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Background
Several years of intensive study group sessions
for registrars who have failed the RACGP OSCE
exams.
Role-plays and case discussion.
A few registrars have repeatedly failed the
OSCE despite participating.
We looked extensively at the reasons why they
failed and how to help them.
Problems identified
Difficulty in communicating
Lack of insight about their clinical and
consultation techniques
Problems with clinical reasoning
Personality and attitude factors affecting
consultation skills
Learning patterns
Performance anxiety during exams
Difficulty Communicating
Kelapa-coconut
Kepala-head
Dr Challenge
External resources
The two external resources we used to help this
registrar were:
Performance and language coaching with a
professional actor and language coach
Sessions with Dr Guy Gordon on managing
performance anxiety.
Performance anxiety
Sessions with Dr Guy Gordon
Two to three sessions on relaxation techniques
to use before exams
Key Outcomes
1. Develop
Communication skills including performance and
accent.
Structured consultation; history and examination
techniques.
Clinical Reasoning-what they are doing and why it is
being done
Management- appropriate investigations, ability to
negotiate management with patients and their
families; involving other team members
Mental Health
Womens health
Aged care
The Difficult
consultation-angry
patient/ breaking bad
news
Sexual Health
Critical Appraisal
Activities
To complete a self-assessment grid to identify areas for
improvement
To develop a short case for the role play sessions and
role play this with colleagues
To actively participate in role plays and have a video
recording done of a consultation and receive feedback
To complete learning module on Evidence based
Medicine and do a Critical appraisal of a journal paper
with the group
Specific areas
Evaluation
1.How the registrars found the
content
organisation
diversity of discussion
Results-work in progress
Only 4 registrars have participated in
language/performance and performance anxiety
sessions to date
All felt they all improved in language and
performance and found the sessions on
performance anxiety beneficial
Improvements
Script Concordance testing questions developed
by Dr Canalese to assess clinical reasoning in
the first session
Encouraging the registrars to complete Direct
Observation Teaching forms while their
colleagues role play and provide feedback on
performance.
Thank You
Thank you
Thank you for your help and contribution:
Dr Anne Eastwood
Dr Graham Lee
Dr Rosa Canalese
Dr Guy Gordon