Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Sample scenarios

OSCE sample 1: Using ISBAR, communicating a patient's deteriorating condition

Purpose of the station
The purpose of this station is to assess how you communicate a patient’s deteriorating condition to a team member. Underpinning the station is your competencies and patient safety.

Scenario

Mr Murray, a 19-year-old patient, was involved in a motor-bike accident. Following review in the Emergency Department, he was transferred to the operating theatre where he underwent intramedullary nailing (IM) of the left tibia and external fixation.

Following surgery, he was transferred to St John’s ward. Four hours following transfer to St John’s ward, Mr Murray appeared slightly agitated and his heart-rate was slightly elevated. His neurovascular assessment of the limb including pedal pulses showed that all were within normal ranges. He complained of pain in his left leg especially on movement. Analgesia was given as charted.

An hour after his analgesia was administered, he has become increasingly distressed and is complaining of increasing pain and his heart-rate shows a further elevation. He is sweating profusely but his body temperature is normal. Regarding his lower left leg: the pedal pulses are difficult to palpate; it feels cooler; and he is complaining of a feeling of tightness.

You are required to
  1. Demonstrate a level of competence essential for safe practice.
  2. Fully consider the scenario
  3. Analyse the patient’s Neurovascular Assessment Chart
  4. Contact Dr Smith via telephone and effectively and assertively communicate with the her/him in a systematic manner, providing a clear rationale on why and when she/he should come and review the patient 
  5. In your communication with the doctor, you must use:
  • The scenario; and
  • Your analysis of the patient’s Neurovascular Assessment Chart; and
  • Your professional judgement; and 
  • The ISBAR communication tool. 
You will be assessed on the following competencies:
  • Professional values and conduct of the nurse competences
  • Nursing practice and clinical decision-making competences
  • Knowledge and cognitive competences
  • Communication and interpersonal competences
  • Management and team competences
  • Leadership and professional scholarship competences

OSCE sample 2: Wound care

Purpose of the station
The purpose of this station is to assess how you carry out a wound dressing. Underpinning the station is your competencies and patient safety.

Scenario

The patient, Mrs Green, is two days post-surgery and requires changing of a wound dressing.

You are required to
  1. Demonstrate a level of competence essential for safe practice
  2. Clean and set-up the trolley
  3. Explain the procedure to the patient and interact with the patient throughout
  4. Prepare the patient
  5. Remove wound dressing
  6. Assess the wound and verbalise what you are assessing for
  7. Clean the wound and explain your method of cleaning
  8. Apply new wound dressing
  9. Dispose of waste appropriately
  10. Adhere to aseptic technique throughout
  11. Explain to the assessor the wound healing process: Primary Closure or Delayed Primary Closure
You will be assessed on the following competencies:
  • Professional values and conduct of the nurse competences
  • Nursing practice and clinical decision-making competences
  • Knowledge and cognitive competences
  • Communication and interpersonal competences
  • Management and team competences