This is one of the most important aspect of preparing for OSCEs, whilst there may be stations described as “communication’ stations. The truth is that communication is important in every single station, whether it is an examination station or a procedure station. It is a gateway to form rapport and trust with the patient. With good rapport, it allows things to go much smoother. It cannot be underestimated how important good communication is to make the patient feel comfortable.

1. Explain things to patients in layman terms – get out of the habit of explaining things in technical terminology and start to incorporate using every day plain language, it can be difficult but that is why you need practice. I would recommend filming yourself trying to explain common conditions to people – you can pick up and evaluate where you go wrong. Only when we can visualise and critique ourselves can we improve

2. Metaphors – one of the things that I tried to do was to use metaphors when explaining conditions e.g. I used to talk about hypertension and used a boiler and radiator system to explain – too much pressure in the pipes can damage the central heating system etc.

3. Speed and tone of voice – when you are communicating it is important to speak to patients in a slow and where possible soft tone of voice. It makes you appear composed, in control of the situation and by default more empathetic

4. Professionalism – when you have been on placement and you have been working with doctors, see how they communicate with patients, attempt within your own comfort zone to replicate professionalism in your language in each station

5. Bite size information and pausing – when you are trying to explain an illness, management plan etc, make sure you do it in small section of information and allow it to sink in ... it is vital to allow for pausing when doing breaking bad news

6. Non-verbal communication – this is just as important as what you say. How is your eye contact, body language, posture and facial expressions helping to make the patient feel at ease and convey you are really listening to them? If you need to, look in the mirror the practice this. My natural facial expression tends to look like I am up to something mischievous, so I had to work on it.

7. Empathy - whilst you have limited time and it can be playing on your mind, do make every attempt to empathise with your patient using a variety of the skills mentioned before. It is an important concept needed beyond your examinations and into practice. If you feel you are losing the ability to empathise when working, it can be a sign of burn out.

8. ICE, ICE, ICE, ICE, ICE, ICE – It has helped me so much beyond exams when dealing with patients. It is important in communication stations to allow the patient the space for them to express any worries or concerns they may have.

9. Utilise your setting – during breaking bad consultation OSCE, I did not like the way the seating was arranged in the room as I felt distant from the patient so I moved my seating closer – I know it can seem like a bold move, but you would do that in real life

10. Know your reference ranges for common chronic conditions - sometimes stations will not tell you what the problem is, you will have to work it out based on results of investigations e.g. HB1AC, TSH, INR, pH.

11. Strong Introduction - When you enter the OSCE station, it is important that you introduce yourself in a strong and confident manner, it sets the tone for the station. It will be the first time that the examiner and patient interacts with you. If your introduction is passive, timid or unclear it will come across from the onset.