OCANZ OSCE Preparation: Essential Clinical Skills and Stations

The OSCE (Objective Structured Clinical Examination) component of OCANZ tests your practical clinical skills. Here's your comprehensive preparation guide.

Understanding the OSCE Format

Structure

• Multiple clinical stations
• Each station 10-15 minutes
• Standardised patients and examiners
• Marked against competency criteria

Assessment Areas

• Clinical technique
• Patient communication
• Clinical reasoning
• Professional behaviour
• Time management

Station Types and Preparation

1. History Taking Station

Common Scenarios

• Red eye presentation
• Vision changes
• Headaches and eye symptoms
• Paediatric concerns
• Systemic disease screening

Key Skills

• Systematic approach
• Open and closed questions
• Symptom characterisation (SOCRATES)
• Red flag identification
• Differential diagnosis formation

SOCRATES for Eye Symptoms

• Site: Which eye? Location?
• Onset: When did it start? Sudden or gradual?
• Character: What does it feel like?
• Radiation: Does it spread?
• Associated symptoms: Vision changes? Discharge?
• Timing: Constant or intermittent?
• Exacerbating/relieving: What makes it worse/better?
• Severity: Scale of 1-10?

2. Refraction Station

Skills Assessed

• Retinoscopy technique
• Subjective refraction
• Binocular balancing
• Prescribing decisions

Common Challenges

• Irregular retinoscopy reflexes
• Small pupils
• High refractive errors
• Accommodative patients

Tips

• Verbalise your technique
• Explain to the patient
• Work systematically
• Justify your final prescription

3. Slit Lamp Examination

Anterior Segment Assessment

• Systematic examination technique
• Illumination techniques
• Corneal assessment
• Angle assessment (Van Herick)
• Lens examination

Key Techniques to Master

• Diffuse illumination
• Direct focal illumination
• Specular reflection
• Indirect illumination
• Sclerotic scatter

Common Findings to Recognise

• Corneal staining patterns
• Anterior chamber cells/flare
• Cataract grading
• Anterior chamber depth estimation

4. Fundus Examination

Direct Ophthalmoscopy

• Systematic technique
• Red reflex assessment
• Disc, macula, vessels, periphery

BIO Technique

• Lens positioning
• Patient positioning
• Systematic examination
• Peripheral examination

Key Findings

• Disc changes (cupping, swelling)
• Macular changes (drusen, haemorrhages)
• Vascular changes (AV nicking, haemorrhages)
• Peripheral lesions

5. Visual Fields Station

Confrontation Testing

• Count fingers in quadrants
• Kinetic targets
• Central field assessment

Automated Perimetry

• Patient instruction
• Result interpretation
• Pattern recognition
• Artefact identification

Common Patterns

• Glaucomatous defects
• Neurological patterns
• Macula-involving patterns

6. Binocular Vision Assessment

Cover Test

• Technique demonstration
• Measurement accuracy
• Interpretation

Motility

• Smooth pursuit
• Saccades
• Versions and ductions

Near Point Testing

• NPC measurement
• Accommodative amplitude
• Fusional reserves

7. Contact Lens Station

Assessment Tasks

• Fit evaluation
• Lens selection justification
• Aftercare procedures
• Problem solving

Common Scenarios

• New fit assessment
• Troubleshooting poor comfort
• Overwear complications
• Material selection

8. Tonometry Station

Goldmann Tonometry

• Anaesthetic application
• Fluorescein instillation
• Measurement technique
• Reading accuracy

Common Errors to Avoid

• Incorrect mire alignment
• Corneal pressure
• Poor calibration awareness

9. Communication Stations

Scenarios

• Explaining diagnosis
• Discussing treatment options
• Breaking difficult news
• Referral explanation

Key Skills

• Clear explanations
• Checking understanding
• Empathy
• Appropriate language level

10. Management Planning

Clinical Scenarios

• Acute presentations
• Chronic disease management
• Prescribing decisions
• Referral decisions

Structure Your Response

1. Summarise findings
2. Working diagnosis
3. Immediate management
4. Follow-up plan
5. Referral if needed

General OSCE Tips

Before the Exam

1. Practice under timed conditions
2. Use study partners as patients
3. Verbalise all techniques
4. Review Australian guidelines

During the Exam

1. Read station instructions carefully
2. Introduce yourself to every patient
3. Explain what you're doing
4. Maintain professional manner
5. Watch the time

Common Mistakes

• Not reading instructions fully
• Poor time management
• Forgetting infection control
• Not explaining to patients
• Incomplete examinations

Equipment Familiarity

Ensure you're comfortable with:

• Slit lamp (various brands)
• BIO and condensing lenses
• Retinoscope
• Trial frame and lenses
• Tonometer
• Visual field instruments

Practice Resources

1. Study partner practice sessions
2. Video recordings of your technique
3. Clinical mentorship
4. Practice with different equipment
5. Mock OSCE sessions

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The OSCE tests practical competence. Regular practice with feedback is the key to success.