Station 8 - April 2016 OSCE-Melbourne - Nicotine Addiction Management for a Patient With Schizophrenia

Sep 20, 2026

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Objective Structured Clinical Examination (OSCE) Station 8 (Melbourne, April 2016) focuses on assessing and managing nicotine addiction in Alex, a 35-year-old man with schizophrenia who requires extended hospitalisation for an orthopaedic procedure and rehabilitation, and has comorbid epilepsy. The candidate must take a focused substance-use history, negotiate a preferred management plan, and educate Alex on treatment risks, including that bupropion is contraindicated in epilepsy. Required competencies include assessing readiness to quit, integrating psychological interventions, and discussing at least two pharmacological nicotine-related options.

LanguageEnglish

CategoryExam

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Station 8: Descriptive summary

Station 8: Main assessment aims

Station 8: Required standard

Station 8: Station covers

Station 8: References

Station 8: Station requirements

Instructions to Candidate

Scenario and tasks

Time and communication rules

Station 8: Operation summary

Prior to examination

During examination

At conclusion of examination

Committee for Examinations Objective Structured Clinical Examination Station 8 Melbourne April 2016 1.0 Descriptive summary of station: In this station the candidate is to assess and manage nicotine addiction in Alex, a 35-year-old man who suffers from schizophrenia and requires an extended hospitalisation for an orthopaedic procedure and subsequent rehabilitation. Alex also has comorbid epilepsy. The candidate is required to negotiate a preferred management plan and simultaneously educate the patient about the risks of his using bupropion, which is his preferred choice of treatment (bupropion is contraindicated in epilepsy) . 1.1 The main assessment aims are: • To take a relevant history. • To explain treatment options and assist the patient in making a decision about his treatment. 1.2 The candidate MUST demonstrate the following to achieve the required standard: • The ability to assess the patient's readiness to quit. • Knowledge that psychological interventions are an essential component of therapy. • Knowledge of at least 2 pharmacological options from nicotine replacement therapy, veranicline, and nortriptyline. • The ability to impart adequate information to the patient highlighting the risk of bupropion. 1.3 Station covers the: • RANZCP OSCE Curriculum Blueprint Primary Descriptor Category of: Substance Use Disorders • Area of Practice: Addiction • CanMEDS Domains of: Medical Expert, Communicator • RANZCP 2012 Fellowship Program Learning Outcomes of: Medical Expert (Assessment, Management) Communicator (Conflict Management) References: • Mendlesohn CP, Kirby DP, Castle DJ. Smoking and Mental Illness. An Update for Psychiatrists. Australasian Psychiatry 2015, 23(1) 37-43. • Zwar N, Richmond R, Borland R et al. Supporting Smoking Cessation: A Guide for Health Professionals. Royal Australian College of General Practitioners, 2014. • Rustin TA. Assessing Nicotine Dependence. Am Fam Physician. 2000 Aug 1;62(3):579-58 • The New Zealand Guidelines for Helping People to Stop Smoking. Ministry of Health, June 2014. 1.4 Station requirements: • Standard consulting room; no physical examination facilities required. • Four chairs (examiner x 1, role player x 1, candidate x 1, observer x 1) . • Laminated copy of ‘ Instructions to Candidate’. • Role player – Male. Mid 30s. Preferably slightly overweight. Walks with a limp. • Pen for candidate. • Timer and batteries for examiner. © Copyright 2016 Royal Australian and New Zealand College of Psychiatrists (RANZCP) All Rights Reserved. All persons wanting to reproduce this document or part thereof must obtain permission from the RANZCP. Station 8-April 2016 OSCE-Melbourne Page 1 of 11 2.0 Instructions to Candidate You have eight (8) minutes to complete this station after two (2) minutes of reading time. You are working as a junior consultant psychiatrist in the community team . You have been asked to see Alex, a 35-year-old man, who is a patient of the service and suffers from schizophrenia which is well maintained on his current treatment. He has comorbid stable epilepsy. He is due to have an operation in the near future and will require an extended admission. To avoid acute nicotine withdrawal, the hospital team has advised Alex that he should stop smoking cigarettes before his admission, as smoking is not possible during his hospital stay. His current medication is olanzapine 15mg at night and valproate 500mg twice daily. Your tasks are to: • Take focussed history that relates to substance use. • Explain the management options available to Alex. • Negotiate a management plan with Alex. You will not receive any time prompts. © Copyright 2016 Royal Australian and New Zealand College of Psychiatrists (RANZCP) All Rights Reserved. All persons wanting to reproduce this document or part thereof must obtain permission from the RANZCP. Station 8-April 2016 OSCE-Melbourne Page 2 of 11 Station 8-Oper

FAQs

What are the main assessment aims for Station 8?

The candidate should take a relevant history and explain treatment options to help the patient make a decision about treatment.

What competencies must the candidate demonstrate to meet the required standard?

These include assessing readiness to quit, knowing that psychological interventions are essential, knowing at least two pharmacological options (nicotine replacement therapy, varenicline, and nortriptyline), and providing adequate information emphasizing the risk of bupropion.

What should the candidate do if Alex asks for information or clarification?

The candidate should respond: “Your information is in front of you –– you are to do the best you can.”

Sep 20, 2026

Upload by Rowan