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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
as
Scie
ntis
t an
d Sc
hola
r
Dr a
s Pr
actit
ione
r
Dr a
s Pr
ofes
sion
al
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
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