Inhaled Medication: OSCE Station Checklist

The inhaler station is a teaching station wearing a technique costume. The actor plays a patient who uses their inhaler badly, in scripted ways, and the checklist marks whether you spot the errors, correct them without condescension, and confirm the fix stuck.

The technique you’re teaching, for a standard MDI:

1. Check the prescription and the inhaler: right drug, expiry, dose counter.
2. Shake the inhaler. Remove the cap, check the mouthpiece is clear.
3. Sit or stand upright. Breathe out fully, away from the mouthpiece.
4. Seal lips around the mouthpiece.
5. Press the canister as a slow, deep breath begins; keep inhaling.
6. Hold the breath about 10 seconds, or as long as comfortable.
7. For a second puff: wait 30 to 60 seconds, shake, repeat.
8. Steroid inhaler? Rinse the mouth and spit afterwards.

The rhythm mistake to name: MDIs want slow and deep; dry powder inhalers want quick and deep. Candidates who switch between the two devices in their teaching, or teach a sharp DPI-style inhalation on an MDI, lose the central technique mark.

Spacers

A spacer removes the press-and-breathe coordination problem and cuts mouth deposition, so it’s the default answer for children, older adults, the acutely breathless, and anyone on inhaled steroids. Two rules carry the marks: one puff into the spacer at a time (multiple puffs stick to the walls), and breathe from the spacer promptly after firing, either one slow breath with a hold or several tidal breaths for those who can’t manage that. Monthly washing in soapy water, air-dried without rinsing, stops static charge stealing the dose; it’s the detail question examiners like.

How the marks distribute

Technique is maybe half this station. The rest is the teaching loop: watch the patient demonstrate, name the specific errors you saw, coach the correction, then teach-back (“show me once more”) to confirm. Add the standing habits, hand hygiene before handling the device, consent before touching, documentation of the teaching and the patient’s technique afterwards, and the station is complete. Documentation here means recording that education was given and how the patient performed, which candidates forget because nothing was “administered”.

If the pairing on the day puts this with an injection skill, the SC and IM chapters cover that half. Five questions below, then suppository administration.