What are OSCEs?

An OSCE, or Objective Structured Clinical Examination, is a practical test that checks your clinical skills in real-life situations. Instead of a traditional exam, in OSCEs you’ll move through a series of stations, each presenting a different task. These tasks mirror common scenarios you’ll face as an optometrist in the UK, from conducting eye tests to communicating with patients.

Whilst this post is primarily aimed at pre-registration optometrists in the UK about to undergo their final OSCEs to become a qualified optometrist, the tips shared here will apply to many OSCEs that optometrists will encounter – from first year university exams to the higher qualifications available later in your optometric career.

My OSCE Experience

I remember feeling terrified before my OSCEs. The thought of failing was overwhelming, and I forgot that resits were even an option should all go wrong. To make things more stressful, I had a late afternoon slot, meaning sitting in a holding area with no phone and just whatever paper notes I could carry. As a nervous person (especially back then!), this really didn’t help with my pre-OSCE jitters.

Whilst I was sitting there, I realised cramming wasn’t going to help. If I hadn’t learned it by then, trying to stuff information into my brain in those last hours would only make me more anxious. This would especially be the case if I stumbled upon a gap in my revision. So, I focused on keeping calm instead.

One thing I noticed during the OSCEs was that the cases were textbook examples. In my pre-reg experience, I dealt with complex cases where symptoms didn’t always add up neatly. But during the OSCEs, everything was straightforward. If you’ve prepared and know your textbook presentations well, the chances are that you’ll be fine.

“If you’ve prepared and know your textbook presentations well, the chances are that you’ll be fine.”

Jason Searle

Remember, as I have already mentioned, I am generally an anxious person and suffer from the occasional bout of imposter syndrome – so if I can overcome it and still be practising 10 years on, you can too!

Why OSCEs Matter in Optometry

The OSCEs are a significant milestone for pre-registration optometrists in the UK. They’re not just another exam; they’re a practical assessment of your readiness to step into the professional world. These exams test your ability to apply knowledge in real-life scenarios, which is crucial for providing quality care to patients.

The importance of OSCEs lies in their ability to assess not just your clinical skills, but also your communication and professionalism. They ensure you can perform essential tasks competently and safely. The examiners aren’t looking for perfection – just that you are competent enough to be signed off into the real world. Minor mistakes might not matter much if you handle the situation correctly and reach the right outcome.

Tips to Prepare and Perform Well in OSCEs

I will now move on to cover tips on how you can best prepare and perform during the OSCEs. Feel free to comment below if you have any additional tips to share!

Stay Calm and Collected

Feeling nervous is normal before OSCEs. Anxiety can peak when you’re waiting for your slot, especially if it’s later in the day. Staying calm is crucial. Deep breaths and positive thoughts can help steady your nerves. Techniques like the amygdala hack (see below) can manage anxiety by calming your body’s fight-or-flight response.

The Amygdala Hijack and How to Hack it Back

The amygdala hijack is when you have a significant psychological and emotional response to stress, treating the thing that is causing you stress as if it were an immediate physical danger. This can lead to your fight-or-flight response kicking in, leading you to act irrationally – potentially disrupting your performance in an exam. Not great if this happens in your OSCEs!

The “amygdala hack” is a grounding technique that you can use to try and off-set the effects of the amygdala. Take time to notice how you respond to stress and when you start noticing them, take a moment to calm yourself – it may not be easy in the constraints of the 5-minute OSCE station, but taking the time to practice mindfulness, relaxation techniques and dealing with any other stressors in your life (relationship, family, home and work can all contribute to your overall wellbeing) can significantly help prevent the amygdala hijacking you at this time.

My post on Mindfulness Matters also provides additional information on how to manage stress within an optometry setting. Please consider reading this prior to sitting the OSCEs!

Don’t Dwell on Past Stations

If a station didn’t go as you’d hoped, it’s important to let it go and focus on what’s ahead. Overthinking slip-ups can cloud your mind and affect your performance in the next ones. Each station offers a fresh start—a new chance to show your skills. Take a moment to reset: breathe deeply, clear your thoughts, and remind yourself that you’ve prepared for this. By staying present and not letting previous hiccups weigh you down, you’ll approach each task with clarity and confidence.

“If a station didn’t go as you’d hoped, it’s important to let it go and focus on what’s ahead. Each station offers a fresh start—a new chance to show your skills.”

Jason Searle

This tip isn’t just for your OSCEs—it’s an important skill to have when you’re seeing patients in the clinic. I usually have positive interactions with my patients, but sometimes things don’t go as planned. Maybe an appointment didn’t go well, or I just had to refer someone urgently to ophthalmology, which can be stressful. Even then, I need to reset and be ready for my next patient, who needs to see me at my best. So don’t just learn this skill for the exam—keep it fresh and use it every day!

Act Confident in Your OSCEs

Even if you’re nervous inside, showing confidence can make a big difference. For those of you that are lucky (or, I suppose, unlucky!) to have had a lecture from me – you may not think I am suffering from stage fright – but I can assure you that I feel my heart beating through every moment of that lecture. That said, many do say I looked calm and collected. It is amazing how you can train yourself to act confident, even if you feel the complete opposite!

