are trained to avoid interactions with candidates and to follow specific scoring guidelines. If any concerns arise, report it to the examination staff for documentation and reporting to PEBC.
2. What if I get sick or can't finish the exam?
In this case, you can advise the assessor or one of the examination staff; staff are trained to call for appropriate assistance. You will not be permitted to leave the exam site until candidates in your session are dismissed, except in an emergency and under supervision. If you are unable to finish the examination, you may provide a written explanation to PEBC within seven days of the examination. You will be required to provide documentation of a valid reason to support your request. Please review the Qualifying Examination Information booklet, page 5, for further details or go to the Application Procedure section of the web site.
3. What if I take a different approach, based on how I have been taught?
Different approaches may be used in resolving the problem/s. Remember to follow the instructions provided and listen carefully to the client; prioritize your responses and use the time efficiently to ensure that you deal with the main issues of the task at hand in the time available.
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