It goes without saying that the NAC-OSCE is an intimidating, challenging exam but you have the expertise to succeed. Imposter syndrome is often the greatest obstacle to overcome but practising self-compassion and positive self-talk can help as your prepare for the exam.

Remember, you're a highly trained physician and you belong in the NAC-OSCE. Don't ever lose sight of this truth. Project confidence and avoid these unconscious behaviors that can undermine your professional competency in clinical practice and the exam:

1- Using Tentative Language

Here are a few examples of commonly used words and expressions that unintentionally undermine your expertise or give the SP (simulated patient) and examiner the impression that there is some hesitation in your clinical approach.

"Hi! I'm just the ER Doctor on call today." ---> "Hi! I am the ER Doctor."

"I'm only able to do this test" ---> "We will certainly look into this."

"Maybe we could run some tests" ---> "I'd like to run some tests."

"I'm not sure, but I think I'll order some blood work." ---> "Let's start with ordering some blood work."

2- Avoiding Eye Contact

In the NAC-OSCE, the examiner wants to see you build a relationship with your patient. Maintaining appropriate non-verbal behaviour like regular eye contact (meeting your patient's gaze) and an open posture is crucial for establishing a rapport with your patient. Be especially mindful of your notetaking, as your patient may feel unseen and ignored and the examiner will take notice.

If you find yourself taking very detailed notes be sure to balance it accordingly by looking up at your SP every 20-30 seconds.

3- Over Summarizing

Customarily, we summarize to show the patient that we are actively listening (accurately recalling their information) and to confirm that all parties are on the same page. However, if summarizing is done too frequently (over 3-4 times), it may give the patient and the examiner the impression that you're lost in the station.

If you're feeling lost in the station and you've already tried summarizing a few times to get back on track, try taking a moment to gather your thoughts. Just explain to the SP that you're going to take a moment to review your notes and think about the information they've shared. The SP will be understanding, as will the examiner. This practice is good exam etiquette and you'll make better use of your time in the station.

Again, be kind to yourself as you prepare for the NAC-OSCE. Practice positive self-talk and remember, you're a highly trained physician and you belong in the NAC-OSCE. Hold tight to this truth, project confidence, and avoid these unconscious behaviors in the stations and you'll excel in the exam.

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