Keeping it real! Enhancing realism in standardised patient OSCE stations

Background: Objective structured clinical examinations (OSCEs) are a<br/>commonly used method of assessing clinical competency in healthcare education. They can providean opportunity to observe candidates interacting with patients.<br/>There are many challenges in using real patients in OSCEs, and increasingly standardised patients are being used as a preference. However, by using standardised patients there is a risk of making the encounter arti?cial and removed from actual clinical practice.<br/>Context: Efforts made in terms of cognitive, auditory, visual, tactile, psychological and emotional cues can minimise the differences between a simulated<br/>and real clinical scenario. However, a number of factors, including feasibility, cost and usability, need to be considered if such techniques are to be practicable<br/>within an OSCE framework.<br/>Innovation: This article describes a series of techniques that have been used in our institution to enhance the realism of a standardised patient encounter in an<br/>OSCE. Efforts in preparing standardised patient roles, and how they portray these roles, will be considered. A wide variety of equipment can also be used in<br/>combination with a patient and the surrounding environment, which can further enhance the authenticity of the simulated scenario.<br/>Implications: By enhancing the realism in simulated patient OSCE encounters, there is potential to trigger more authentic conscious responses from candidates and implicit reactions that the candidates themselves may be less<br/>aware of. Furthermore, using such techniques may allow faculty members to select scenarios that were previously not thought possible in an OSCE