Subject: Friend, Learn Top Seven Principles For Successful OSCE Preparation

Hello Friend,

Top Seven Principles For Successful Learning In Both Clinical Placements As Well As Practice


Dr Al Imari, MD.

November 25, 2016


At one time we were all starting our clinical placements as medical students and residents, suddenly immersed into a strange and novel world. The field has an extremely steep learning curve. New residents are tasked with the challenge of simultaneously learning basic medical knowledge, patient interview skills (history taking and communication skills), physical examination clinical skills, and clinical decision making and management. Medical schools devote little time to these topics, and I know of no existing resources that are designed specifically to help medical students and residents at the beginning of their careers.


There are seven core proficiencies that are critical for development as a physician:


1.      Basic medical knowledge,

2.      Patient interview skills: History taking,

3.      Patient interview skills: Physical examination clinical skills,

4.      Patient interview skills: Communication skills,

5.      Patient interview skills: Time efficient organizational skills,

6.      Clinical decision making and management,

7.      Surgical skills.


Basic knowledge is the foundation of every profession. For example, residents should understand how disease develop and progress and know its signs, symptoms, and lab results. In addition, they should know its differential diagnosis as well as the differences between different types of medical intervention, in addition to side effects and prognosis of each intervention.


History taking from the patient requires to know what to ask to fulfill the OSCEs examiner checklists and cover the differential diagnosis?… While physical examination requires to know what to do in the physical exam part of an OSCE station?….


Communication skill is a key issue in physician-patient interviews. How to phrase your questions and comments to be ethically and legally correct even if English is your mother language?.. How to appear relaxed, confident, organized, capable, safe, and professional in your OSCE Exams?….


Time efficient organizational skills for both the OSCE station and clinical patient interviews is a crucial aspect. You have no time to waste in both settings!. How to organize the station and lead the interview in a time efficient manner?


Surgical skills are not only for surgeons. Non-surgeons need to learn basic skills such as wound suturing, abscess drainage, emergency room bleeding control, airway intubation, venous access, central lines,.. etc. For surgeons, developing surgical skill involves understanding the protocol for different surgeries, as well as developing the kinesthetic skills necessary to execute them — for example, understanding the steps involved in a specific surgery and being able to perform the surgery itself.


Finally, a physician must integrate his or her understanding of basic clinical knowledge with that specific patient presentation and sound clinical judgment in order to make good clinical decisions.


To best learn and retain the knowledge, there are Seven key principles of education:



Principle 1: Prepare the material to study and memorize


We have the tendency to buy several textbooks recommended by our friends, senior students and residents. And then jump between them while memorizing. This is a frank mistake! Research proved that we memorize and remember information by our five senses and learning circumstances. The more sensory inputs for the same information are, the longer and deeper that information will be stored in our memory.


While books smell, taste, and feel the same, they look and sound different when we read them loudly! The environment around us has a smell and feel and can be different from time to time. Don’t study the same subject from two different textbooks. If you have time, read every subject in all the recommended textbooks. Then decide what material concerning that subject from which textbook to memorize. You can choose one of the textbooks (or a photocopy of it) and add side notes and stickers from other textbooks, or create your own detailed notes gathering information from all the textbooks into one note. That what you will memorize, recall, and practice and never again open other textbooks for that subject. Repeat the same process for other subjects and so on...


Principle 2: Distance/distributed learning — utilizing new teaching modalities

Web-driven online/offline, outside-the-classroom audio and video learning that can be accessed from anywhere a mobile device can go. The ability to learn independent of time and location increases efficiency, and getting input from different modalities may improve retention itself. However, remember to stick to your pre-prepared notes.


Principle 3: The art of memorization


Use all you senses to memorize the same notes that you created for each subject. Now you have a visually constant material to memorize photographically by your eyes. Memorize it by reading it both silently and loudly. This will provide your brain with a second constant memory input of the same material. Then write it. This is a third memory input for that same material. Now speak it by pretending you are teaching it to a student with all the gestures, visualization and imagination. This is a forth memory input for the same material. Repeating the same visual, auditory, sensory, motor inputs makes the information stored deeply and for longer time.



