OSCEs offer very real, very rigorous rehearsal

When Ami Patel ’23 counsels her first patient as a full-fledged pharmacist, it will feel like slipping on a comfortable pair of shoes.

The third-year student at the MUSC College of Pharmacy just finished a round of Objective Structure Clinical Exams (OSCEs), which give students a dose of real-world clinical life. It’s timely preparation for rising fourth-year students, who will spend the next year on rotations.

“They’re difficult to do but I feel more confident than I did before doing them,” the University of South Carolina graduate said. “They help give us real-life experience, and it’s better to stumble and fall now than fall then.”

She neither stumbled nor fell. Patel aced her OSCEs, in which the student counsels a “patient” played by either a faculty member, resident, or fourth-year student. But had she struggled, she would have gotten a first-hand sense of what is at stake.

“If they make an error that would lead to an adverse event, then a few days later they’ll receive a ‘Dear Doctor’ letter that tells them one of their patients is in the ER,” said Marc Lapointe ’95, professor of clinical pharmacy and outcomes science. “That’s what would happen in real life. They would need to come in and explain what happened, so that’s what they have to do with us. We want them to do more than just learn about the critical nature of medication safety; we want them to feel it.”

A handful of students felt it when they got a notice during the Super Bowl and had to face the music the next day – an uncomfortable 30-minute one-on-one discussion in the lab so they could learn from their mistakes.

During the fall semester, students have an opportunity to practice OSCEs each week. Those are usually focused on one disease state and they are given the cases in advance. In the spring, the OSCEs get more complex and are graded. Students have 45 minutes to study a case.

“You basically go in blind,” said Natalie Nix ’23. “But not knowing until you get there is good experience, because many of your actual patients will be someone who just walks in the pharmacy and you have no history. So you have a little mini-panic, then take a breath and go in.”

Lapointe and faculty colleague Anthony DeClue ’16 draw the cases from actual patient scenarios. For instance, the patient might be a diabetic who is going on some anticoagulants. They also tap on fourth-year students as mentors, since students on rotation have just gone through the adjustment to actual patients.

In addition to counsel, students taking the OSCEs might also have to demonstrate how to use a medical device. The OSCEs are typically in person but students also get experience counseling via telehealth, which is an increasingly popular element of a pharmacist’s job.

“You can have a little better face-to-face time with the patient when it is in person,” said Tina Zhou ’23. “But the telehealth does give an opportunity to reach patients who might not have access otherwise.”

It’s a challenging experience. The faculty want to ensure the students are ready for rotations and the fourth-year students have garnered plenty of patient interactions to inspire their role play.

“The OSCEs give you great experience,” said Christopher Taylor ’23. “It’s a great way to test your knowledge.”

(pictured: Ami Patel ’23 during an OSCE with faculty member Anthony DeClue ’16 in background; Eric Warne ’23 counseling Marwah Alnewais, the college’s first academic fellow; Luke Nesbitt ’23 studying a case; Marc Lapointe ’95 talks with Patel after her OSCE.)