Clinical Skills Assessment Medical OSCE Exam (OSCEs Home)

Ethics OSCEs 

Prepare yourself for these common ethics topics in Objective Structured Clinical Examinations

The common topics that have been tested in OSCE exams during USMLE Step 2 CS, MCCQE Part II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

• Decision to forgo treatment.

• Respect patient's decision and provide education, support, and empathy.

• Delivering bad news: HIV, Cancer, Death.

• Telling the truth.

• Confidentiality / Breaking confidentiality.

• Competency / Capacity.

• Death before arrival.

• Pharmacist / health care provider refusal to provide care.

• Brain death and organ donation.

• Relative as a decision maker.

• Surrogate decision maker.

• Women abuse.

• Child abuse.

• Drug seeking.

• Informed consent.

• Angry patient.

• Violent patient.

• Seduction.

Common ethics OSCEs 

Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:

(Please note: For USMLE Step 2 CS, there is no examiner in the room. The encounter is video monitored and taped. Thus, there will be no questions asked in the room other than the patient's questions. However, during physical examination, you are still required to explain what are you going to do to the patient before physically touching him/her. All USMLE Step 2 CS stations are of 15 minutes long and require focused history taking, physical examination, and counseling as needed. Thus, ignore the last statement in the following sample stations about the available time and required tasks to do.).

1. Ronald King is a 58 years old diabetic patient who has got leg gangrene but refusing surgery. Please talk to him in the next 5/10/15 minutes. (Decision to forgo treatment / Respect patient's decision and provide education, support, and empathy)

2. Kevin Mcfadden requested HIV test two weeks ago and the results has come positive. Please talk to him in the next 5/ 10/15 minutes. (Refuses to tell his partner: Breaking confidentiality/ reportable)

3. Sheila Rogers is a young women who comes to your office complaining of headache. Please interview her in the next 5/ 10/15 minutes and address her concerns. (Drug seeking).

4. Rosita Lazzam is the daughter of your patient Mr. John Lazzam, a 68 years old man who just was diagnosed with pancreatic cancer. Rosita has asked to see you immediately to talk to you about an important matter. Please talk to her in the next 5/ 10/15 minutes and address her concerns. (Telling the truth / Competency / Capacity).

5. You are the ER physician working in a rural area of 5000 population. Julie Murphy is a 16 years old girl who came to your office in the morning concerning her unprotected sex last night with her boyfriend. You prescribed the morning after-pill for this and she went to the only pharmacy of this area. The pharmacist, Dr. Stewart, refused to fill the medication for her. You decided to go to the pharmacy and talk to him directly. Please enter the room and talk to him in the next 5/ 10/15 minutes. (Pharmacist / health care provider refusal to provide care).

6. Mrs. Hilary Weston found your appointment card in her daughter's coat when she was taking it to the laundry. She has come to your office to find out why her daughter, Laura, came to see you. Please address her concern in the next 5/ 10/15 minutes. (Confidentiality).

7. Kathy Astrom is Mr. David Astrom's wife waiting in the meeting room to talk to you. David was involved in an accident 4 days ago with severe head injury and now has all the criteria of brain death. All attempts to restore his brain function failed. Two neurologist and neurosurgeon also confirmed that with "apnea test". Please enter the room and talk to her about this issue and the prognosis in the next 5/ 10/15 minutes. (Brain death and organ donation/ empathy).

8. Mrs. Elaine Young was diagnosed with lung cancer recently but she refuses to get chemotherapy and surgery as treatment.  She wants to go to Mexico to get homeopathy treatment for that. Please enter the room and talk to her in the next 5/ 10/15 minutes. (Decision to forgo treatment / Respect patient's decision and provide education, support, and empathy).

9. Margaret Hart is a 78 year old women known case of COPD who comes frequently to the ER with severe episodes of shortness of breath. Yesterday she came with same problem and you intubated and resuscitated her. She was hospitalized in the ward and now is alert and fine. Her daughter, heather is requesting to you to write a "DNR: Do Not Resuscitate" order in her chart. Please enter the room and talk to her in the next 5/ 10/15 minutes. (Competency / Capacity / Relative as a decision maker). 

10. James Ottlyk is the husband of Mary Ottlyk who got involved in a bad accident six years ago and since then she has been in a vegetative state. She never regained her consciousness and only open her eye's but doesn't seem to follow anything. She is 100% dependent on the nurses care. She has had feeding tube for a long time. Now Mr Ottlyk is in the meeting room to discuss removal of the feeding tube. Please enter talk to him in the next 5/ 10/15 minutes. (Competency / Capacity / Relative as a decision maker).

11. Mrs. Tara McDonald is a 52 year old woman, a known case of diabetes type I, who was rushed to the hospital in a profound coma, but dies almost immediately. You are the emergency physician who saw her first and there was no pulse or respiration. She was pronounced dead. You must notify the coroner. Her husband and daughter are waiting to talk to you. Please enter the room and talk to them in the next 5/ 10/15 minutes. (Note: You'll find that the husband gave her an extra insulin dose unknowing she already had an overdosed shot). (Death before arrival/ Delivering bad news).

12. Joanne Brown, a middle aged woman, came to your office because she is very angry and upset with a surgeon colleague of yours who operated on her father before her father's death during the bypass surgery last week. She wants to sue this surgeon and wants you to agree that the surgeon caused her father's death. Please talk to her in the next 5/ 10/15 minutes. (Angry patient).

13. You are working in the emergency. A young man with a gun shot wound was admitted. Within minutes, officer Stephen George, a policeman, arrived informing you that this young man has just shot someone downtown and you must give him his chart for investigation. Please talk to him in the next 5/ 10/15 minutes. (Confidentiality).

14. Lucy Armstrong is 23 year old woman who came to your office after she felt a lump in her right side of her upper neck. In the next 10/15 minutes take a focused history and perform a focused physical exam. (Note: She keeps her bra and thighs exposed with gestures of seduction and may ask if you are free tonight (even if your are a female doctor). The case is infectious mononucleosis and she is sexually active. Take sexual history and safe sex counseling too.) (Lymphadenopathy/ Seduction/  Safe sex).

Now;

What do you have to do in these OSCE stations in order to cover the checklist?..... 

What to ask to be thorough and cover the differential diagnosis?.... 

How to ask in an efficient, respectful, and empathic way?.....

How to wrap up the station?.....

How to counsel the patient?..... 

How to perform a complete, safe, and respectful physical examination?.....

Your biggest challenge in OSCE exams is the limited available time.

You need to memorize sets of questions and actions to be asked and done while you're in an autopilot manner!

Do not think you will be able to do it completely by yourself,

and then sit down and wait for good OSCE Exam scores.

If you do, you will never get your best potential!

 Act now.

There is never any time but now, and there never will be any time but now.

If you are ever to begin to make yourself ready for what you want for your OSCE exam, you must begin NOW...

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Find reliable tested answers here: 

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