The ultrasound application station: format and tasks
Stem
The door card reads "Application of Ultrasonography." Inside, a healthy adult standardized patient lies supine on a stretcher beside an ultrasound machine with linear, curvilinear and phased-array probes. An examiner sits at the machine and will operate it. You will complete three tasks in turn: a vascular access image, a nerve block image and a POCUS view, each limited to two and a half minutes. You may position the patient as you need.
Question
Before the first task begins, the examiner asks: how will you run each task so that every scored step gets credit?
Ideal answer
HeadlineOne routine for every task, said aloud: the examiner cannot score what I do not say.
- Name the probe and why. Linear for superficial vessels and nerves, curvilinear for deep or abdominal, phased array for the heart.
- Position, then ask for preset and depth, because the examiner runs the machine while I hold the probe.1
- Orient the marker and prove it. Usually patient's right or head; I tap the probe edge and see it on screen.
- Landmark, target, freeze. Usually artery first; sweep, tilt, rotate to center it; I state orientation and name each structure asked for.
- Show the scored endpoint: optimal needle position for the vessel, needle-tip location for local anesthetic around the nerve, or the color-flow Doppler box over the valve.1
Watch for: the clock: a good image with every item named beats a perfect one half-named.
Breaking down the answer
- Know the station — the only station scoring my hands: three tasks, two and a half minutes each at most.1 IJ, cubital fossa, radial and femoral vessels; interscalene, supraclavicular, infraclavicular, axillary, TAP, femoral, adductor canal and popliteal sciatic blocks; POCUS cardiac, lung, abdominal and gastric views.2
- What it tests — choosing the right probe, holding it correctly, asking for the settings I need, and identifying the target on a standardized patient I may position as I need.1
- Probe choice is scored — high frequency gives resolution but loses depth; low frequency reaches deep but blurs detail. I state the frequency range and the reason, which shows application of knowledge.
- Ask for settings explicitly — the examiner adjusts depth and gain on request:1 "reduce the depth to 3 cm," "increase the gain," "add color Doppler." Silent struggling with a bad image is scored as inability to optimize.
- Orientation before anatomy — left of the screen must match the marker side; a mirrored image makes every structure I name wrong.
- PART — artery first is faster than hunting a nerve, which keeps a fixed relation to it. Pressure compresses and confirms veins, alignment, rotation turns an oblique cut into a true cross-section, tilting changes nerve brightness through anisotropy.
- The endpoint is a scored line — without it a correct image leaves an item blank;1 I state the plane, the trajectory and the structure I am avoiding, organization the examiner can tick off.
Follow-up question
On the nerve block task the examiner asks for an interscalene image. At the level you expected, the model's anatomy does not match the textbook and you cannot find the roots in the groove. What do you do?
Follow-up answer
HeadlineAn anatomy problem, not a failed task; I say what I see instead of going quiet.
I ask the examiner for less depth, slide down to the supraclavicular fossa where the plexus lies beside the subclavian artery, and trace it back up to the interscalene groove. If the clock runs out, I name the structures I have found, where the target should be relative to them, and how I would confirm with color Doppler or tracing. If the examiner asks "What is that bright structure?", I answer directly, then return to the task. A narrated methodical search scores better than silence, and it is where the examiner sees adaptability.
Pitfalls that cost points
-
Working with the depth set to 8 cm for a target at 1 cm.
-
Running out of time on one task chasing a perfect image.
Rapid-fire
Q: Who controls the machine? A: The examiner; I choose the transducer, manipulate the probe and request changes such as depth or gain.1
Q: How many tasks are there? A: Three (vascular, nerve block, POCUS), no more than 2 minutes 30 seconds each,1 inside one of the seven scored 8-minute stations with 4-minute breaks to read the next scenario.3
Q: Why identify the artery first? A: It is pulsatile, non-compressible and confirmable with color, and the nerves keep a constant relationship to it.
Q: What is anisotropy? A: A nerve or tendon is brightest when the beam strikes it at 90°; tilting the probe a few degrees makes it disappear or reappear.
Numbers to know
| Item | Value |
|---|---|
| Station length | 8 minutes, 4-minute read3 |
| Tasks | 3, ≤2.5 minutes each1 |
| Warning bell | At 6 minutes |
| Linear probe | 6–15 MHz, targets <5 cm |
| Curvilinear probe | 2–5 MHz, abdomen and deep blocks |
| Phased-array probe | 1–5 MHz, cardiac |
Links
- OSCE day: stations, timing, who is in the room, POCUS image acquisition: probe positions and Doppler sectors, Vascular access: IJ, femoral, radial, cubital fossa, Interscalene, supraclavicular, infraclavicular, axillary, Femoral, adductor canal, popliteal sciatic, Transversus abdominis plane
- Atlas: The 5 POCUS cardiac views
- ABA APPLIED Examination OSCE content outline and OSCE example scenarios; ASRA/ESRA Recommendations for Education and Training in Ultrasound-Guided Regional Anesthesia (2009)
Sources
- 1.OSCE Example Scenarios (all stations) · ABA, 2023 · theaba.orgApplication of Ultrasonography sample: three task templates, examiner operates machine, 2 min 30 s per task.
- 2.APPLIED Exam Objective Structured Clinical Examination (OSCE) Content Outline · ABA · theaba.org
- 3.APPLIED Exam · ABA · theaba.org
Facts on this page were checked against these sources on Oct 14, 2026. Guidelines change; confirm doses against current institutional protocols.