NAC OSCE key terms

A structured interview that gathers the details of the presenting problem, its onset, course, and associated symptoms, plus relevant past history, medications, allergies, and social context, before any physical examination begins.

An interviewing technique in which the candidate asks questions designed to confirm or exclude specific diagnostic possibilities generated early in the encounter, rather than collecting data in a fixed sequence.

A prioritized list of plausible explanations for a patient's presentation, ordered by likelihood and by how urgently each must be excluded, which guides further questions, examination, and testing.

A symptom, sign, or historical feature that raises concern for serious or life-threatening disease and therefore mandates prompt investigation or escalation rather than routine outpatient management.

A systematic screen of symptoms by body system, used to uncover features the patient has not volunteered and to support or refute items on the working differential diagnosis.

An examination whose maneuvers are chosen to test the leading diagnostic hypotheses and to detect complications, performed with clear explanation, consent, draping, and attention to patient comfort.

The reading of blood pressure, heart rate, respiratory rate, temperature, oxygen saturation, and sometimes glucose or pain score together, recognizing patterns that indicate instability or a specific physiologic state.

A justified set of laboratory, imaging, or bedside tests selected to confirm or exclude diagnoses, estimate severity, and guide treatment, with attention to cost, delay, and patient preference.

A prioritized, written outline of pharmacologic and non-pharmacologic treatment, referrals, monitoring, and follow-up, negotiated with the patient and consistent with the working diagnosis and its severity.

The cognitive process of integrating history, examination, and test findings to form and revise diagnostic hypotheses and to choose proportionate action, while remaining alert to cognitive bias.

Explicit advice given at the end of an encounter describing which symptoms should prompt the patient to seek urgent care, where to go, and how quickly, with confirmation that the plan was understood.

Arranging same-day or emergency assessment by an appropriate service when findings suggest a time-critical condition, including clear communication of the concern to the receiving clinician.

A brief spoken acknowledgment that names the patient's emotion or difficulty, showing that the clinician has registered the human impact of the illness before moving on to further questions.

A mnemonic for responding to emotion: naming, understanding, respecting, supporting, and exploring. Each response is a short sentence that conveys recognition without prematurely offering solutions.

Asking at the start of the interview what the patient most wants addressed, then agreeing an order for the topics so that both the patient's priorities and the clinician's concerns are covered.

A funnel technique that begins with broad invitations allowing the patient to tell their story, then narrows to specific closed questions once the main themes have been elicited.

A check of understanding in which the patient restates the plan or instructions in their own words, allowing the clinician to correct gaps immediately rather than assume comprehension.

Speech that avoids jargon, abbreviations, and complex sentence structure, using everyday words and short explanations so that the message is accessible to a patient with limited health literacy.

Working with a trained medical interpreter, in person or by phone or video, rather than relying on family members, to ensure accurate communication and confidentiality for patients with limited English proficiency.

Deliberately pausing after a patient speaks or becomes emotional, giving space for reflection and further disclosure instead of filling the gap with another question.

A conversation in which the clinician presents options and evidence, the patient states values and preferences, and both agree on a course of action together.

Obtaining permission for an investigation or treatment after explaining its purpose, benefits, risks, alternatives, and the consequences of declining, and confirming the patient's voluntary agreement.

Determining whether a patient can understand relevant information, appreciate the situation and consequences, reason about options, and communicate a consistent choice regarding a specific decision.

The duty to protect patient information from disclosure without permission, including explaining its limits when there is risk to the patient or others, and being discreet in shared clinical spaces.

Maintaining a professional relationship by declining inappropriate requests, avoiding dual roles, and managing gifts, social invitations, or personal disclosures in a way that preserves trust and objectivity.

The internalized sense of what it means to act as a physician, encompassing accountability, humility, self-awareness, and commitment to patients over personal convenience.

A structured communication format for urgent or interprofessional messages: situation, background, assessment, and recommendation, delivered concisely with a clear request for action.

The transfer of responsibility for a patient between clinicians or teams, using a consistent structure to convey current status, outstanding issues, anticipated problems, and required actions.

A exchange in which the sender gives an instruction, the receiver repeats it back, and the sender confirms accuracy, reducing error in high-stakes or noisy clinical settings.

A group of health professionals from different disciplines who coordinate care around shared patient goals, each contributing distinct expertise and accepting mutual accountability for outcomes.

Openly establishing who on the team is responsible for which tasks and decisions, preventing duplication and gaps, and enabling appropriate delegation within each member's scope of practice.

Addressing disagreement among colleagues by clarifying interests, using respectful and specific language, focusing on patient safety, and escalating through agreed channels when needed.

Assigning a task to another team member after confirming that the person has the competence, authority, and resources to perform it, with a plan for reporting back.

Choosing investigations and treatments wisely, avoiding low-value tests and treatments that add cost or harm without benefit, and considering system capacity alongside individual need.

A structured, iterative approach to making care safer and more effective by measuring a problem, testing small changes, and studying whether the change produced improvement.

The conditions of income, housing, education, employment, food security, and social support that shape a patient's health and access to care, and which clinicians should screen for and address.

Acting on behalf of a patient or community to remove barriers to health, such as arranging transportation, connecting with social services, or raising a systemic concern with an institution.

Local services such as shelters, food banks, home-care programs, support groups, and crisis lines that can be offered to patients to address needs beyond what the clinic can provide.

An ongoing stance of curiosity and self-critique about one's own assumptions, combined with asking patients how their background, beliefs, and preferences should shape care.

Regularly examining one's own performance, emotions, and assumptions, using feedback and structured reflection to identify learning needs and to improve future clinical encounters.

The ability to seek, interpret, and act on feedback from examiners, supervisors, and peers, distinguishing useful specific observations from general impressions and turning them into learning goals.

Identifying one's own knowledge gaps, selecting credible resources, and applying new learning to practice, rather than relying solely on formal teaching to set the curriculum.

Judging the validity, importance, and applicability of a study or guideline by examining its design, bias, effect size, and relevance to the patient in front of you.

Integrating the best available research evidence with clinical expertise and the patient's values and circumstances, rather than applying guidelines mechanically to every patient.