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Clinical Skills

OSCE prep, orthopedic tests, neurological exams, and condition libraries — for every health discipline.

6
Disciplines
4
Conditions (Chiro)
8+
Practice Questions
Free
Always
Choose your discipline
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Chiropractic
OSCE history taking, orthopedic tests, neurological exams, and condition-specific clinical reasoning for chiro students.
OSCE Flow OLD CART PPMFLOAT Ortho Tests Red Flags Quiz
🤸
Coming Soon
Physiotherapy
Movement-based assessment, outcome measures, special tests, and OSCE preparation for PT students.
OSCE Flow Outcome Measures Special Tests Exercise Rx
💉
Coming Soon
Nursing
Systems-based history taking, head-to-toe assessment, clinical reasoning, and medication review for nursing students.
Head-to-Toe Vitals Meds Review SBAR
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Coming Soon
Medicine
Comprehensive clinical history, systems review, physical examination, and diagnostic reasoning for medical students.
Systems Review Physical Exam Differentials SOAP Notes
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Coming Soon
Physician Assistant
PA-specific OSCE prep, clinical decision making, prescribing frameworks, and patient communication skills.
OSCE Clinical Reasoning Prescribing
🖐️
Coming Soon
Occupational Therapy
Functional assessments, occupational history, standardized tools, and goal-setting frameworks for OT students.
Functional Assess. Goal Setting ADLs
All Disciplines › Chiropractic
🦴 Chiropractic
Select a module to begin studying
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5 sections
OSCE — History Taking
Master the full history taking flow: OLD CART, PPMFLOAT, red flag screening, and condition-specific cues.
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20+ tests
Orthopedic Special Tests
Key ortho tests by region — cervical, lumbar, shoulder, hip — with positive findings and clinical significance.
🧠
Coming Soon
Neurological Exam
Dermatomes, myotomes, reflexes, and upper/lower motor neuron testing.
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Coming Soon
Conditions Library
Expanded condition database with full clinical pictures, differentials, and management principles.
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8 questions
Practice Quiz
Test your knowledge with clinical scenario questions and instant detailed feedback.
🫀
Coming Soon
Clinical Anatomy
Clinically relevant anatomy linked to chiropractic assessment and treatment.
All Disciplines › Physiotherapy
🤸 Physiotherapy
Content is being built — check back soon!
🚧
Physio content coming soon
We're building out OSCE history taking, special tests, outcome measures, and exercise prescription content for PT students. Built by students, for students.
OSCE Flow Special Tests Outcome Measures Exercise Rx Red Flags
All Disciplines › Chiropractic › OSCE History Taking
📋 OSCE — History Taking

History Taking — Master Flow

Follow this sequence every single time. The order builds patient trust and ensures nothing is missed before your physical exam.

