OSCE – 18 stations in total.

1 ECG – lots of questions, not much time! Make sure you look at the back of the sheet, there’s questions there too! (unmanned)

2 Please examine the praecordium of this patient (actor). Explain what you’re doing as you go along.

3 Scenario – an obese woman needs surgery for a strangulated hernia. How would you proceed? (very interactive station, examiner kept me on track)

4 Critical incident – diagnosis and management of malignant hyperpyrexia. Lots of questions so need to think and write quickly. (unmanned)

5 Equipment – loads of pictures on a laptop and questions relating to those pictures, cylinders, rotameters, other aspects of gas supply. Again, loads of questions but not much time! (unmanned)

6 Airway station. Scenario – can’t get a good view on laryngoscopy. What do you do? Moved on to discussion about needle cricothyroidotomy. Shown some equipment (LMA, Aintree catheter…there was other stuff on the table too).

7 Anatomy of spinal cord and vertebral bones (unmanned).

8 Patient for TURP with comorbidities in anaesthetic room. There is a display with SaO2, ECG and NIBP on it. Patient in fast atrial fibrillation. What do you do? Surgeon wants to get on with case. Know what drugs to use, know when to deliver DC shock.

9 Anxious patient for elective surgery has heart murmur. Please speak with patient.

10 Ankle block. Anatomy of nerves and related structures. Contraindications. What local anaesthetic would you use? What dose? Serious adverse effects associated with these techniques.

11 Questions on electrical circuit diagrams – identify the symbols. Questions on ultrasound, questions on Doppler shift. (unmanned)

12 Jehovah’s witness patient requiring major (semi elective) surgery. Please talk to the patient.

13 Chest x ray. Lots of questions. (unmanned)

14 Discuss the influence of anaesthesia on hypothermia. How might we avoid hypothermia? What are the effects of hypothermia on various organ systems?

15 Blood results from a preoperative assessment of a young patient for elective surgery. Please interpret. (Sickle trait). How will you manage this patient? (unmanned)

16 Critical incident a) young female known asthmatic presents in extremis, outline management. b) patient undergoing hysterectomy suddenly loses significant quantity of blood – outline management. (unmanned)

17 rest station

18 Collapsed patient, BLS then moves swiftly to ALS.

OSCEs

1. ALS - VF - 2010 Algorythm (they don't have pads in Ireland, only paddles on defribilattors/ learn how to use them)

2. ECG

AV block Mobitz II; how do you deal with such a patient? what is the risk? what do you do before surgery?

Acute Inf MI : Treatment options

3. Pacemakers (examiner asks questions)

whole range of questions on what the letters mean; indications; why wouldn't you use sux in a patient with a pacemaker

4.Physical exam; precordium

some questions: why would you use the diaphragm or the belly?

5. RSI (written): indications, complications; cricoid presure: how would you prepare and perform it ?

6.electrical equipment (3 pictures on one screen/ you needed to scroll through the images and write down)

a. BF, B, CF defibrillator protected identification of signs
b. components of defibrillator
c. can't remember the 3rd picture (sorry)

then answer about 15 questions on next page; definitions of Coulomb, Power, Energy

7. Airway assessment/ DAS guidelines of emergency cat I CS; some questions on nasal paediatric ETT tubes

8. Anatomy of vertebra (thoracic); Also questions about different ascending/ descending pathways in spinal cord

9.Simulation; no manequin, but high fidelity monitor; questions about different capnograph traces

10. clinical anesthesia; smoking and iv drug user; simple questions really

11. comunnication skills; lady for hysterectomy; had previous DVT ; on warfarin 5 years ago; Now feels fine, no symptoms; she didn't seem to have major concerns, not even about a new DVT; Brief scenario also incuded the words "do a preop assessment" which was a bit confusing in a communication station

12.communication skills 2 : lady after diagnostic laparoscopy; on the word on PCA; in pain , starving and with sore throat; also emesis; nothing prescribed or given; also complained about shoulder tip pain

13.x-rays

a. COPD ; problems with surgery; what anaesthetic technique for a laparotomy?
b. lady for mastectomy; had a left sided pleural effusion; differential diagnostic;treatment before surgery?

14. radial artery cannulation; technique; allen's test; invasive monitoring; questions on resonance and damping; indications

15. humidification/ equipment

HME

Other methods;

Definitions; Relative and Absolute Humidity;

Measurement for both rel and abs humidity

16. rest station

17. critical incident (air embolism); quetions on causes,recognition, monitoring, treatment