Royal College of Surgeons in Ireland

Intermediate Cycle 3 Clinical OSCE MARK SHEET

STATION: Upper limb neuro motor exam (2016)

Examiners Name ............... ……………………...................... Candidate Number………………

Examiner to greet student and say:

“Please perform a upper limb MOTOR neurological examination. After 5 minutes I will ask you some questions”
Patient’s findings: This patient has ______________
Please tick the appropriate box for each criterion. The standard expected is that of third year medical student.

Not Done Done Done

Done Poorly Adequately Well

Initial approach to the patient: performs hand hygiene, introduces him/herself, explains
what he/she will be doing, obtains consent, asks about pain, positions and exposes
patient correctly
General inspection: mentions posture, mentions any environmental aids/devices
presence/absence, walking aids, any focal neurological signs, abnormal movements
Closer inspection: mentions presence/absence of fasciculations, muscle wasting,
symmetry, scars, amputations, contractures
Drift analysis:
Mentions pronator drift

Tone
** compares “like with like”,
Power:
** compares “like with like”, attempts to isolate muscle groups where feasible, grade
out of 5
Coordination:
• Finger-nose test. Should be near full extension to correctly assess
• Rapidly alternating movements
Reflexes: like with like
• Biceps, triceps, brachioradialis.
• Uses reinforcement (Jendrassik) manoeuvre if indicated
Examiner: “What are your findings on examination”?
Presents a systematic description of findings

Examiner: “What is your differential diagnosis”?

Questions:
0 1-2 3-4 ≥5
Overall approach to task including approach to patient and clinical acumen

Overall Grade* (Please circle as appropriate)

<30% 40% 50% 60% 70% >80%
Very Poor Excellent
Please indicate Poor Adequate Good Very Good Please indicate
precise % precise %
 Royal College of Surgeons in Ireland
Intermediate Cycle 3 Clinical OSCE MARK SHEET
Comments: (essential if candidate does not pass)

% GRADE DESCRIPTOR PERFORMANCE

>80% Excellent All criteria done well Outstanding performance for a 3rd
year medical student - Excellent
examination technique, excellent
summary of patient problems,
excellent related knowledge, and
excellent approach to patient
70% Very Good All criteria done adequately and at Excellent in most respects
least 3/4 done well

60% Good All criteria done adequately and at Good sound overall performance
least 1/2 criteria done well.

50% Adequate – Bare Pass All basic examination criteria done
adequately or well, but
limited/incorrect responses to
some of the questions concerning
findings, differential diagnosis and
additional knowledge
40% Poor - Fail 3-4 criteria poorly done or not
done including at least 1 basic
examination criteria done poorly or
not done
Just reaching acceptable pass
standard in physical examination
Poor performance – the candidate
may display some adequate attributes
but does not reach an acceptable
pass standard overall

<30% Very Poor – Clear Fail > 5 criteria poorly done or not The candidate’s performance is so
done poor in most/all areas that the
standard required is not even remotely
approached.