UNIVERSITY OF HARGEISA

COLLEGE OF MDICINE AND HEALTH SCIENCES

July 12, 2021
PSYCHIATRY OSCE STATION 2021

Station 1
A 34-year-old married woman comes to an appointment with a chief complaint of “I’ve been
depressed recently.” One year ago she was raped by an unknown assailant in the parking lot of a
grocery store, and, since that time, “things just have not been the same.”

TASK

ASSESS THE CONDITION OF THE PATIENT AND TELL THE EXAMINER HOW YOU
WOULD MANAGE HER

8 minutes
OSCE station 1
Actor instructions:
You are a 34-year-old married woman coming to an appointment with a psychiatrist with a chief
complaint of “I’ve been depressed recently.” One year ago you were raped by an unknown
assailant in the parking lot of a grocery store, and, since that time, “things just have not been the
same.” You describe becoming irritable and angry with your spouse for no apparent reason and
feel disconnected from him emotionally. In fact, you feel “numb” most of the time, having “lost
the joy from life.” Your sleep is restless, and you are having trouble focusing on your work as a
laboratory technician. You have nightmares about the rape in which the event is replayed. You
admit that you have told very few people about the rape and try “not to think about it” as much as
possible. You avoid going anywhere near the location where the event occurred and remains
anxious when shopping at a supermarket. Your appearance, behavior, and speech are all
unremarkable. Your mood is “depressed,” and your affect is congruent and restricted. Your
thought process is linear and logical. You do not have suicidal or homicidal ideation, although you
wish your attacker would “die a horrible death.” You do not have paranoia[], delusions, or
perceptual disturbances.
Station 1
OSCE STATION ANSWER SHEET

Student ID-----------------------------------------------------------------Examiner Name ------------------

--------------
No Marking criteria Achieved Not achieved
1 Student has to give full introduction
2 Has to explain purpose of the interview
3 Ensure he/she is comfortable
4 Mention the exposure to actual or threatened death, serious
injury, or sexual violence
5 Elicit avoidance of triggering stimuli associated with trauma
6 Mention cognitive and mood symptoms
7 Irritability, hyper vigilant and increased arousal
8 Has to exclude any substance or medical illnesses
9 Exclude any anxiety symptoms
10 Assess any kind of trauma
11 as examiner directly as how did you manage and what is the
first line management ( the answer is antidepressant SSRI is
first line management
12 Ask about the side effect of the medications
13 CBT approach of therapy
14 Supportive therapy and family therapy
15 Next appointment and follow up

Global score
Global rating
Poor Borderline unsatisfactory Satisfactory Very good Excellent
Station 2

Ahmed is a 30-year-old man presents to your office complaining of being “down” the last month.
He has been suffering from difficulty falling and staying asleep, severe fatigue, guilt, poor appetite,
and thoughts of wanting to take his life. He has stopped talking with his friend and has no interest
in doing anything.

TASK

Please assess the condition of the patient in order to confirm a diagnosis

Duration is 8 minutes
OASCE station 2

Actor instructions:

You are Ahmed a 30-year-old man presents to your office complaining of being “down” the last
month. You have been suffering from difficulty falling and staying asleep, severe fatigue, guilt,
poor appetite, and thoughts of wanting to kill himself by using a knife. You didn’t have this feeling
before.

You did not have any interest of playing and staying with your friends.

You have depressed mood for the last month weight loss, loss of energy feeling guilty and
difficulty on remembering thinks.

