The physical-examination station: what examiners look for

OSCE station

An OSCE station where you examine a patient while the examiner watches your order, technique, courtesy and how you present the findings.

Updated Nov 13, 2026

What it is

The examination station gives a one-line task («Examine this patient's respiratory system», «Examine the abdomen of a patient with abdominal pain») and a few minutes. The patient may be a standardised patient with normal findings, a volunteer with real signs or a manikin, and the examiner follows a checklist or a global rating. Marks come from four places. First, the professional start: hand hygiene, introduction with name and role, confirmation of identity, a short explanation, consent, privacy and a chaperone offered for intimate examinations. Second, preparation: correct position and enough exposure, and a question about pain before touching. Third, a complete and logical sequence: general inspection from the end of the bed (appearance, breathing, colour, oxygen, inhalers, drains, walking aids), then hands, face and neck, then the region by inspection, palpation, percussion and auscultation, comparing both sides; joints follow look, feel, move and special tests, and the neurological examination follows tone, power, reflexes, coordination and sensation. Fourth, the close and the report: thanking and covering the patient, washing hands, and presenting a concise summary of relevant positive and negative findings with a likely diagnosis and the next tests. Report only what you find: a standardised patient with normal findings is a test of honesty as well as technique.

What is assessed

A professional start: hand hygiene, name and role, patient identity, explanation and consent.
Privacy and dignity: curtains, exposure of only what is needed, a chaperone offered for intimate examinations.
Correct positioning: about 45 degrees for the heart and lungs, flat with one pillow for the abdomen.
A logical, complete sequence for the system asked, without jumping back and forth.
Correct technique: the right part of the hand, the stethoscope on skin, both sides compared.
Comfort and safety: asking about pain, warm hands, watching the face, covering the patient at the end.
A clear presentation: relevant positives and negatives, a likely diagnosis and a plan.

How to do it (and why)

Wash hands, introduce yourself, confirm identity and ask: «I would like to examine your chest; is that all right?» — consent comes first.
Ensure privacy and offer a chaperone for intimate examinations — dignity is marked and the chaperone protects both people.
Position and expose correctly and ask about pain — about 45 degrees for heart and lungs, flat for the abdomen.
Inspect from the end of the bed: appearance, breathing, colour and objects around the bed — many signs are seen before touching.
Examine the hands, then face and neck, then the region — a fixed route stops you forgetting clubbing, pallor or a raised JVP.
In the region inspect, palpate, percuss and auscultate, comparing sides — symmetry shows what is abnormal.
Say briefly what you are looking for, if the examiner allows it — it shows your reasoning even when findings are normal.
Finish: thank the patient, cover them, help them dress, wash your hands — the close is on the checklist too.
Present: «On examination… The most likely diagnosis is… I would complete this with…» — summary, diagnosis and next steps.

A common sequence by system (adapt to the task)

System	Position	Sequence	Complete with
Respiratory	Sitting at about 45 degrees	General inspection, hands, face, neck and trachea; expansion, percussion and auscultation, front and back	Oxygen saturation, peak flow, chest X-ray
Cardiovascular	About 45 degrees	Hands, pulses, blood pressure, JVP, face; apex beat, heaves, thrills; auscultation of the four areas; lung bases and ankles	ECG, echocardiogram
Abdominal	Flat, one pillow, arms by the sides	Hands, face, chest; inspection; light then deep palpation; liver, spleen and kidneys; percussion; auscultation; hernial orifices	Rectal and genital examination (state it), urinalysis
Neurological, limbs	Lying or sitting	Inspection, tone, power, reflexes, coordination, sensation, gait	Cranial nerves, fundoscopy, imaging if indicated
Joint	Standing, then lying	Look, feel, move (active then passive), special tests, function	Neurovascular check of the limb, the joints above and below

Mistakes that cost marks

Touching the patient before consent, or forgetting hand hygiene at the start or the end.
Exposing too little (auscultating through clothing) or too much (leaving the patient uncovered).
Causing pain: deep palpation over the painful area first instead of starting away from it.
Jumping around without a sequence, or skipping the back of the chest, the ankles or the hernial orifices.
Reporting signs that are not there because the «typical» case should have them.
Ignoring clues in the room: oxygen, inhalers, a walking aid, a urinary catheter bag, a sputum pot.
Running out of time and never presenting the findings.

Self-check list

Did I wash my hands, introduce myself, check identity and get consent?
Did I offer a chaperone and keep the patient covered except where needed?
Did I position the patient correctly and ask about pain before touching?
Did I start with general inspection from the end of the bed and the hands?
Did I inspect, palpate, percuss and auscultate, comparing both sides?
Did I examine the back and the less obvious parts the task needs?
Did I thank and cover the patient and wash my hands at the end?
Did I present a concise summary, a likely diagnosis and the next tests?

Test yourself

Think of the answer, then tap the question to see it.

A standardised patient has normal breath sounds, but the task says «suspected pneumonia». What should you report?

What you found: normal breath sounds. Then say which signs you would expect in pneumonia (crackles, bronchial breathing, dullness) and what you would do next. Inventing signs loses marks.

Why do you ask about pain before palpating the abdomen?

To start away from the painful area, watch the face and avoid hurting the patient; causing avoidable pain is marked as unsafe and makes the rest of the examination unreliable.

When should a chaperone be offered in an examination station?

For every intimate examination (breast, genital, rectal) and whenever the patient or the examiner prefers one; record the offer, the answer and the chaperone's name.

How should a physical-examination station end?

Thank the patient, cover them, help them dress and wash your hands, then present a concise summary with relevant positives and negatives, the likely diagnosis and the tests you would request.

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Educational content; it does not replace supervised hands-on training, your institution's protocols or a prescriber's order. A procedure is learnt with a teacher and done only once you are trained to do it.

Sources: Set Up and Execution of an Effective Standardized Patient Program in Medical Simulation (StatPearls (NCBI Bookshelf), 2023); Medical History (StatPearls (NCBI Bookshelf), 2026).

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Representative model, for educational purposes only.