All station types
CPSA · OSCE station
Communication & explanation
Explain a diagnosis, procedure or result; shared decision-making; breaking bad news; consent; counselling.
Communication and professionalism carry equal weight to clinical knowledge in OSCE marking — you cannot clinical-knowledge your way past this station. Be yourself, be honest, avoid euphemisms and jargon.
A structured approach
Structure (e.g. SPIKES for bad news)
- 1Setting — private, sit down, no interruptions
- 2Perception — find out what the patient already knows/understands
- 3Invitation — ask how much they want to know
- 4Knowledge — a warning shot, then information in small chunks, plain language
- 5Emotions — respond to feelings; allow silence
- 6Strategy & summary — a clear plan and follow-up
Throughout
- 1Chunk and check understanding regularly
- 2Avoid jargon and euphemisms; be honest — “I don’t know, but I’ll find out” is fine
- 3Explore and address ideas, concerns and expectations
- 4Safety-net and offer written information / support
What the examiner wants
- Empathy that is *demonstrated*, not just claimed — responding to cues
- Information pitched at the patient, checked for understanding
- Honesty and appropriate escalation/safety-netting
- A shared, realistic plan
OSCE tips
- Silence after bad news is powerful — don’t rush to fill it.
- A warning shot before breaking bad news softens the blow and is marked.
- Chunk-and-check beats a monologue every time.
- If a patient is angry, acknowledge it explicitly and don’t get defensive.
Marking domains
Every station is scored against these. The ones this type leans on most are highlighted.
Data gathering
Right questions, focused examination, relevant investigations.
Clinical reasoning & management
Plausible diagnosis, sensible investigations, safe evidence-based management.
Communication
Active listening, clear explanation, exploring concerns (ICE), shared decisions, safety-netting.
Professional behaviour
Rapport, respect, empathy, handling challenge, honesty.
Patient safety
Recognising and responding to safety-critical issues; escalation.
Topics that appear
Breaking bad newsExplaining a diagnosis / resultConsent for a procedureShared decision-makingMedication counsellingDealing with distress / angerLifestyle & behaviour change
Communication frameworks
Structured approaches (SPIKES etc.), phrases that work & pitfalls — in Finalist.
Breaking bad newsThe angry patient / relativeExplaining a diagnosis / resultsConsent for a procedureMedication counsellingDiscussing DNACPR and ceilings of careBehaviour change — smoking, alcohol, weightChronic disease counselling — a new diagnosis to live withExplaining a procedure or investigationTelephone referral to a senior or specialtyA colleague’s error, and raising a concernConsulting through an interpreterThe patient not taking their medicationReceiving a safeguarding disclosureExplaining uncertainty and a normal resultFitness to drive and the DVLA
Guide library
Jump straight to the step-by-step guide for a specific station — and rate your confidence in each.
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