You didn’t use any substance, you did not have any medical illness, no previous history of sleep
problems also you did not take any medications.
Station 2
OSCE STATION ANSWER SHEET

Student ID-----------------------------------------------------------------Examiner Name ------------------

--------------
No Marking criteria Achieved Not achieved
1 Student has to give full introduction
2 Has to explain purpose of the interview
3 Ensure he/she is comfortable
4 Screen about depressed mood or lack of interest
5 Ask about feeling guilty and level of concentration
6 Ask about sleeping pattern and also appetite
7 Ask about fatigue, tired and lack of energy
8 Assess carefully about homicide and suicide
9 Screen whether if he/she use any substance
10 Assess level of psychomotor activity
11 Screen about insomnia
12 Rule out any anxiety disease like worry and fearfulness
13 Rule out any psychotic symptoms like Hallucinations
14 Rule out any medical and substance use
15 Summarize and explain about the about the condition

Global rating
Poor Borderline/Unsatisfactory Satisfactory Very good Excellent

Examiners comments
Station three

Amina is a 75 year old lady in Burao who is brought to clinic by her family. She has been
forgetting things over the past year and now forgets the names of her relatives. She is able to talk
about her past in great detail and seems to think that she is only 18 years old.

TASK
Please perform Mental State examination only
DURATION IS 8 MINUTE
OSCE Station three
Actor instructions:

You are a 65 year old woman, Hodan, but you actually feel and believe that you are 20 years old.
You believe that your husband is alive though he died 10 years ago, and you think it is the year of
independence. You believe that you are in the market place waiting for your husband to collect
you and it is reported that you have been out to the market place to find him on your own.
You think it is night time when it is day. You are not sure which day it is or even the time. You do
not know the name of the president of Somaliland or names of other important people in the world.
You do know dates of history from Somaliland for example, Independence Day. You are unable
to remember whether you are sleeping well or not. You think you are eating properly. You are not
suicidal. You feel good in your mood.
You find it difficult to count backwards or to say the days of the week/months of the year
backwards. You are able to remember one item only of three items and cannot remember an
address. You become a bit stressed when the doctor perseveres with this test.
You have no psychotic symptoms. You lack insight and you do not feel you need a doctor. Your
speech is normal. Your thought is normal
Station 3
OSCE STATION ANSWER SHEET

Student ID-----------------------------------------------------------------Examiner Name ------------------

--------------
No Marking criteria Achieved Not achieved
1 Student has to give full introduction
2 Has to explain purpose of the interview
3 Ensure he/she is comfortable
4 Assess his risk behavior
5 Communication skills include Empathy
6 Assess concentration
7 Assess memory –short term and long term
8 Assess orientation
9 Checks mood
10 Check for psychotic symptoms
11 Check for level of suicide
12 Check her insight
13 Summarize the Mental state Examination
14 Make next appoint and follow up
15 Great the patient and assure her

Global rating
Poor Borderline/Unsatisfactory Satisfactory Very good Excellent
Examiners comments

Station 4
Twelve hours after admission to a hospital, 42-year-old Amina complained of feeling shaky. Six
hours later, she is irritable, has gastrointestinal disturbances and hallucinations, and is
diaphoretic. She is hypertensive, mildly febrile, and tachycardia. She reports no previous medical
problems.

Task
Assess the condition of this patient
Duration of the station is 8 minutes
OSCE STATION 4
Actor instructions:
Twelve hours after a surgical admission because of broken arm, a 42-year-old Amina begins to
complain of feeling jittery and shaky. Six hours later, she tells staff members that she is hearing
the voice of a dead relative shouting at her, although on admission she denied ever having heard
voices previously. She complains of an upset stomach, irritability, and sweatiness. Her vital signs
are BP 150/95 mm Hg, pulse 120 beats/min (bpm), respirations 20 breaths/min, and temperature
100.0°F (37.8°C).
The patient reports no prior significant medical problems and says that she takes no medications.
She has not had prior complications due to general anesthesia.
As an actor you have to look down, you have to pretend us if you have hand termer
You have to look like aggressive and sometimes not respond well. And not talk too much just
respond questions they ask you
Station 4
OSCE STATION ANSWER SHEET
Student ID-----------------------------------------------------------------Examiner Name ------------------
--------------
No Marking criteria Achieved Not achieved
1 Student has to give full introduction
2 Has to explain purpose of the interview
3 Ensure he/she is comfortable
4 Assess her risk behavior
5 Assess her autonomic hyperactivity
6 Assess her level of tremor like looking her hand
7 Ask about her sleep pattern
8 Ask if she has nausea and vomiting
9 Screen about hallucinations and delusion
10 Discuss about the anxiety
11 Assess her level of aggressiveness
12 Ask about seizure
13 Ask about history of drinking alcohol
14 As is she use any other substance
15 Exclude any medical illness

