How to Explain a Condition in an OSCE
Explaining a condition is a key OSCE communication skill.
The aim is not to show how much you know. The aim is to help the patient understand what is happening in clear, simple language.
By the end, the patient should understand:
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What the condition is
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How it explains their symptoms
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What problems it can cause
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How it can be managed
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What happens next
Why this Matters?
OSCE Talk Tip
Explain the condition to the patient, not the examiner.
Use simple language, avoid jargon, link the explanation to their symptoms and give information in small chunks.
If you are talking for several minutes without checking in, you are probably giving too much information at once.
Always refer to relevant NHS resources, including leaflets or websites.
Opening the Consultation
Start as usual:
“Hello, my name is Peter. I’m one of the medical students. Could I just check your name and date of birth please?”
“Today I’d like to talk with you about your diagnosis and explain what it means. Is that okay?”
If the diagnosis is not confirmed, you could say:
“Today I’d like to talk through what we think might be going on and answer any questions you have. Is that okay?”
Check understanding and ICE
Before explaining, check what the patient already knows and what matters to them.
“What have you been told so far?”
“What do you understand about this condition?”
“Is there anything in particular you’re worried about?”
“What were you hoping we could cover today?”
This helps you pitch the explanation at the right level.
Take a Brief Focused History if Appropriate
The amount of history depends on the station.
In a short counselling station, keep it very focused. In a longer station, you may have time to ask more about symptoms, impact and relevant background.
Useful questions include:
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“Can I quickly check what symptoms you’ve been having?”
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“How has this been affecting you day to day?”
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“Are you taking any regular medication?”
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“Do you have any other medical conditions?”
The aim is not to take a full history unless the station asks for it.
A Simple Structure for Explaining a Condition
A clear explanation can be structured around:
Normal Function — what normally happens in the body
The Condition — what has changed and how this causes the patient’s symptoms
Causes — possible causes or risk factors
Possible Problems — how the condition may affect the patient and any important complications
Management — lifestyle measures, treatment, monitoring, follow-up and safety-netting
This keeps your explanation organised and stops you jumping straight into treatment before the patient understands the condition.
Normal Function
Start with what normally happens.
For example:
“Normally, the kidneys act like filters. They clean the blood and remove waste products in the urine.”
“Normally, the lungs bring oxygen into the body and help remove carbon dioxide.”
“Normally, the heart pumps blood around the body to deliver oxygen to the organs.”
Keep this brief. You only need enough background for the patient to understand the problem.
The Condition
Next, explain what is wrong in plain language.
For example:
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“In your case, the kidneys are not filtering the blood as well as they should.”
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“In asthma, the airways can become inflamed and narrowed, which makes it harder for air to move in and out.”
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“In heart failure, the heart is not pumping as strongly as the body needs.”
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Try to link this back to the patient’s symptoms.
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“That helps explain why you have been feeling more breathless.”
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“That may be why you have noticed ankle swelling.”
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“That can explain why you have been feeling tired.”
Causes
Then explain what may have caused the condition.
Sometimes the cause is clear. Sometimes there are several possible causes. Sometimes you do not know yet.
You can say:
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“There are a few things that can contribute to this.”
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“We may not know the exact cause yet, but there are some common causes we look for.”
Be careful not to blame the patient.
Instead of saying:
“This is because you smoke.”
You could say:
“Smoking can increase the risk of this condition, so stopping smoking is one of the things that can reduce further risk.”
Possible Problems
Next, explain why the condition matters.
For example:
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“The problem with asthma is that the airways can narrow, which can cause wheeze, cough, chest tightness and breathlessness.”
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“The problem with high blood pressure is that, over time, it can put strain on the heart, brain, kidneys and blood vessels.”
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You do not need to scare the patient, but you should be honest.
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A useful phrase is:
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“The reason we take this seriously is that, if left untreated, it can lead to problems later on.”
Management
Finally, explain how the condition is managed.
A simple structure is:
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Lifestyle or practical measures
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Medication
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Specialist treatment or procedures, if relevant
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Follow-up and monitoring, including referral to the appropriate teams
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Safety-netting
You do not need to list every possible treatment. Focus on what is relevant to the patient and the station.
