::TOSCE::

for my colleagues, this TOSCE thingy might be sound familiar to u. but lemme brief to those who are currently wondering what it is..

[N and feyt, it's not a food keh? :p ]

TOSCE stands for Team Objective Structural Clinical Examination. so that gives u a slight hint aite? it's basically a team comprised of 3-4 students, performing history taking and and medical physical examinations, to be assessed by an examiner ( or two, depending on the strictness of the examiner )

so why it's a nightmare to us? since it's based on "budi bicara" of the examiner, too many human factors might be involved. one might never be fairly assessed since every examiner has his/her own style. it really depends on how well u perform and also, how cooperative the patient is! some patient might give u a clue on what  disease that they are suffering from, and u can systematically work it out from there. but some are too mean not to even give u a slightest clue! again, it's based on your skills to dig out and find an answer!

so on 28th may, we had our TOSCE and i think it will be good to compile all the things that worth remembering later.

case 1

in waiting area

the previous team came out from the exam room with one of them was heavily sweating. can u imagine all of his face was wet with sweat and his face was pale. i wonder what the examiner and the patient did to him lol

us: was it hard?

john: seemed like the patient is okay but the student had respiratory distress

us: lol

case 2:

in the room, physical exam

examiner: can u please auscultate the patient?

student: ok

*explaining to the patient*

student: now im going to tap on my own finger and that would not be painful

examiner: i asked u to auscultate the patient...( ee budak ni paham ke x? )

student: oo im sorry. now im going to listen to ur chest ( sambil cover malu besar lol )

case 3:

in the room, physical exam

examiner: now i would like u to perform an examination on the face

[it was a heart failure case, so some GIT signs are irrelevant!]

student: she doesn't appear to be jaundiced, no kleiser fleischer ring [camana la ring tu bleh sesat dlm heart failure case? haih]

case 4:

in the room, history taking

student: so what brought u here? 

patient: a car? lol

[ the right question will be "what problem brought u here today?]

case 5:

in the room, physical exam

examiner: now, i would like u to perform physical examination on the patient

student: okay *confidently walking towards the patient*

*squeezed the alcohol tube with all her heart. result: hands were smudged with alcohol and every eyes were on her clumsiness* but still she looked confident haha

case 6:

in the room, JVP examination

student: i cannot really see the JVP [ since the patient is a plump lady and she actually din really look for it! malas~ ]

examiner: okay. so what differentiate JVP and an artery

student: JVP is compressible, with multiple waves and u can see it but cnt compress it [ OMG, it's contraindicated with her previous statement!] 

examiner and the team: *laughing at her*

student: *still confidently talking...like no one can stop her heh? haha*

and she got the name of " muka history taking" due to her unwavering confidence throughout :p

case 7

history taking on routine medical questions

student: so are u under any contraceptive pills? 

patient: im 54 and menopause. in terms of that, im safe! 

team: *laughing*

see how nervousness can put us in very witty situations? it's not that we din study for the big exams, it's just that our tongues were twisted being in the stressful atmosphere. plus, it also depends on ur luck! but thnx dude, because all the witty things, we laughed together in the room and sumhow decreased the level of tense.

here are some tips to reduce nervousness based on observations and experience:

• be confident
• be confident
• be confident. believe that u have done all the necessary things to perform and there is only one shot not to be wasted. so prove to them!
• take a deep breath in, all d way out and repeat that few times
• surah al-insyirah, and all the dua that can keep u calm
• practice a lot. only that will make smooth presentations
• wear something that u r comfortable with. nice dress, descent make up will definitely do.
• smile all the smile :)
• and drink some water before u get in. due to symphatetic nervous system activation, ur mouth will b dry and may cause u startled in ur speech.
• and remember, the examiner is there not to fail u, but to assess ur capability.