Principle 4: Active recall — recall without contextual cues


Active recall strategies that encourage free recall retrieval (without contextual cues) of previously learned facts improve memory retention far better than simply rereading a passage of text. An example of this is when an attending asks a resident how to distinguish the three major differential diagnoses of a presenting complaint from one another.


This is much more effective than having the resident read an article about that. Studies have shown that active recall compared with passive reading improves memory retention, even when the recall attempt is unsuccessful.


Try to ask yourself questions about the material you memorized. In clinical setting when you see a case, try to recall all those notes that you wrote about this case.



Principle 5: The testing effect — testing directly improves learning


Standardized tests are an inescapable part of every physician’s career. While they are often seen as a method of assessing knowledge, the act of taking the test itself directly improves memory retention. The testing effect generally differs from active recall. Most tests in medicine are not a true active recall experience because they are presented as multiple choice exams that provide contextual clues for answer recognition. However, cued recall in multiple choice questions is still an effective means for improving long term memory retention.


The greatest weakness with using testing to reinforce knowledge is the potential to reinforce incorrect facts. Pre-preparing the study material from trusted resource (as you should have done in principle one) play an important role to avoid this.



Principle 6: The feedback effect — feedback on both incorrect and correct answers improves learning

The testing effect can be further enhanced by providing feedback on your performance. Providing feedback is an effective way of not only rectifying incorrect answers, but also of reinforcing correct answers. This is especially helpful for those questions that the user answered correctly but with low confidence. It is not always easy to give immediate, direct feedback in class or clinic, but this principle can be leveraged by studying and practicing with a partner. Each will act as an examiner for the other partner, then flip roles. A well-developed online tool that uses interactive features to test and evaluate users will also help.


Principle 7: Spaced repetition — the ‘flashcard’ effect

It makes intuitive sense that increasing repetitions of knowledge retrieval attempts increases the likelihood of memory retention. In addition to increasing the sheer quantity of repetitions, introducing a delay between repetitions further improves learning.

Practice, practice and practice is the important rule. Memorize a subject, then recall it (not re-read it) next day, then again recall it the day after, then recall it after 10 days. This memorization technique will assure memorizing 90% of the material after two weeks and 80% after three weeks. This will improve if you recall again on periodic intervals.


Spaced repetition is becoming easier by using online and offline apps that automatically schedule repetitions for them. These are most often done in the form of virtual flashcards.


The OSCEhome Systematic Approach provided in “A Step By Step Guide To Mastering The OSCEs and Patient Clinical Encounters” ebook package is a huge step to finalize principle 1.

The OSCEhome 12 ebooks package is designed to be compatible for any OSCE.

It contains detailed step by step instructions about WHAT to ask or perform,  WHEN to ask or perform, and HOW to ask or perform.

The OSCEhome 12 ebooks are electronic ebooks that can be downloaded to your computer or tablet. OSCEhome ebook package can be installed on two devices/computers.

It is compatible with Windows PC, Mac, iPad, and Android devices.

You will be able to print all or just parts of the 640 pages.

It contains no OSCE stations checklists, however, as over 4000 copies had been sold so far with minimal refund requests.

If, in 60 days,  you find them invaluable for you, uninstall them and we will sent you a refund.

You can order it online now here:

(Copy paste the whole line to your internet browser address bar).

You need a system that does the job in the 5-15 minutes interview time! Just memorize it, practice it, and that's it! Not figuring out how!