Stand up straight, make eye contact, and speak clearly. Your body language tells a story. When you act confident, you help yourself perform better, and you show the examiners that you know what you’re doing. This can put them at ease and let them focus on your skills.

Confidence can also boost your own feelings. The more you project it, the more you’ll start to feel it. So take a deep breath, trust in your preparation, and let your confidence shine through.

Manage Your Time Wisely

Each station can fly by quicker than you’d expect. It’s important to keep an eye on the clock without letting it make you nervous. Be mindful of how much time you have, but don’t rush yourself. Before the exam, practice tasks with a timer to get comfortable with the pacing. This helps you move through each station calmly and thoroughly. Knowing how to manage your time ensures you cover all the necessary steps without feeling pressured. Remember, steady and focused work leads to better results than hurrying and missing key details.

This is where many benefit from mock-OSCEs from fantastic optometrists such as the Optom Academy and Out Of The Box Optics. If you are having your OSCEs imminently, this may not be of use here; but if you do have OSCEs on the horizon – do check them out. There are many offering mock-OSCES, so do check them out!

Communicate Effectively

Speaking clearly and using simple language is important when talking to patients. Introduce yourself to your patient when you enter the station. Avoid technical terms they might not understand. Show empathy, especially when discussing sensitive topics.

Treat the simulated patients as if they were real people. This makes your interactions more genuine. Remember, when you are going to do anything with a patient, seek consent – as this is another area you will be marked upon. When patients feel heard and understood, it builds trust. Good communication is a key skill that examiners are looking for so practice explaining things in a way that anyone can grasp.

“Treat the simulated patients as if they were real patients. This makes your interactions more genuine.”

Jason Searle

I can wholeheartedly recommend @theopticscommunicationcoach on Instagram – as his posts are about communication in optics (not surprising, based on his instagram handle!). This is not only a great account for help in performing your OSCEs, but for you to continue growing as an optometrist into your career! He also has a fantastic book too, which you can check out here: The Optometrist’s Guide: Better Communication, Better Care, Better Commercial Results.

Rehearse Scenarios

Practicing common cases with friends or colleagues can make a significant difference in your OSCEs. Role-playing different scenarios helps build your confidence and prepares you for unexpected questions. It allows you to become familiar with the exam format and improves your communication skills. You’re able to receive feedback in a supportive environment, which can highlight areas for improvement.

If you’re unsure where to start, my book on History and Symptoms might be helpful. It offers insights into common history and symptoms presentations and guides you on how to approach them effectively. It has scripts that you can practice with one another too – which has helped many a student and pre-registration student ace history and symptoms components to their eye exams.

Remember Hand Hygiene

Don’t overlook hand hygiene during your OSCEs. Hand sanitiser is usually available at each station, so make sure to use it. This simple act shows you’re mindful of professional standards and patient safety. Examiners pay attention to these details.

Sanitising your hands demonstrates that you understand the importance of infection control. It’s not just about passing the exam; it’s about developing good habits for your future practice. Taking a moment to sanitise can make a positive impression, so make it a part of your routine during each station.

A good hint to throw in here is – if there is sanitiser or a sink present – they expect you to use it!

“If there is sanitiser or a sink present – they expect you to use it!”

Jason Searle

Read the Instructions Carefully

Before each station, take a moment to really read the instructions. They tell you what’s expected. Sometimes they’ll specify doing something on a particular eye—like the patient’s right eye. It’s easy to miss these details when nerves are high. Double-check so you don’t end up examining the wrong eye.

Remember, you can’t say you weren’t told—the instructions are right there to guide you. Paying close attention helps you avoid simple mistakes and shows the examiners you’re thorough.

Don’t Panic at the OSCEs!

Feeling overwhelmed during OSCEs happens to many. If anxiety starts to creep in, take a moment to breathe deeply. Simple grounding techniques can bring your focus back.

During my OSCEs, I used the break station to calm myself. I’d take a few deep breaths, and remind myself why I was there. This helped me stay centered and approach each station with a clear mind. Remember, it’s okay to feel nervous. Acknowledge it, but don’t let it control you. Stay present, trust in your preparation, and take one station at a time. Keeping calm not only improves your performance but also makes the experience more manageable.

Keep hacking your amygdala to prevent it being hijacked!

Wrapping Up

Facing OSCEs can feel overwhelming, but remember that they’re just one step on your journey to becoming a qualified optometrist in the UK. Trust in the preparation you’ve done. Stay calm, be confident, and focus on each station as it comes.

Take care of yourself during this time. Get enough rest, eat well, and give yourself moments to relax. Connecting with fellow pre-reg optometrists can also provide support and encouragement.

For more information, check out the resources available from the College of Optometrists. They offer helpful guides on what to expect and how to prepare for your OSCEs.

You’ve worked hard to get here. Believe in yourself, and you’ll do great!

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A great way to practice the History & Symptoms OSCEs is by buying my book – History and Symptoms: The Eye Examination. Within, there is theory work on what makes a good case history – but the biggest help is the 20 case studies within. Each case study looks at a different personality and presenting issue – with each case having detailed reflections to help you grow as an optometrist.