In clinical practice open-ended questions are the best way to invite your patient to share their story with you, however, in the NAC-OSCE asking short closed-ended questions is the most effective and efficient way to get to the heart of your patient's concern. In practice you'd commonly ask your patient to tell you about any new symptoms that they've been experiencing but in the NAC-OSCE it is critical to ask specific, focused questions in your stations to not only save time but to allow the simulated patient to promptly and accurately answer your questions.

So, in the NAC-OSCE ask the patient questions about specific symptoms to demonstrate to the examiner that you know what to look for: "Have you had any headaches? How about ringing in your ears? Have you had any nausea? Have you vomited?"

Focus and shorten your questions and try to avoid asking lengthy questions with added formalities. For instance, I often see IMGs who repeatedly ask for their patient's permission when introducing a new topic: "If it is alright with you, I'd like to ask you some questions about your family's health history." Although this courteous behavior is always well received by patients the first few times it is mentioned, it can eventually become an irritation. Further, it is really unnecessary to repeat this formality during the entire course of your encounter because:

1. It eats up time.

2. The patient expects you to ask them some questions. That's why they are there.

Instead try introducing your next line of questioning with "Now, let's talk about your family's health history."

In the end, keep it specific, short and sweet! 

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