What you need is a real system that works. A system that covers:


1.   What to ask to fulfill the OSCEs examiner checklists and cover the differential diagnosis?… You’ll Get Questions Templates, One For Each Body System,  Covering All Possible Patient Complaints. Templates That Cover All Related Differential Diagnosis And Covers The Medical OSCE Exam Checklists Even If You Couldn't Figure Out The OSCE Station Differential.  Key Questions To Differentiate The Causes Are Included And Marked…. You’ll appear Experienced!  


2.   How to ask the patient questions without leading him or appear judgmental or disrespectful?….  You’ll Get Ready To Use Questions Templates Of What, How, And When To Ask The Patient. Not Only Checklists That You Need To Figure Out How To Ask About Them Yourself In Your Medical OSCE Exam. Complete History Taking Templates For ALL OSCEs In ALL Specialties. Just Memorize and Practice Them!… You’ll Be Knowledgeable and Understanding!  


3.    How to phrase your questions and comments to be ethically and legally correct even if English is your mother language?…. You’ll Get Complete Carefully Phrased Sentences That Show Respect, No-Judgment, And Yet Time Efficient And Comprehensive. Sentences Of How To Approach Sensitive Issues Like Menses, Sexual History, And Abuse In An Ethical Manner?…. You’ll be Courteous!  


4.   What to do in the physical exam part of an OSCE station?…. You’ll Get A Step By Step Guide Of How To Perform A Physical Examination in just 5 minutes. What To Examine in focused or complete exam? How To Organize It In A Time Efficient Manner. What To Tell Both The Patient And The OSCE Examiner While Examining (if the OSCE examiner is present in the room). What To Do To Show Respect For The Patient And His/Her Privacy?…. You’ll appear Competent!  


5.   How to appear relaxed, confident, organized, capable, safe, and professional in your OSCE Exams?…. You’ll Get That By Mastering A Proven Step By Step Organized Follow Through Guide For Your Medical OSCE Exam…. You Will Be Able To Handle ANY OSCE Station. Not Only 50 or 70 Stations. Not Only Specialized OSCEs. Just Any OSCE Station AND Real World Medical Encounters!  


6.   What to ask or examine in an Emergency setting OSCE Exam station? How to MANAGE the patient in an Emergency setting OSCE Exam station?…. You’ll Get A Step By Step Guide To Follow Concerning What To Ask, Examine And WHEN?…. Detailed How To Manage Any Emergency Setting OSCE Station is included?…. As A Bonus, Medications And Doses For Common ER OSCE Stations Are Included In A Step By Step Manner!…. Your ER Performance Will Be Outrageously Competent And Efficient!  


7.   How to counsel the patient in an OSCE Exam station?…. You’ll Get An Organized Counseling Station Format. You'll Know What To Ask The Patient? How And When To Inform The Patient?…. You’ll Be and Look Organized!  


8.   How to deal with difficult patient scenarios in an OSCE Exam station?…. You’ll Get Knowing How To Deal with 20 Difficult OSCEs Scenarios Like Depression, Breaking Bad News, In Your E-book How To Unlock Difficult Medical Encounters? …. You’ll Be in Control Of The Medical Encounter!  


9.     How to know if your communication skills are sending the right messages during your OSCEs?… You’ll Master Verbal Communication Skills Indirectly By Just Memorizing The Templates and Performing Them Confidently In Your OSCE Exam. You’ll Learn How to sit, talk, behave and lookfor your OSCEs?…. You’ll Be and Look Attentive, Friendly and Yet Professional!  


10.   What to study and how to practice for your Medical OSCE Exam?…. You’ll Get EXACTLY What Medical Knowledge Is Needed And ENOUGH To Pass Your Medical OSCE Exam!…. You’ll Know How To Prepare Yourself For Your Medical OSCE Exam!…. You’ll Be CONFIDENT in Your Clinical Skills In No Time!


You can order it online now here:

(Copy paste the whole line to your internet browser address bar).

Have a nice day.

Dr Al Imari


Acknowledgment: Dr Uday Devgan, MD, Ocular Surgery News, U.S. Edition, October 25, 2016