NDEB Virtual OSCE flashcards

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

Chief complaint

The patient's primary reason for seeking care, recorded in the patient's own words and quoted. It anchors the interview and directs the focus of the history and examination.

OLDCARTS

A mnemonic for symptom history: onset, location, duration, character, aggravating and relieving factors, timing, and severity. It ensures all dimensions of the presenting symptom are systematically captured.

Review of systems

A structured head-to-toe inquiry about symptoms in each body system, used to uncover problems the patient has not volunteered. Positive findings are then explored with focused questions.

Red flag symptoms

Features suggesting serious disease, such as unintentional weight loss, night pain, fever, bleeding, dysphagia, or neurologic deficit. Their presence mandates urgent investigation rather than routine follow-up.

Teach-back method

A comprehension check in which the patient explains the plan in their own words. It reveals gaps in understanding and is more reliable than asking whether the patient understood.

Sensitivity

The proportion of people with disease who test positive. A highly sensitive test with a negative result makes the diagnosis unlikely, which is the basis of the SnNout rule.

Specificity

The proportion of people without disease who test negative. A highly specific test with a positive result makes the diagnosis likely, which is the basis of the SpPin rule.

Likelihood ratio

The ratio of the probability of a test result in diseased versus non-diseased patients. Values above 10 or below 0.1 substantially shift post-test probability; values near 1 do not.

Anchoring bias

Committing to an initial diagnosis and discounting later contradictory evidence. It is countered by deliberately listing features that do not fit and seeking disconfirming information.

Differential diagnosis

A prioritized list of possible explanations for a presentation, ranked by prevalence, severity, and treatability. Worst-case diagnoses are excluded before common benign ones are accepted.

Treatment threshold

The probability of disease at which the benefits of treating outweigh the harms of treating without further testing. Testing is useful only if it moves probability across this threshold.

Informed refusal

A patient's documented decision to decline recommended care after being informed of alternatives and the risks of non-treatment. It must be recorded with the discussion that occurred.

Restorability assessment

Determining whether a tooth can be predictably restored and maintained before committing to complex treatment. An unrestorable tooth is an indication for extraction rather than heroic therapy.

Staged treatment plan

Sequencing care by urgency: stabilization of acute problems first, then definitive treatment, then elective care. Consent and review occur at each stage of the sequence.

Host factors

Patient-related variables such as systemic disease, smoking, oral hygiene, and adherence that modify prognosis independently of the procedure performed. They must be addressed in the plan.

Elements of informed consent

Capacity, adequate disclosure, comprehension, voluntariness, and a documented decision. All five must be present; a signature alone does not establish valid consent.

Material risk

A risk a reasonable patient would consider significant when deciding on treatment, plus any risk the individual patient has identified as important. Such risks must be disclosed.

Shared decision-making

A two-way process in which the clinician presents evidence and options while the patient contributes values and preferences. Both parties agree on the resulting plan of care.

Motivational interviewing

A counselling style using open questions, affirmation, reflection, and summarization to strengthen the patient's own motivation. Confrontation and persuasion are avoided because they increase resistance.

SBAR handover

A structured communication format: situation, background, assessment, and recommendation. It reduces omission and miscommunication during transfers of care between clinicians or teams.

Autonomy

The ethical principle that competent patients have the right to make their own healthcare decisions, including refusing recommended treatment, after adequate disclosure of relevant information.

Confidentiality limits

Disclosure of health information without consent is permitted only for legal mandates such as reportable diseases, imminent serious harm, or court order. Each disclosure is documented.

Decision-making capacity

The ability to understand relevant information, appreciate consequences, reason about options, and communicate a choice. It is decision-specific and does not follow automatically from a diagnosis.

Mandatory reporting

A legal duty, defined by jurisdiction, to report specified conditions such as suspected child or elder abuse and certain communicable diseases to the appropriate authority.

Open disclosure

Prompt, honest communication with a patient after a harmful error, including what happened, consequences, and next steps. It is an ethical obligation and is documented in the record.

Addendum correction

A dated later entry that corrects or clarifies an earlier record without altering it. The original entry is preserved, and the addendum states the date and time of the correction.

Contemporaneous record

Documentation completed at the time of the encounter or as soon as practicable afterward. Delayed entries are labeled with both the event time and the entry time.

Minimum necessary rule

A privacy principle limiting disclosure of identifiable health information to the least amount needed for the stated purpose, such as a referral or insurance claim.

Levels of prevention

Primary prevents disease onset, secondary detects disease early, and tertiary limits disability or recurrence. Each level implies different interventions and outcome measures.

Caries risk assessment

A structured evaluation of factors such as diet, fluoride exposure, oral hygiene, saliva, and history of lesions. It determines recall interval and the intensity of preventive measures.

The 5 A's

A behaviour-change framework: assess, advise, agree, assist, and arrange follow-up. It structures counselling for smoking cessation, diet change, and other health behaviours.

Closed-loop referral

A referral process in which the referring clinician confirms the appointment occurred and receives the consultant's report. Without confirmation, the referral remains an unresolved care gap.