Patients do not always give the same history repeatedly; they can become tired or unwell and may develop new signs and symptoms or even lose old clinical findings; however they can be a most valuable resource and need to be treated as such. Using real patients in OSCEs adds greatly to the validity of the assessment. Ideally patients should be used to assess the detection of common chronic clinical signs. For each clinical sign assessed you will need several patients and even the most stoical patient should not be expected to be examined by more than 10 students in the course of a day. Ideally patients should be swapped in and out of a station to allow them to have sufficient rest time.
See the Module Involving Patients in Clinical Teaching for further ideas on using different types of patients.