Introduction OLD CART PPMFLOAT Red Flag Screen
👋
Step 1
Introduction & Consent
"Hello, I'm [name], a student chiropractor at CMCC. May I confirm your name and date of birth? I'll be asking some questions about what brought you in — please feel free to stop me at any time. Is that okay?"
Establish rapport. Confirm identity. Ensure privacy. This is often where marks are lost — don't skip it.
❓
Step 2
Chief Complaint (CC)
"What brings you in today?" — then pause and let them speak fully without interrupting.
Use open-ended questions only. Mirror the patient's own words back to them. Do NOT lead with "is your pain sharp or dull?" yet.
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Step 3
OLD CART — Symptom Analysis
"I'd like to ask some specific questions about your [chief complaint] to understand it better."
Go through O→L→D→C→A→R→T in order. After O-L-D, briefly reflect back: "So you've had lower back pain for 3 weeks after lifting — is that right?" End with 0–10 pain score (now / best / worst).
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Step 4
PPMFLOAT — Past History
"Now I'd like to ask a few questions about your general health background."
Cover all 8 domains. For Medications — always ask about blood thinners, steroids, NSAIDs. For Treatment Hx — ask about prior imaging (X-ray, MRI, CT) and whether it helped.
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Step 5
Red Flag Screen
"I need to ask a few important safety questions before we continue."
Screen for: unexplained weight loss, cancer history, fever/night sweats, bowel/bladder changes. Cervical add-ons: bilateral symptoms, gait changes, dizziness with neck movement.
✅
Step 6
Transition to Physical Exam
"Thank you for sharing that. Based on what you've told me, I'd like to do a physical examination now — I'll explain everything as we go."
Summarize key findings aloud. State your working hypothesis if the OSCE format asks for it.
🔍 OLD CART — Symptom Analysis
O
Onset
"When did it start? Sudden or gradual? Any injury or trigger? First episode or recurring?"
L
Location
"Where exactly? Can you point to it? Does it travel or radiate anywhere?"
D
Duration
"How long have you had this? Constant or comes and goes? Better, worse, or the same?"
C
Character
"Describe the pain — sharp, dull, aching, burning, shooting, tingling? Rate 0–10 now, at worst, at best."
A
Aggravating Factors
"What makes it worse? Movement, posture, time of day, sitting, bending, coughing/sneezing?"
R
Relieving Factors
"What helps? Rest, heat, ice, medication, certain positions?"
T
Timing / Trends
"When is it worst — morning, end of day? With activity or rest? Night pain that wakes you?"
📁 PPMFLOAT — Past History
P
Past Health History
"Any previous illnesses, hospitalizations, surgeries? Prior episodes of this complaint?"
P
Personal / Social History
"Living situation, support system? Stress levels? Major life changes recently?"
M
Medications
"Current medications or supplements? OTC meds? Blood thinners, steroids, NSAIDs?"
F
Family History
"Relevant conditions in the family — arthritis, disc disease, cancer, osteoporosis?"
L
Lifestyle / Habits
"Smoking, alcohol? Diet, sleep quality, exercise routine?"
O
Occupation
"What kind of work? Physical demands, prolonged sitting/standing, ergonomics?"
A
Activities / Hobbies
"Recreational sports, hobbies? Any recent change in activity level?"
T
Treatment History
"Tried anything for this? Chiro, physio, massage, injections? Any imaging — X-ray, MRI, CT?"
🍑
Piriformis Syndrome
Pseudo-sciatica / Deep Gluteal
Onset / Mechanism
  • Trauma to gluteal region (fall, direct blow)
  • Overuse: runners, cyclists, prolonged sitting
  • May be gradual with no clear trauma
Location / Radiation
  • Deep buttock — not in the spine itself
  • May refer to posterior thigh (rarely below knee)
  • No true dermatomal pattern
Aggravating / Relieving
  • ↑ Worse: sitting, climbing stairs, hip IR, crossing legs
  • ↓ Better: standing, lying down, stretching hip ER
🔑 No dermatomal pattern + deep buttock + worse with sitting + hip IR aggravation
🦾
Cervical Radiculopathy
Nerve Root Compression — C5 to C8
Onset / Mechanism
  • Younger: disc herniation, acute, flexion MOI
  • Older: foraminal stenosis, insidious, degenerative
  • Whiplash or prolonged poor neck posture
Dermatomal Pattern
  • C5: lateral arm, shoulder
  • C6: lateral forearm, thumb + index
  • C7: middle finger, triceps (most common)
  • C8: ring + pinky, medial forearm
Aggravating / Relieving
  • ↑ Worse: extension + rotation to affected side
  • ↓ Better: arm overhead, cervical traction
🔑 Dermatomal arm pain + worse with extension/rotation ipsilateral + arm overhead relief
🦴
Facet Joint Syndrome
Somatic Referred Pain — Cx or Lx
Onset / Mechanism
