OSCE Toolbox | Cholera Counselling - Scenario

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By Femi Lana • May 26, 2026 • Last reviewed: 2026-01-12 •

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Summary Intermediate

In this scenario, the student is working as a community pharmacist and tasked with counselling a patient on cholera vaccinations prior to overseas travel. The student must provide appropriate advice and answer any questions.

Please ensure that this scenario and mark scheme align with the most up-to-date guidelines from the UK NICE and the BNF when using it for your OSCE assessment.

You will need a student pharmacist and an actor for this OSCE station.

Revision Topics

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Student Instructions

Actor Instructions

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Mark Scheme

Introduction

0 / 2

Introduces self as the pharmacist with an appropriate greeting

+1

Confirms patient details: Name, age

+1

History

0 / 7

Takes a brief travel history:

Travelling to cholera-risk destination (Bangladesh, rural village) [

+1

Duration of stay (6 weeks)

+1

Type of accommodation (rural home)

+1

Food and water exposure risk (home-cooked local food, limited bottled water)

+1

Confirms medical history

+1

Childhood asthma

Confirms medication history

+1

No regular medications

Checks for any allergies and confirms the nature of reaction.

+1

Answer Q1: How will I know if I’ve got cholera?

0 / 4

Explains that cholera usually presents with watery diarrhoea, which can lead to serious dehydration

+1

Warns about other signs: vomiting, muscle cramps, feeling weak, dry mouth, decreased urine output

Explains the importance of seeking urgent medical attention if these symptoms develop

+1

Advises that prompt rehydration is critical (oral rehydration solutions or hospital care)

+1

Answer Q2: Do I need the vaccine? How do I take it?

0 / 6

Confirms increased risk due to rural stay, uncertain water and food safety, and duration of travel

+1

It’s important to conduct a full travel-risk assessment to ensure you are not missing key factors that determine whether vaccination is required. Country-specific travel advice can be found on NaTHNaC

The student effectively counsels on Dukoral® use:

Dukoral® is an oral cholera vaccine that comes as a powder sachet and solution

+1

Explains how to prepare the solution

+1

Dissolve the powder sachet in 150 mL of cool water, stir until fully dissolved (this is the buffer solution). Shake the Dukoral vial and pour into the buffer solution. Stir again gently, and drink immediately / within 2 hours.

Explains administration details: must take with safe water, avoid food 1 hour before and 1 hour after

+1

Explains the vaccine schedule: two oral doses, at least 1 week apart, with the second dose taken at least 1 week before travel

+1

The student explains that abdominal pain, nausea, vomiting, diarrhoea, and headache are common side effects of the vaccine and are usually short-lived, but advises the patient to seek medical attention if they persist or become severe.

+1

Answer Q3: I’ll be travelling back to Bangladesh later this year. Will I need to take the vaccine again?

0 / 2

Explains Dukoral® protection lasts around 2 years in adults and if travelling within this period, repeat administration is not required.

+1

If travelling after protection has lapsed, the full two-dose course must be repeated.

+1

Management

0 / 5

Explains that Dukoral® is not 100% effective at preventing cholera, even when taken correctly, so vaccination must be used alongside hygiene and food/water precautions to further reduce the risk of cholera infection.

+1

Suggests appropriate protective measures to the patient: Maximum 3 marks awarded

Wash their hands with soap and water regularly, especially after using the toilet and before preparing or eating food.

Only drink bottled water or water that has been boiled.

Brush their teeth using bottled or boiled water.

Avoid uncooked fruit and vegetables unless washed with bottled or boiled water

Advises the patient to seek urgent same-day medical assessment (A&E / urgent care / GP same-day) if symptoms develop during travel or after returning to the UK.

Communication

0 / 6

Use appropriate language for the person and situation.

+1

Demonstrates empathy

+1

Ensure the patient understanding

+1

Signposts and refers patients to relevant resources e.g. NHS website

+1

Concludes the conversation well by asking if there are any further questions

+1

The student did not say anything that could harm the patient

+1

This includes but is not limited to, providing incorrect information or medication, misdiagnosing conditions, neglecting to inquire about allergies, making incorrect referrals, or failing to act on red-flag symptoms.

Time Management

0 / 1

Completed the scenario in time and achieved 70% of marks

+1

Referral Criteria

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Referral Criteria for Cholera

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Referral Criteria for Cholera

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