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OSCE Stop - Lecture Long History
OSCE Stop - Lecture Long History
History Taking
Dr Celine Lakra
COE Registrar, & OSCE-Aid co-founder
& UCL graduate
We will cover
Summary
Closing
The long station OSCE
30 minutes
5 minutes to read question & write notes
Write a differentials list
Generate a written structure for your history
taking including key points you want to cover
20 minutes to take a history
10 minutes for presentation, discussion &
questions (patient leaves)
Students can fail their exam if they royally fail this station
The long station OSCE
Real patients with chronic long
standing disease(s)
E.g.: Diabetes, epilepsy, rheumatoid
arthritis
Know the common chronic diseases well
Home and
social life
Support (non
medical & Environment
medical)
The patient
Cultural and
Knowledge &
religious
understanding
beliefs
Finances &
resources
The long station history
Mr P is a 45 year old gentleman with type 1 diabetes. He
presents to you with tiredness. Please take a full history.
Introduction
PC/HPC
5 minutes
Address acute issue first e.g.: classic tired all the time history
Then history of the chronic disease:
1. The systems affected by the disease (eyes, feet, kidneys, nerves in DM)
2. Conditions linked to / complicating the disease (e.g.: cardiovascular &
cerebrovascular disease)
3. The patients feelings about the disease
Understanding
Effect on self, lifestyle, job, family
General management clinics, therapists, doctors, medicines
Mood
The long station history
Mr P is a 45 year old gentleman with type 1 diabetes. He
presents to you with tiredness. Please take a full history.
PMH
If they have multiple problems, Which bothers them the
most? Why?
DH
Allergies and type of reaction
Drugs and their side effects
Management of medications
Compliance
Dossett box?
Previous therapies?
The long station history
Mr P is a 45 year old gentleman with type 1 diabetes. He
presents to you with tiredness. Please take a full history.
SH
5 minutes Home and
social life
Living situation
medical)
Financial
Finances &
How has illness affected their occupation? resources
FH
SR
Can be really helpful in the long station
Closing
The long station history
Presenting your patient
Provide a focused problem list. Include the patients concerns here if
applicable.
I have taken a history from this 45 year old gentleman. His problem list
is as follows;
1.Tiredness all the time. This may be due to renal failure as I note
his type 1 diabetes has been poorly controlled. Other differentials I
am considering are hypothyroidism (as this runs in his family) and
low mood
2.Poorly controlled diabetes. This seems to be due to lack of
compliance which may also be due to his low mood.
3.His largest concern is financial trouble caused by being unable to
work at present
The long station history
Questions from the examiner:
Support (non
medical & Environment
medical)
The patient
Cultural and
Knowledge &
religious
understanding
beliefs
Finances &
resources
Thank you