OSCE

The scenario portion of the OSCE is designed to simulate patient care as you would provide it in the field. It is performed in front of a four person panel chaired by our EMS Medical Director, Dr. Stone. Alongside Dr. Stone are two peer ALS providers (one volunteer and one career), as well as one EMS Duty Officer.

The primary goal of the OSCE process is to determine whether or not a paramedic candidate has reached minimum entry level competency as an ALS provider. Your performance will be objectively evaluated using rubrics derived from a variety of sources such as the Maryland Medical Protocols, accepted Standard of Care, and policies and procedures. The evaluation process is inclusive and takes into consideration protocol knowledge, affect, crew management, patient assessment and treatment.

Your patient will be either an actor or a high fidelity manikin. Any assessment you wish to conduct or non-invasive skill you wish to perform, must actually be done on the actor or manikin, just as you would do in the field (i.e. ECG, lung sounds, vitals). All invasive procedures must be performed on the appropriate task trainer (i.e. intubation, medication administration).

Interact directly with the patient and bystanders and conduct your assessment and interview just as you would with an actual patient. Proctors will provide any information necessary for you to progress through the scenario. Panelists are there to evaluate your performance and will not interact with you during the patient encounter. Following the patient encounter, panelists may ask for clarification if additional information is needed to evaluate your performance.

Measure vital signs directly on the patient just as you would in the field and the proctor will provide you with adjusted vitals where applicable. Certain procedures such as blood glucose monitoring may be verbalized; the proctor will provide results as appropriate and based only upon your request.

Communication throughout the patient encounter is critical - be sure to verbalize everything you see, everything you hear, everything you're thinking, to your partner and panelists.

You will be given twenty minutes to complete this section of the OSCE.

As the title suggests, the Team Lead is responsible for the management of the patient and crew. The Lead assumes the primary provider (charge) role and must direct the patient and crew throughout the encounter. Your partner, also trained at the Paramedic level, will perform any and all actions you request unless an action is unsafe. You are encouraged to interact with your partner and communicate your thoughts throughout the patient encounter. You can ask questions, obtain guidance, and share ideas about the patient, the patient's condition, best treatment approach, etc.

Imagine yourself as the second paramedic on the call. The Lead will ask you to perform skills, prepare medication, and discuss patient findings, differential diagnoses, and relay patient care strategies. You're encouraged to interact candidly with the Lead and prevent any clinical decision-making or treatment errors, should either arise. Do not perform any action you feel would jeopardize patient safety and articulate your concerns to the Lead. If you see the Team Leader about to perform an improper act you will be expected to voice your concerns.