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CASC Cognitive Assessment Stations

Cognitive assessment stations test your ability to use standardised tools, interpret results, and communicate findings — all under time pressure.

Overview

Cognitive assessment stations in the CASC test your ability to administer standardised cognitive screening tools (such as MMSE, ACE-III, or MoCA), interpret the results, explain findings to patients or relatives, and integrate cognitive findings into a differential diagnosis. These stations may also test your knowledge of dementia subtypes and the distinction between delirium, dementia, and depression.

Key Skills Assessed

  • Administering cognitive screening tools (MMSE, ACE-III, MoCA)
  • Interpreting scores and identifying patterns
  • Differentiating dementia subtypes based on cognitive profiles
  • Distinguishing delirium, dementia, and depression
  • Explaining cognitive test results to patients and families
  • Formulating an investigation and management plan

Recommended Framework

1

Introduction

Explain purpose of testing, gain consent, ensure patient is comfortable and able to engage

2

Orientation

Test orientation to time, place, and person

3

Attention

Serial 7s, spelling WORLD backwards, months backwards

4

Memory

Registration, recall (immediate and delayed), address recall

5

Language

Naming, repetition, comprehension, reading, writing

6

Visuospatial

Clock drawing, intersecting pentagons, cube copying

7

Interpret & Explain

Score the assessment, explain results sensitively, outline next steps and investigations

Example Exam Scenarios

Administer a cognitive screening assessment for a patient with memory concerns

Explain the results of cognitive testing to a patient's family

Differentiate between delirium and dementia in a hospital inpatient

Discuss the diagnosis and prognosis of Alzheimer's disease with a patient

Common Mistakes to Avoid

  • Not explaining the purpose of cognitive testing before starting
  • Rushing through the assessment without building rapport
  • Failing to recognise and adjust for educational and cultural factors
  • Not considering delirium as a differential when cognition is impaired
  • Giving a dementia diagnosis based on screening alone without further investigation

Examiner Tips

  • Always normalise cognitive testing: "These are routine questions we ask everyone..."
  • Be sensitive — cognitive testing can be distressing for patients
  • If a patient becomes frustrated, acknowledge this and offer to take a break
  • Know the key cognitive profiles for each dementia subtype
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