  • Insidious — degeneration, repetitive extension
  • Acute after hyperextension injury (whiplash)
  • Morning stiffness that eases with movement
Location — Non-Dermatomal
  • Cervical: suboccipital, shoulder, scapula — not into hand
  • Lumbar: buttock, posterior thigh — not below knee
Aggravating / Relieving
  • ↑ Worse: extension + ipsilateral rotation
  • ↓ Better: flexion, movement, warmth
🔑 Extension-provoked + NO neuro deficit + non-dermatomal + warms up with movement
🦵
Lumbar Radiculopathy
Sciatica — L4, L5, S1 Most Common
Onset / Mechanism
  • Younger: disc herniation — acute, flexion + loading
  • Older: stenosis — bilateral, neurogenic claudication
Dermatomal Pattern
  • L4: medial lower leg — ↓ patellar reflex
  • L5: dorsum of foot, big toe
  • S1: lateral/plantar foot — ↓ Achilles reflex
Aggravating / Relieving
  • ↑ Worse: sitting, bending, Valsalva (cough/sneeze)
  • Stenosis: shopping cart sign (leaning forward relieves)
🔑 Dermatomal leg pain below knee + Valsalva aggravation + SLR positive on exam
⚠️ Universal Red Flags — ALL Presentations
Unexplained significant weight loss (>10 lbs unintentionally)
History of cancer / malignancy
Fever, chills, or night sweats — suspect infection or tumor
Night pain that does NOT improve with position change or rest
Age <20 or new onset >50 without trauma
IV drug use or prolonged steroid use
Immunosuppression or HIV
Recent significant trauma — fracture risk
Progressive neurological deficit — worsening, not just pain
🧠 Cervical-Specific Red Flags
Bilateral upper limb paresthesia or weakness
Gait disturbance or clumsy hands — suspect myelopathy
Lhermitte's sign — electric shock down spine with neck flexion
Drop attacks, vertigo, diplopia with neck movement (VBI)
Dysphagia or hoarseness
🚑 Lumbar — Cauda Equina (EMERGENCY)
Bowel or bladder dysfunction — retention OR incontinence
Saddle anesthesia — perineum or inner thighs
Bilateral leg weakness or numbness — sudden onset
⚡ ANY of these = immediate ER referral. Do not proceed with the exam.
All Disciplines › Chiropractic › Orthopedic Special Tests
🔬 Orthopedic Special Tests
Key tests by region — positive finding and clinical significance
Cervical Spine
C-SPINE
Spurling's Test
+ = radicular arm pain with extension + ipsilateral rotation → cervical radiculopathy
Distraction Test
+ = relief of arm pain with axial distraction → nerve root compression
Shoulder Abduction
+ = arm pain relieved by arm overhead → cervical radiculopathy
Lhermitte's Sign
+ = electric shock down spine with neck flexion → cervical myelopathy
Upper Limb Tension
+ = radicular sx reproduced with shoulder depression + elbow ext → C6/C7 radiculopathy
Lumbar Spine
L-SPINE
SLR (Lasègue's)
+ = radicular leg pain at 30–70° → L4/L5/S1 disc herniation
Crossed SLR
+ = contralateral leg pain with SLR → large central disc herniation
Slump Test
+ = radicular sx with slump + knee ext + ankle DF → neural tension
Femoral Nerve Stretch
+ = anterior thigh pain with prone knee flex → L2/L3/L4 radiculopathy
FABER / Patrick's
+ = groin or SI pain → hip pathology or SIJ dysfunction
Kemp's Test
+ = local or referred pain with extension + rotation → facet joint or foraminal stenosis
Sacroiliac Joint
SIJ
FABER / Patrick's
+ = SI pain → SIJ dysfunction
Gaenslen's Test
+ = SI pain with hip hyperextension off table → SIJ pathology
Thigh Thrust
+ = posterior SI pain with axial femur force → SIJ dysfunction (high sensitivity)
Distraction Test
+ = SI pain with iliac crest spreading → SIJ pathology
Compression Test
+ = SI pain with lateral iliac compression → SIJ pathology
Hip
HIP
FABER / Patrick's
+ = groin pain → hip joint pathology (OA, labral tear)
FADIR
+ = anterior hip/groin pain → femoroacetabular impingement (FAI) or labral tear
Trendelenburg
+ = contralateral pelvis drops → weak ipsilateral glute med / hip abductors
Piriformis Test
+ = deep buttock pain with passive hip IR in flexion → piriformis syndrome
Ober's Test
+ = hip stays abducted after release → tight IT band / TFL
Shoulder
SHOULDER
Neer's Sign
+ = anterior shoulder pain with passive flexion → subacromial impingement
Hawkins-Kennedy
+ = anterior shoulder pain with internal rotation at 90° → subacromial impingement
Empty Can
+ = pain or weakness → supraspinatus tear or impingement
Speed's Test
+ = bicipital groove pain → biceps tendinopathy or SLAP lesion
Apprehension Test
+ = apprehension with ER + abduction → anterior shoulder instability
Knee
KNEE
Lachman's Test
+ = anterior tibial translation → ACL tear (most sensitive)
McMurray's Test
+ = click/pain with rotation → meniscal tear
Valgus Stress
+ = medial joint line pain/laxity → MCL tear
Varus Stress
+ = lateral joint line pain/laxity → LCL tear
Patellar Grind
+ = pain with compression + movement → patellofemoral syndrome