NAC OSCE flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

OPQRST symptom analysis

A structured pain and symptom history: Onset, Provocation and palliation, Quality, Radiation, Severity, and Timing. It converts a vague complaint into discriminating features that narrow the differential.

Red flag escalation

A feature that signals possible life-threatening disease, such as thunderclap headache or painless vision loss. Its presence mandates urgent investigation or referral rather than watchful waiting.

Pretest probability

The estimated likelihood of a diagnosis before a test is ordered. It determines whether a positive or negative result meaningfully changes management.

Safety net statement

Explicit instructions on which symptoms should prompt return, within what time frame, and where to seek care. It is documented and confirmed by teach-back.

Number needed to treat

The number of patients who must receive an intervention for one additional patient to benefit. It equals one divided by the absolute risk reduction.

Ask-Tell-Ask

A disclosure technique: elicit what the patient already understands, provide a short chunk of new information, then check comprehension and emotional response before continuing.

SPIKES framework

A six-step approach to breaking bad news: Setting, Perception, Invitation, Knowledge, Emotions with empathy, and Strategy with summary. Each step is completed before moving on.

Teach-back method

The clinician asks the patient to restate the plan in their own words. A correct restatement confirms comprehension; errors reveal gaps requiring re-explanation.

Empathic reflection

Naming the patient's emotion and its apparent cause without immediately reassuring or advising. It signals that the concern has been heard and usually invites further disclosure.

Informed consent elements

Diagnosis, nature of the proposed intervention, material risks and benefits, alternatives including no treatment, and confirmation that the choice is voluntary and uncoerced.

Professional interpreter use

Required when the patient's preferred language differs from the clinician's. Untrained family members, and children in particular, are not acceptable substitutes for consent discussions.

Closed-loop communication

The sender names the receiver and gives a complete order; the receiver repeats it back; the sender confirms accuracy. This prevents dropped or misheard instructions in urgent settings.

SBAR handover

Situation, Background, Assessment, Recommendation. Each element is stated explicitly, and the receiver reads back the plan to close the transfer of accountability.

Graded assertion

A staged escalation phrase used when a safety concern is not acknowledged. It moves from a stated concern to a direct request for confirmation, then to stopping the action.

Role clarity at team formation

Each team member states their role and scope, and the leader is named explicitly. This reduces duplicated tasks and clarifies who is accountable for each decision.

Consultation documentation

A record of who was consulted, the specific question asked, the advice received, and the agreed plan. It preserves accountability across the transition of care.

Triage prioritization

Ordering care by time-critical need rather than arrival sequence. Airway, breathing, circulation, disability, and exposure take precedence over completing a full history.

Plan-Do-Study-Act

A quality improvement cycle: define the problem with data, test one measurable change, study the result, then act by adopting, adapting, or abandoning the change.

Root cause analysis

A structured review that asks why repeatedly to separate system failures from individual error. Its output is a process change, not a person to blame.

Delegation accountability

Tasks are delegated according to the other person's competence and scope of practice. The delegating clinician remains accountable for the outcome of the delegated task.

Low-value care

A test or treatment that does not change management or whose harms exceed its benefits. Reducing it is a stewardship target measured by utilization and outcome data.

Screening program criteria

An important condition, a detectable preclinical phase, an acceptable test, effective early treatment, and net benefit exceeding harm. All must hold before population screening is justified.

Secondary prevention

Detecting disease early in its preclinical phase to reduce morbidity, such as cervical cytology or blood pressure screening. It differs from primary prevention, which prevents onset.

Social determinants screen

Routine questions about housing, food security, income, transportation, and personal safety. Each positive screen is linked to a named community resource.

Mandatory reporting duty

A legal obligation to report suspected child or elder maltreatment or specified communicable diseases. It overrides confidentiality and is disclosed to the patient.

PICO question

A focused clinical question structured as Population, Intervention, Comparator, and Outcome. It drives the search strategy and determines which study designs are relevant.

Sensitivity and specificity

Sensitivity is the proportion of diseased patients correctly identified; specificity is the proportion of non-diseased correctly excluded. Both are properties of the test, independent of prevalence.

Positive predictive value

The probability that a positive test result represents true disease. Unlike sensitivity, it depends strongly on prevalence and falls when disease is rare.

Likelihood ratio

LR+ equals sensitivity divided by one minus specificity; LR− equals one minus sensitivity divided by specificity. Values far from one meaningfully shift post-test probability.

Intention-to-treat analysis

Analysis of trial participants in their originally assigned groups regardless of adherence. It preserves randomization and gives a conservative estimate of treatment effect.

Decision-making capacity

The ability to understand relevant information, appreciate its consequences, reason about options, and communicate a choice. Capacity is specific to each decision, not global.

Confidentiality exceptions

Disclosure without consent is permitted with patient consent, when legally required, to prevent serious imminent harm, or for mandatory reporting. Each exception is documented.