Psychosis — characterise a first presentation of abnormal experiences
1 of 6 debrief stages revealed
Fictional OSCE teaching station. A deterministic station with a rubric for learning and self-assessment — it is not auto-graded, produces no score, and is not a diagnosis exam. Not a real patient.
Auditory Hallucination Delusion
Candidate instructions
Type C · Psychosis · time limit 10 min
You are a psychiatry trainee in an outpatient clinic. A 25-year-old has been referred after describing unusual experiences. In 10 minutes, elicit and characterise any abnormal perceptual and belief experiences phenomenologically. Do NOT attempt to reach or state a diagnosis; describe what you find.
Task: Elicit and characterise the perceptual experience and the belief, on their own terms, keeping description ahead of diagnosis.
Simulated patient role (reveal when practising with a partner)
Role (simulated patient): For two months you have heard a voice, clearly outside your head, that comments on your actions. You have started to believe your neighbour is behind it. You are guarded at first but open up to warmth and open questions; you become defensive if labelled or interrogated. You have no thoughts of harming yourself or others.
This is a fictional teaching station. If a real patient disclosed risk, safety enquiry and escalation would take priority; here, screen for risk and document its absence.
Attempt the station (10 min)
Read the candidate instructions and patient brief above, then run the station — ideally aloud with a peer playing the patient. Reveal the debrief only after you have attempted it.
Consider: What will you establish about the voice and the belief before anything else?