Your ABA OSCE Made Easy

Just when you though you were safe … The OSCE is Back.

The American Board of Anesthesiology (ABA) has introduced an Objective Structured Clinical Examination (OSCE) component to the Applied Exam.

Now the Applied Exam will have an Oral Exam component, called the Standardized Oral Examination (SOE), and an Objective Structured Clinical Examination (OSCE) component.

This will add another component to an already long day of testing.

What is the OSCE?

You should be familiar with the testing format of the (OSCE) since you probably took this exam during your USMLE / COMLEX Step 2 Exams. (If you were lucky like me and took the Step 2 Exams before there was an OSCE, the process will be new to you.)

Instead of telling the Oral Examiners what you would do, you will be showing them during your OSCE.

The OSCE is a series of “low fidelity” simulation stations. You might interact with a simulated patient or surgeon to assess communication and professionalism. There will be other stations where you will all evaluate a clinical scenario. You might be:

interpreting a monitor or lab value
commenting on a cardiac echo, or
discussing an ultrasound picture for vascular access or a nerve block.

“The OSCEs will assess two domains that may be difficult to evaluate in written or oral exams – communication and professionalism and technical skills related to patient care.”

Who will take the OSCE?

According to the ABA, if you complete residency training on or after 10/1/2016, then you will have to take the OSCE. You will have to pass both the SOE and the OSCE to pass the Applied Examination.

What is the structure of the OSCE?

The ABA OSCE outline lists nine skills that you may be tested on. During your exam, you will be tested on seven of those nine skills. Each 8 minute station will test a skill on either a simulated patient/surgeon, or a simulated monitor. You will have a four minute break in between stations.

How does the ABA OSCE and SOE Fit together for the Applied Exam?

There are two morning groups of examinees and two afternoon groups of examinees. In the morning groups, Group A will start with the SOE, then transition to the OSCE. Group B will start with the OSCE, then transition to the SOE. The afternoon groups are structured the same way. You can see a sample schedule on the ABA website here.

What will be tested on the OSCE?

There are two main sections: A. Communications & Professionalism and B. Technical Skills

A. Communications & Professionalism section has 6 parts:

Informed consent
Treatment options
Peri-procedural complications
Ethical issues
Communication with other professionals
Practice-based Learning and Improvement

B. Technical Skills Section has three parts:

Interpretation of monitors
Interpretation of echocardiograms
Application of ultrasonography

How should you prepare for the ABA OSCE

Check out the FAQ about the OSCE This is a good place to start. You will know most the information about the exam after reading this article, but it is a good please to start.
OSCE Overview Video Take a look at the video. It is about 12 minutes long and gives a good overview of the process.
OSCE Content Outline Download the content outline and see what kinds of topics you can expect from the exam.

Resources to help you prepare for the ABA OSCE

A. Communications & Professionalism

The ABA only gives you direction on one resource: The Ethical Issues section. The ABA sites the ASA’s Guidelines for the Ethical Practice of Anesthesiology. It would be good to read through this document because you may be tested on the principles discussed in the document.

B. Technical Skills Section

Interpretation of monitors

Most of the information that will be asked of you can be found in one of your Basic Anesthesiology Texts, or in the Faust Anesthesia Review (which happens to be one of my favorite anesthesiology books). This is the time to review things like what is the C wave, A wave, etc. on a CVP waveform. The key will be to review the actual waveforms that you may encounter during the exam.

Transesphongeal Echo (TEE) Images

The OSCE may ask you to identify 11 different basic TEE views. A great review article describing these views can be found at A Consensus Statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. You can review these views and be able to identify them on sight.

Ultrasound for Vascular Access

There is a good review articles written by American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists which you can find here. Spend some time thinking through how you can identify the different structures if asked during the OSCE.

Ultrasound for Regional Anesthesia

I am sure that by now you are familiar with nysora.com. (I remember going to the website one night on call as a resident to look up a block we had to do for a patient who had a strong family history of Malignant Hyperthermia.)

Click on the blocks below to see the article on the nysora.com that shows you the ultrasound guidance.

The OSCE Reviewed

There is still so much we don’t know about the OSCE. I have tried to give you some resources to help you prepare for this new part to the Applied Exam. I will continue to update this page as new information comes out.