Panic! No don't panic. Panic! No, stay calm...

It's about a month to go till OSCE's, I've just finished my ENT week (as part of Neurology and Special Senses block) and I keep dipping in and out of pure panic and then calming down.

I don't know what i'm more stressed about: the examinations, the explanations the history taking. I used to feel so comfortable with the explanations and history taking but i've seen myself properly fuck that shit up. I'm still trying to get used to the idea that those latter two are far far more about communication and structure of your consultation more than anything else. I think I've been more preoccupied with getting a diagnosis and saying the right information before but that's not what bothers me now. I either will or won't nail the diagnosis but who cares as long as I have some suitable differentials and the worst case scenerio is I don't actually know anything about the thing i'm explaining - reassure the patient as best as you can, refer to senior as appropriate.

My method for explanations is currently: assess their knowledge, signpost your consultation at the beginning, get your ICE in there already, "Do you have any ideas about what epilepsy is?" "What were you expecting to take away from todays consultation?" chunk it up into 3 things, and give 3 points for each. So e.g. Epilepsy is diagnosed when you have more than one 'seizure' or 'fit'. Everybody has electrical brain activity. A 'fit' or 'seizure' occures when there is a sudden burst of electrical brain activity in the brain.

And then S.A.S. - Summarise, ask if they have any questions, signpost to the next chunk. So epilepsy is when the brain activity sometimes goes wrong. Do you have any questions? Next i'm going to talk about the common ways it affects people. And move on. By CHUNK 2 you need to know their concerns before you get to chunk 3 "Is there anything about epilepsy that's really worrying you at the moment?"

Chunk 3, SAS, Offer leaflet and get out.

I think previously when i've practiced these explanation stations, i've been trying to explain too much and always ran out of time so keeping it simple and essentially giving 9 points chunked into 3 should mean that I am OK with time.

*Sigh* I hope this is coming on OK. I've been making posters to help me remember but honestly, I just don't know if they're useful or not.

Next block: geriatrics.