OSCE: Problem focused HPI

Abdomen
Testing dimension
1.

Professionalism (dress, eye contact) and introduction

2.

Explains task, assures confidentiality, obtains consent

3.

Begins with open ended questions and transitions

4.

Establishes presenting complaint and duration

5.

Establishes history of presenting illness including:

Site of pain
Radiation
Quality
Exacerbating and relieving factors.
Associated symptoms including
Weight changes
Appetite
GIT symptoms (vomiting, dysphagia, diarrhea, constipation, hematemesis, melena, jaundice,
tea colored urine)
Urinary symptoms (dysuria, urgency, polyuria, poor stream, nocturia)
Reproductive symptoms (vaginal discharge, amenorrhea, dyspareunia, LMP)

6.

Communication skills and summary presentation

Knowledge question

OSCE: Problem focused HPI

CVS

Testing dimension
1

Professionalism (dress, eye contact) and introduction

Explains task, assures confidentiality, obtains consent

Begins with open ended questions and transitions

Establishes presenting complaint and duration

Establishes history of presenting illness including

Site of pain
Radiation
Severity
Quality
Exacerbating and relieving factors
Associated symptoms including
Weight change
Shortness of breath on exercise
Night cough
Pink sputum
Orthopnea
Paroxysmal nocturnal dyspnea
Dependent edema
Palpitations
Syncope/near syncope
Fatigue

Communication skills and summary presentation

Knowledge question

OSCE: Problem focused HPI

Neurologic

Testing dimension
1

Professionalism (dress, eye contact) and introduction

Explains task, assures confidentiality, obtains consent

Begins with open ended questions, demonstrates empathy and transitions

Establishes presenting complaint and duration

Establishes history of presenting illness and inquires about

Site and area of involvement
Motor symptoms: weakness, abnormal movements, tremors, balance, gait
Sensory symptoms: numbness, tingling
Central symptoms: seizures, syncope, dizziness, headache, diplopia, slurred speech, vision and
hearing

Communication skills and summary presentation

Knowledge question

OSCE: Problem focused HPI

Respiratory
Testing dimension

Professionalism (dress, eye contact) and introduction

Explains task, assures confidentiality, obtains consent

Begins with open ended questions and transitions

Establishes presenting complaint and duration

Establishes history of presenting illness including

Site
Radiation
Exacerbating and relieving factors
Associated symptoms
Specific RS;
Shortness of breath
Cough: night; day; exercise; other precipitants
Sputum, color, amount, consistency
Chest tightness
Pleuritic chest pain
Fever
Night sweats

Communication skills and summary presentation

Knowledge question

OSCE: Comprehensive History

Testing dimension
1

Professionalism (appearance, eye contact, behavior)

Explains task, assures confidentiality, obtains consent

Begins with open ended questions and transitions

Establishes presenting complaint and duration

Establishes history of presenting illness including but not limited to:

Onset of symptoms and timing
Exacerbating and relieving factors
Associated symptoms
Pain:
Location and radiation of pain,
Severity and quality

Establishes past medical history

Includes chronic medical illness, operations, hospitalization, mental illness, childhood
illness, trauma, allergy (food, environment)

Establishes drug history including

Prescription name and dosage, over the counter and herbal, supplements, drug allergy

Establishes social history including home life, work, exercise, diet, tobacco, drug and alcohol
use

Establishes family history

Includes age/age of death/cause of death for family members
Includes family history of diabetes, hypertension, cancer, alcoholism, stroke, heart attack etc.

10

Asks a complete review of systems

11

Summary presentation and communication skills

12

Knowledge question