Global rating
Poor Borderline/Unsatisfactory Satisfactory Very good Excellent

Examiners comments
Station 5
Samsam is a 13 years old child who presents with poor attention, concentration, impulsivity,
oppositional and defiant behavior.

TASK:
Take a brief focused history from Samsam’s mother and explain to her how
she can manage her daughter's behavior.

DURATION IS 8 MINUTE
OSCE Station 5
Actor instructions:
You are Samsam’s mother. You report that your daughter has always been inattentive, lacking
concentration, and impulsive at home, school and other social settings since she was very little
girl. She has got worse recently and has become more disruptive, challenging your authority and
others. Samsam shouted at you two weeks ago and she hit you in the face. You lost it and you hit
her back. This made you feel that you are a bad parent.
Your husband has lost his job as a driver and you are worried about finances. You ask the doctor
how you can deal with this child who is so bad.
Station 5
OSCE STATION ANSWER SHEET

Student ID-----------------------------------------------------------------Examiner Name ------------------

No Marking criteria Achieved Not achieved
1 Student has to give full introduction
2 Has to explain purpose of the interview
3 Ensure he/she is comfortable
4 Good communication with active listening
5 Mixed with verbal and nonverbal, open and close end
questions rephrase and repeat response
6 Clarify mothers concerns
7 Elicit main feature of ADHD
8 Elicit Main features of ODD
9 Show empathy and respect
10 Discourage disproportionate punishment of a child
11 Pick up social stress
12 Explain parenting skills
13 Explain clearly boundaries and rules
14 As examiner ask about how did you manage
15 End interview with plan and follow up

Global rating
Poor Borderline/Unsatisfactory Satisfactory Very good Excellent
Examiners comments

OSCCE Station 6

You are a doctor in the out-patient clinic and you are giving the results of an HIV test to Ahmed,
a 29 year old male trader. The results are positive and he has symptoms of TB.

TASK:

Please communicate the test results to Ahmed, using good communication skills.

DURATION 8 MINUTE
OESCE 06
Actor instructions:
You are Ahmed, a 29 year old trader who lives in Hargeisa. You often travel to Ethiopia and you
have a girlfriend there that your wife does not know about. You have a one year old son called
Hassan. You love your child and your wife. You have been worried about the test as you noticed
that you were coughing, but never thought you would have HIV. Up until now, you have had good
mood, good sleep and appetite. You were losing some weight.
You now wonder about suicide as you are so ashamed to have HIV and could not tell your wife or
face your son. You have no immediate plans to end your life but you say ‘I don't know’ 3 times
when asked this question during the interview.
You think that you are going to die because of HIV and feel hopeless. You do not want to tell your
wife. You ask the doctor if you have to do this. You do feel some reassurance when they explain
nicely that there is some hope, and both conditions are treatable and they will see you again and
talk to you again about how you deal with your wife and child. You are very worried that you may
have infected them.
Station 6

Marking criteria Achieved No achieved

1 Full introduction
2 Purpose of interview
3 Student has to show empathy
4 Sets the scene, ensures he is comfortable
5 Explores understanding of tests so far and implications
6 Breaks news empathically
7 Has to mention all of the steps of breaking news
8 Does not give false reassurance
9 Sensitively and professionally discusses risks to wife and child
10 Explains treatment in way that he can understand
11 Listens to him and checks if any questions

12 Has to summarize the information

13 Student has to explain in way that the patient clearly understand

14 Gives some hope and clear follow up plan

Global rating
Poor Borderline/Unsatisfactory Satisfactory Very good Excellent

Examiner's comments