OSCE EXAMINER TRAINING Summer 2014

OSCE

• Objective • Structured • Clinical • Examination

• Introduced in 1970s to get round problems of traditional clinical exams

• First used in Newcastle in 1995

PHASE I OSCEs • Introduced in 2007/8 • Stage 1, 2 & Accelerators

• Formative OSCE in January (Feb for Acc Prog)

• 3 stations • 6 minutes + 2 minutes feedback

• Summative OSCE in May (July for Acc Prog)

• 7 (Stage 1); 10 (Stage 2 &A101) stations • 6 minutes (no feedback)

KEY POINTS • Every student (in theory) sits the same exam

• more or less

• Judgements are based on explicit criteria and are thus more reliable, fairer and transparent • more or less

• Eliminates biases such as ‘hawks’ & ‘doves’,

maverick examiners, halo effect • more or less

MORE KEY POINTS • In a summative OSCE candidate should not be

prompted • However this is formative

• If seriously off track, appropriate to say: “Would you like to read the instructions again?” • If student completely blows it (e.g. bursts into

tears) Alert invigilator; can repeat the station later

• Nonetheless ignorance/mistakes are powerful starting points for learning!

Commenting/Narrating during examination/procedure

• Students should explain to the patient what they are doing as they proceed in a patient friendly manner.

• They can comment on observations (inspection) made but they need not narrate to you the examiner when they are doing something which can be seen

• Summarising an examination is no longer required for Phase 1.

• If they do comment on more than they need to and/or summarise but are still communicating effectively with the patient please do not mark them down.

GIVING FEEDBACK • 2 minutes • No time for the full ‘S**t sandwich’ approach • Start with “How did that go?” but move rapidly

on…… • Be specific • Quick skim of what was done well • Highlight important areas not done so well and

how they might do better

REMINDER: SKILLS TAUGHT/LEARNT SO FAR

Stage 1 • Clinical skills and procedures

• Hand-washing • Chest examination • Basic CPR • Venepuncture

• Communication skills • Initiating the interview • Gathering information (active listening) • Family Study patient • 1 GP & 2 hospital visits

OSCE DATES Stage 1 Friday 24th January, all day Accelerated Wednesday 12th February, am only

MOCK OSCE EXAMINER GUIDANCE EXAMINER BRIEFING • An OSCE Examiner briefing will be given on the morning

of the examination at 8.00am in Clinical Skills (12.30 pm for afternoon examiners)

• This will include details of the exam process, timings, the

OMR marking sheets, yellow cards and also to meet your “patient” or role-player

• Check all equipment is in working order at each station

• Raise any concerns with a member of staff

MOCK OSCE EXAMINER GUIDANCE TIMINGS AND WARNINGS • 3 blasts of an electronic ‘car horn’ will indicate the start

of each station • A single electronic ‘bell’ will sound after 5 minutes to

indicate there is 1 minute of assessment time remaining • A double ‘bell’ will sound after 6 minutes to indicate the

end of the assessment period and the start of 2 minutes of feedback

• 3 blasts of an electronic ‘car horn’ (the same sound as the start of the station) will indicate the end of the station

• 60 seconds before next station starts (preparation time) • Cycle is then repeated for each station

MOCK OSCE EXAMINER GUIDANCE • Candidates must be allowed to read the written instructions for each

station to avoid misinterpretation

• Do not give verbal instruction as they can be misinterpreted

• If a candidate fails to wash their hands prompt them to do so, however, do not prompt or give hints or tips to the candidate in any other way

• In some stations you are required to ask the candidate a question(s), to summarise their findings. This should be done within the 6 minutes of examination (i.e. before the 2 minutes of feedback)

• Any question(s) to be asked will be provided on the mark sheets (indicative answers are provided but please use your discretion)

• Allow candidates to move to the next station promptly after the ‘end signal’ if a candidate finishes early they should remain in the station

MOCK OSCE EXAMINER GUIDANCE EXAMINER’S MUST.. • Not be interrupted

• no phones or bleeps

• Be able to stay and complete entire circuit • to avoid problems with examiner variability

• Remain at the station throughout • if a problem arises attract the attention of the examination organiser

MOCK OSCE EXAMINER GUIDANCE MARKING SHEET • Candidates will bring an orange envelope with them to the station

containing all their mark sheets.

• Extract the correct mark sheet for your station and ensure you have the correct candidate

• Complete the mark sheet in pencil only by putting a line through the box to the right of the appropriate score

• Ensure the correct space is filled in; do not mark in shaded areas and that you mark every item.

• If a candidate gains no credit please indicated 0 on mark sheet • if a change is made please ensure your intentions are clear

• Please keep to the marking schedule even if you disagree with it!!

MOCK OSCE EXAMINER GUIDANCE MARKING SHEET CONT. • You should give an overall impression of the candidate’s

global performance independent of numerical score EX = excellent, CP = clear pass, BP = bare pass, BF = bare

fail, CF = clear fail

• This global mark does not count towards a student’s score but is used for setting the pass threshold for the station

• Grading mark sheets for the first few candidates can be difficult – you may wish to review their sheets after the session is complete

• Retain mark sheets at the station when candidate moves on - these will be collected after the morning and afternoon sessions

MOCK OSCE EXAMINER GUIDANCE MARKING SHEET CONT. – Professional Behaviour • We have the yellow card system. Yellow cards allow you to provide

detail of any professionalism issue

YELLOW CARDS

• Semi structured form to be used when required • not expected to complete one for every student

• Must only be completed if you think the candidate’s appearance, conduct or professionalism was inappropriate

• Do not give these to candidates. They should remain with the marking sheets for collection

• Please also bring any concerns to the attention of staff • any concerns will be followed up

CHECKLIST OR GLOBAL RATING • Checklists generally more appropriate when

there is an agreed set of steps/procedures • Yes/No • 0/1/2

• Global ratings require judgement

• 0-1-2-3-4 • relates to ‘construct’ or grouping of items

• Overall judgement

• Excellent, Clear pass, Bare pass, Bare fail, Clear fail

OVERALL GLOBAL RATING • Overall global rating

• EX = excellent, CP = clear pass, BP = bare pass, BF = bare fail, CF = clear fail

• What do we mean by ‘fluency’? 1. Smooth, easy flow, esp in speech or writing; 2. “A ready command of words or of a specified foreign

language” (Concise Oxford 9th Ed.)

• The impression that the candidate knows what they’re doing and has done it before, and actually does it well on the day

Station Specific Briefing………

Examples:

On the day………

EQUIPMENT LIST