How To Ace Your CMTO OSCE Exam: Health History

This station is probably the easiest station for you to score points on. The main thing to keep in mind, first and foremost....READ THE STEM (this cannot be emphasized enough). secondly, act as though the examiners aren't in the room (unless they address you directly). You objective is to address the client, do not look at the examiners for confirmation...they can't save you. Now on to the main stuff, you want to make sure you hit a few key points.

1. Communication

• Welcome the Client:

  • "Hello my name is Andrew, I'll be your massage therapist today, how are you?"

• Direct Eye Contact:

  • (Make sure to maintain direct eye contact to show engagement and attentiveness.)

• Open Body Language:

  • (Maintain an open and welcoming posture to make the client feel comfortable and heard.)

• Paraphrase:

  • "So, if I understand correctly, you're experiencing pain in your lower back and it started a few weeks ago?"

• Ask Open and Closed-Ended Questions:

  • "Can you tell me more about your pain?" (Open-ended)
  • "Is the pain constant or does it come and go?" (Closed-ended)

• Show Empathy:

  • "I'm sorry to hear that you've been in pain. We'll do our best to help you feel better."

• Ask if the Client Has Any Questions:

  • "Do you have any questions before we get started?"

2. General Criteria

• Ask About Client’s Goals:

  • "What are your goals for our sessions together?"

• Ask What Areas They Would Like Treated:

  • "Which areas would you like me to focus on today?"

• Ask About Activities of Daily Living Limitations:

  • "Are there any activities in your daily life that are particularly difficult or painful?"

• Ask If There Are Any Other Health Care Practitioners Involved with Client’s Care:

  • "Are there any other health care practitioners currently involved in your care?"

3. Health History

• Investigate Any Medicines Client’s Use:

  • "Are you currently taking any medications?"

• Investigate Anything Client May Have Checked Off on Health History Form:

  • "I see you mentioned a previous injury on your health history form. Can you tell me more about that?"

4. Specific Interview (Location, Onset, etc.)

• Location:

  • "Where exactly is the pain and tenderness located?"

• Onset:

  • "When did the pain first start?"

• Referral Pattern:

  • "Does the pain radiate or refer to other areas? If so, how would you describe the referral – is it numbness, tingling, shooting, burning?"

• Duration:

  • "How long does the pain typically last?"

• Frequency:

  • "Is the pain constant or does it come and go?"

• Intensity:

  • "How severe is the pain on a scale from 1 to 10?"

• Character:

  • "How would you describe the pain? Is it dull, shooting, achy, etc.?"

• Aggravating Factors:

  • "What activities or movements make the pain worse?"

• Relieving Factors:

  • "What helps to decrease or relieve the pain?"

• Alternative Healthcare:

  • "Have you seen any other healthcare providers about this issue, such as a doctor, chiropractor, or physiotherapist?"

• Health History:

  • "Let's review the health history form you filled out. Is there anything else you’d like to add?"

Mock Example Conversation During a Station

Therapist: "Hello and welcome, Cecelia! My name is Andrew, I'll be your massage therapist today. I just looked over your health history form, and I would like to ask you a few questions before we begin, Firstly the purpose of this interview is to find out more information regarding your general health so I can provide you with safe and effective treatment. 

All the information you provide will remain confidential and will not be released without your written and informed consent. I will keep your record on file for 10 years and will update it every year. If anything changes between now and then please let me know. Is all the information on here current and up to date?

Cecelia: Yes it is.

Therapist: Great! and do you have any questions before we begin? 

Cecelia: No

Therapist: Okay, so what brings you in today?

Cecelia: "I injured my lower back lifting heavy boxes a few months ago."."

Therapist: "Where exactly is the pain and tenderness located?" (location)

Cecelia: "Mostly in my lower back,"

Therapist: "When did the pain first start?" (Onset)

Cecelia: "It started right after the injury a few months ago."

Therapist: Does the pain radiate or refer to other areas? (Radiates)

Cecelia: Yes, sometimes it It sometimes shoots down my right leg." 

Therapist: "How long does the pain typically last?" (Duration)

Cecelia: "It can last for a few hours at a time."

Therapist: "Is the pain constant or does it come and go?" (Frequency)

Cecelia: "It comes and goes, but it's more frequent in the evening."

Therapist: "How severe is the pain on a scale from 1 to 10?" (intensity)

Cecelia: "Right now, it's about a 6, but it can go up to an 8."

Therapist: "How would you describe the pain? Is it dull, shooting, achy, etc.?" (character)

Cecelia: "It's mostly a dull ache, but it can be sharp when I move suddenly."

Therapist: "What activities or movements make the pain worse?" (Aggravates)

Cecelia: "Sitting for too long and lifting heavy objects."

Therapist: "What helps to decrease or relieve the pain?" (Relieves) 

Cecelia: "Stretching and applying heat seem to help."

Therapist: "Have you seen any other healthcare providers about this issue, such as a doctor, chiropractor, or physiotherapist?" (Alternative Care)

Cecelia: "Yes, I’ve been seeing a chiropractor regularly."

Therapist: "Are you currently taking any medications?"

Cecelia: "No, I'm not."

Therapist: "Let's review the health history form you filled out. Is there anything else you’d like to add or discuss?"

Cecelia: "No, that covers everything."

Therapist: "Do you have any questions before we get started?"

Cecelia: "Not at the moment."

Therapist: "Alright, let’s proceed with the assessment and treatment plan."