Useful phrases include:
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“There are simple things we can do first.”
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“There are medications that can help.”
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“We will monitor this with follow-up blood tests.”
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“If things become more severe, specialist treatments may be needed.”
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“We will make sure you know what symptoms to look out for.”
Chunk and Check
Do not give the whole explanation in one long speech.
Pause regularly and check understanding.
You could say:
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“Does that make sense so far?”
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“Would you like me to go over that again?”
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“Have I explained that clearly?”
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“What questions do you have so far?”
Try not to make the patient feel tested. Asking them to repeat everything back can sometimes sound patronising unless you specifically need to assess understanding.
Use Patient-Friendly Language
Avoid jargon.
Instead of “renal impairment”, say:
“Your kidneys are not working as well as they should.”
Instead of “hypertension increases cardiovascular risk”, say:
“High blood pressure can put strain on the heart and blood vessels over time.”
Instead of “contraindicated”, say:
“We would usually avoid this because it could be unsafe for you.”
Close the consultation
At the end:
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Summarise the key points
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Check understanding
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Ask for questions
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Safety-net
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Explain follow-up
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Give the patient relevant information, such as a leaflet or website details
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Thank the patient
You could say:
“We’ve covered a lot today. Just to summarise, this condition means that [brief explanation]. It may explain [symptom]. The main things we can do are [management]. We will also arrange [follow-up]. Is there anything you would like me to go back over?”
Ideas, Concerns and Expectations
This example uses kidney disease, but you can adapt the same structure for any condition.
“Before I explain everything, can I check what you’ve already been told about your kidneys?”
“Is there anything in particular you’re worried about?”
“Normally, the kidneys act like filters. They clean the blood, remove waste products and help control the body’s fluid and salt levels.”
“In your case, the blood tests suggest that the kidneys are not filtering as well as they should. That means waste products can build up in the body, which can sometimes make people feel tired, sick, itchy or generally unwell.”
“There are different reasons this can happen. It can be linked to dehydration, infection, certain medications, high blood pressure, diabetes or longer-term kidney problems. We may need to do more tests to work out exactly what has contributed in your case.”
“The reason we take this seriously is that, if kidney problems are not treated or monitored, they can worsen and affect other parts of the body. But there are things we can do to help.”
“The first step is to look for anything reversible. That may mean checking your fluid levels, reviewing your medications, treating infection if present and repeating blood tests. Longer term, we may need to control blood pressure, manage diabetes if relevant and monitor your kidney function.”
“We will not just leave you with this. We will arrange follow-up blood tests and make sure there is a clear plan.”
“Does that explanation make sense so far? Is there anything you’d like me to go back over?”
Possible Examiner Questions & Model Answers
Q1: What should you do before explaining a condition?
Introduce yourself, confirm the patient’s details, explain the purpose, gain consent, take a brief history, check prior knowledge and explore ICE.
Q2: Why check prior knowledge?
It helps you pitch the explanation at the right level and avoids assuming what the patient does or does not know.
Q3: Why explore concerns?
Patients often have specific worries. Addressing those worries makes the consultation more patient-centred.
Q4: What structure can you use to explain a diagnosis?
Normal function, the condition, possible causes, possible problems and management.
Q5: What should you include when explaining normal function?
Briefly explain what normally happens in the relevant part of the body, using simple language.
Q6: What should you include when explaining the condition?
Explain what has gone wrong, name the condition and link it to the patient’s symptoms.
Q7: What should you include when discussing causes?
Common causes or risk factors, while avoiding blame and being honest if the exact cause is not known.
Q8: What should you include when discussing possible problems?
Symptoms, complications and why the condition matters.
Q9: What should you include when discussing management?
Lifestyle measures, medical treatment, specialist options if relevant, follow-up and safety-netting.
Q10: Why is chunking and checking important?
It prevents information overload and gives the patient opportunities to ask questions.
Key Message
Explaining a condition is not about reciting a textbook.
It is about helping the patient understand what is happening and what the plan is.
