How I passed the NP OSCE Exam
Channel: Nurse Howie
Date: 18/05/2019

I describe how I passed the nurse practitioner OSCE physical medical assessment exam.

GREAT QUESTION BY MONA (answered):
Mandeep (Mona) Garha
I'm writing my OSCE next week and feeling super nervous about it. Do you have any additional tips? Are there any tricky or abnormal scenarios or is it pretty straightforward? Thanks, Mona

MY ANSWER:
Hey Mona! Congrats. You will do fine. But there are some things that helped me decrease my anxiety over the exam: 

1. PRACTICE! Focus on preparing for these scenarios: heart, lungs, musculoskeletal, fever/cough. My theory was that the other afflictions such as vision problem, earache, or sinus problems are not as significant as the aforementioned systems. (Why would the school pay live actors so much just to test you on an earache?). It worked for me--my OSCE patient had a cough. Note: I was also lucky that my instructors chose to forego rash/skin exam. 

2. Know your RED FLAGS! There's no point doing everything perfectly but then FAIL if you forget to cover your red flags. Although I was confident, I checked my ego and did the extra office hours just to practice my red flags. Subsequently, I never forgot to ask about smoking, allergies, and always placed my stethoscope directly on the patient's skin (despite how awkward it was for me to ask a female patient). Practice helps you to remain calm so that you don't forget to listen to a patient's lungs if they have a cough. These are "duh" situations and may seem easy to avoid but when your mind is agitated, may make you forget.

3. Have a SYSTEM: When you are given the 5 minutes prior to seeing your live patient, have a system of writing down everything you need to ask your patient. For example, I would split my scratch paper in half & on the left side of the paper I put space to write titles such as: vitals, med/surg history, famhx, medications, allergies, and RED FLAGS to ask the patient (cuz you'll be given the chief complaint prior). Then on the right I would put down all the questions I would ask pertaining to her complaint, such as recent travels, recent illness, trauma, person exposure, etc. This way, I would ask the questions in order and then go over it with the patient before I started the physical exam so I wouldn't miss anything. (My professor almost failed me b/c he thought I forgot to ask allergies! I showed him that I did and that I had written it down. He verified it on the video recording and I passed lol).

4. Know your TIMING: Have some shortcuts. For example, EVERY OSCE scenario can benefit by doing at least a quick survey of the patient's heart and lungs. But don't go overboard. If the teacher sees you doing a full lung assessment or musculoskeletal nerve exam on a complaint about an eye problem, then you will fail by either being stopped or running out of time. 

BOTTOM LINE: It's been psychologically proven that those that practice until the activity is rote develop muscle memory and can easily perform in front of a crowd (Olympic medalists, Broadway performers, etc.), but those who have not practiced enough will usually choke in front of an audience. So practice until you're bored and you'll be fine. Good luck!