OSCE: Objective Structured Clinical Exam

This course is designed for those who either want to do a revision and brush up on their clinical examination skills, or those who needs help to develop a systematic approach to case history and clinical examination. 

Christian Fossum DO, associate professor and head of Osteopathic Studies at the Norwegian School of Health Sciences, want to help the participants developing the right steps towards confidence in clinical assessment of the patient in the first consultation.  It is a theoretical and practical course which will cover clinical assessment strategies with an emphasis on red-flag and musculoskeletal pathologies encountered in osteopathic practice as a part of pre-manipulative and treatment screening.  

For each region covered we will discuss common differential diagnoses, protocols for clinical assessment, orthopedic, neurologic and safety testing as well as clinical judgment and reasoning based on the presentation and findings. Upon the completion of the course the participant should have the tools to use a structured case history combined with clinical examination for improved safety in osteopathic practice.

Programme

Thursday 25th May

STARTING TO UNDERSTAND THE PATIENT 

- Disease and symptoms: from biostatistical theory to the biopsychosocial model

- Objectives of the OSCE 

- Introduction to the diagnostic process

- Symptom-sorting and clinical reasoning

- Structuring the first consultation to improve patient-orientation 

- The comprehensive case history

• Listening to what the patient is telling
• Chief complaint, History of present illness, Past history and Past medical history, Family history, Personal and Social History, and Review of Systems
• The case history and red flags
• Multi-symptom presentations

- The Symptom-experience

• Narrative-based medicine and narrative reasoning
• Feelings, Ideas, Function and Expectations
• The patient´s goals and aspirations

- Goals and Aspirations 

- Risk factors for illness behavior and the development of chronic pain

- Verbal first-aid

Fryday 26th May

MAPPING THE BODY 

- Mechanisms of Pain and their Clinical Expression

• Joint Pain
• Myofascial Pain
• Radicular Pain and Radiculopathy
• Peripheral Neuropathy
• Visceral Pain

- The Map and the Terrain

• Somatic referred pain
• Visceral referred pain
• Dermatomes
• Sclerotomes or Osteotomes
• Frequent nerve entrapment syndromes

- The Pain History, Diurnal Pain Variation and Modulators of Pain

- Mapping neurological involvement: Lower Motorneuron Lesions versus Upper Motor Neuron Lesions with examples of cases and diagnoses 

- Specific versus non-Specific Musculoskeletal Pain. Time to rethink.

- The Art of Clinical Judgement

Saturday 27th May

THE DIAGNOSTIC SCREENING PROCESS

- Developing a Structure for Clinical Examination

• Medical Screening Tests
• Neurological Assessment
• Orthopaedic Assessment
• Safety and Precaution Tests
• Palpation and Pain Provocation
• Assessment of Function

- Cervical region

- Upper Extremity Pain

- Thoracic Pain

- Lumbar Pain

- Pelvic Girdle Pain

- Lower Extremity Pain

- Head and Temporomandibular Joint

PUTTING IT ALL TOGETHER 

• Reflection on the Course
• The Art of Probability and Clinical Judgement
• Questions and Answers

Timetable

Thursday 25th MayFrom 9.00 a.m. to 1.00 p.m. and from 2.00 p.m. to 6.00 p.m.

Fryday 26th MayFrom 9.00 a.m. to 1.00 p.m. and from 2.00 p.m. to 6.00 p.m.

Saturday 27th MayFrom 9.00 a.m. to 1.00 p.m. and from 2.00 p.m. to 4.00 p.m.