Original Publication
Open Access

Objective Structured Clinical Examination (OSCE) Station on Communicating Poor Prognosis to the Family in a Neurological Acute Care Setting

Published: February 13, 2014 | 10.15766/mep_2374-8265.9700

Included in this publication:

  • Instructor's Guide Neurology Code Status Communication.docx
  • Code Status Communication Examiner OSCE Marking Sheet.doc
  • Communication OSCE Station Resident Instructions.docx
  • Actor Standardized Patient Relative Instructions Code Status OSCE.docx

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Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Stroke is a common cause of patient morbidity and mortality. Communicating its prognosis to family members, along with the establishment of goals of care, is a frequent task for neurologists and neurology residents. Given this, we felt it was an appropriate scenario from which to assess neurology resident medical expert and communication skills in an objective structured clinical examination (OSCE) setting. The OSCE station topic was created directly from objectives of training for neurology residents specified by the Royal College of Physicians and Surgeons of Canada. Methods: This is a standardized case with an actor portraying a patient’s relative. Residents are to give bad news of poor neurologic prognosis and establish goals of care for the patient. The case scenario, instructions to the examinee, and examiner marking sheet are included. Results: The OSCE station was implemented with pediatric and adult senior neurology residents (PGY3-PGY5) from three universities. Of the 25 residents who experienced this case, 96% passed the station. Resident scores ranged from 60%-100%, with a mean of 86%. Discussion: We consider the significance of the work to be the interpretation of a clinical scenario of poor neurologic prognosis of severe stroke and the communication of poor prognosis to a standardized family member with resultant establishment of code status, a task that is performed several times per week on the acute stroke service. This OSCE station is appropriate for neurology residents who participate in stroke care and will become neurologists who must communicate bad news on a daily basis.

Educational Objectives

By the end of this session, facilitators will be able to:

  1. Assess resident medical expert knowledge (i.e., recognize prognosis of complete left hemispheric stroke).
  2. Assess resident communication skills in giving bad news.
  3. Assess resident communication skills in establishing a patient’s goals of care.

Author Information

  • Penelope Smyth, MD, FRCPC: University of Alberta Faculty of Medicine & Dentistry
  • Valerie Sim: Uinversity of Alberta Faculty of Medicine & Dentistry

None to report.

None to report.


Smyth P, Sim V. Objective structured clinical examination (OSCE) station on communicating poor prognosis to the family in a neurological acute care setting. MedEdPORTAL. 2014;10:9700. https://doi.org/10.15766/mep_2374-8265.9700