OSCE Examining Skills

Clare McGovern

Training to be an OSCE

examiner http://www.mms.manchester.ac.uk/prime/

For new examiners:-

“How to be an OSCE Examiner for New

Examiners”

Update- every three years:-

“Check you are doing it right- OSCE

examining for current examiners”

The Manchester Curriculum

Phase 1 (Y1+2) Laying foundations

Essential Skills – Sem 1

Life cycle (including ECE) – Sem 1

Cardio/Resp (including ECE) - Sem 2

Mind and Movement – Sem 3

Nutrition & Metabolism - Sem 4

Phase 2 (Yr 3+4) Developing clinical

competence

Yr 4

Mind and Movement OSCE

Families & Children OSCE

Yr 3

Heart, Lungs & Blood OSCE

Nutrition, Metabolism & Excretion OSCE

Phase 3

Yr 5 Consolidation - preparation for

practice

OSCE

Foundation years - Starting a career Dr

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What is an OSCE?

Objective

Structured

Clinical

Examination

How does an OSCE work?

all

Why use OSCEs?

Why use OSCEs?

Traditional Exams

• Unreliable

• Poor sampling across

curriculum

• No formal marking

scheme, and no

standardisation

• Not observed taking

histories, or very

much at all!

OSCEs

• More reliable

• Broad sampling

• Structured marking

schemes

• Observation of

students performing

focussed task

• (always part of a

composite

assessment)

How does an OSCE work?

• 8/16 OSCE stations per exam

• 1 examiner per station- plus simulated

patient/real patient/simulated

staff/volunteer

• equipment

• Instructions to candidate outside station

• 1 minute for candidate to read these

• 8 minutes within the station to complete

task

What skills do OSCEs test?

• History taking/presentation

• Examination skills/presentation

• Communication skills/with patients/staff

• Practical procedures

• Above skills combined with others e.g. interpretation of images/data, dealing with ethical dilemmas, writing prescription charts

• and attitude!

OSCE Blueprint

COMPETENCES

Subject Area History

taking

Physical

examination

Explanation

and planning

Prescribing Procedural

skills

Communication

skills

CVS

x x Resp

x Mind

x GIT

Endocrine/

metabolic x Haem

x Movement

x x

Key practical points for

examiners

Prior to the start of the OSCE

• Check that all the necessary material is

available at the station

• Familiarise yourself with the content of the

station- the Script- e.g. simulated patient’s

story, relevant clinical information

• Familiarise yourself with the marking sheet

Prior to the start of the OSCE

• If your station contains patients or

simulated patients, check their story or

clinical signs

• If your station uses equipment, check it is

all present and correct.

• Attend local examiner briefing

During the OSCE

• Students read the instructions outside

the station

• When they come in:

– Confirm their identity

– Let them start immediately

– Do not delay them by reading the

instructions (instructions are inside also)

• The student should leave when the bell

goes

During the OSCE

• Follow the procedure set out in the station

description

• Mark the students against the marking

guidance given

• Include some written feedback (e.g. one

thing the candidate could have done to

improve their performance)

• DO NOT show the candidate his/her mark

Marking the OSCE

• The mark sheet

• Some recent changes

The new marking domains (or

components of the skill) • Overall conduct of the

consultation

• History taking skills

• Physical examination

skills

• Mental state

examination skills

• Data interpretation

• Clinical knowledge

• Prescribing

• Management planning

• Practical procedure

• Ethics

• Providing information

to the examiner

• Sharing information

• Non-verbal

communication

• Clinical knowledge

and diagnosis

Why use standard marking

domains? • Clarity / familiarity

• Ability to chart progression

• Standardization across stations

• Improved feedback

How does this effect

examiners? • Marking schemes do not have station

specific information (this is in the script)

• You need to use the clinical information to

guide your judgement

• Benefit - familiarity over time

• (Better questions…)

What is the pass mark?

• Mark scale 1 to 7

• 4 pass

• Global mark is important- why?

• Additional criteria to pass..

• No killer stations

Common pitfalls

• There is no marking checklist- relying on

examiner’s judgement to mark candidate

• Judge at the correct standard- use script

to guide this

• Ask only the additional questions in script

• Do not teach or give feedback

• Real patients!

Current OSCE Examiners

What issues do you face?

Thank you!

OSCE group welcome those who would like to

become involved in question writing

mcgovern.clare@gmail.com