Stage III Foundations of Clinical Practise Objective Structured Clinical Examination Examiner Briefing

Objective structured examination Thank you for helping Objective structured examination eliminate observer bias common marking scheme Previously circulated guidance notes to all examiners contain detailed information about OSCE - if any questions please ask

Exam content Designed to reflect learning outcomes At this stage of the students’ education, assessment of process is as important as an assessment of their ability in diagnosis or practical management Assesses skills: History taking Physical examination Practical procedures

Please note There may be students who have been taught to use sterile gloves and sterile field - if students ask for this, please instruct them that for the purpose of the exam they can assume that the gloves/field are sterile.

Exam process Circuit comprises 10 stations Running in 8 centres simultaneously (inc. NUMed) need to minimise variability between circuits and sites Each station lasts 7 minutes warning 1 minute from end candidate must be released promptly marking schedule must be adhered to if you disagree with the schedule, make comments on the feedback sheet 30 seconds between stations to allow students to move on and examiners to complete marking

Exam process Meet your patient, volunteer or role player Examiners are advised to examine patients/volunteers prior to exam starting Check they have the same understanding as you as to what they are expected to do If using a mannequin ensure all equipment is working Ensure well-being of patient – any concerns review with centre organiser PLEASE MENTION STATION 1 catheterisation With regard to the documentation on clinical paper - as part of the patient safety strand of teaching which runs through the clinical years now the students should be documenting that a catheter has been inserted. You should consider whether the documentation is appropriate under the generic skills mark scheme An element of this station is to assess how the student works with a professional colleague and the instructions they give. I would suggest that your helper sets out the sterile field and has the bag open, but doesn’t provide the catheter etc until asked for by the student

Exam process Candidates must read instructions at each station Please do not give verbal instruction as they can be misinterpreted If the candidate fails to wash their hands please prompt them to do so, however, do not prompt the candidate in any other way At some stations you are required to ask the candidate question(s) (indicative answers are provided but please use your discretion) PLEASE MENTION RE HANDWASHING – if you have to prompt the student to wash your hands please use the feedback section of the professionalism form to document this (this scenario could come under the headings “acting without consideration”, “lack of focus of patient’s needs”, or “ other –and specify” – if all 10 examiners provide the same comment then this is a powerful message to the student! Slide 10 goes into more detail for this

Marking Student will bring an envelope with them containing all 10 marking sheets in the correct order Please complete in pencil by putting a line through the box to the RIGHT of the appropriate score Please mark your examiner number on each student’s mark sheet If the candidate gains no credit please indicate D on mark sheet if a change is made please ensure your intentions are clear Please keep to marking schedule even if you disagree with it!

Marking The mark sheet has two main sections, specific and generic skills. The level of competence will be that expected of an end of Stage 3 student This assessment is formative and the students will receive detailed feedback allowing them to improve through-out stage 3 Each micro skill should be graded on the scale A-B-C-D using the descriptor: A is awarded for a comprehensive and correctly executed assessment, B for an acceptable assessment with good technique and only minor errors or omissions, C would be borderline – several errors or poor technique and or omissions and D for a very poor attempt or not attempted Apologies for the amount of text on this slide! Please highlight that we are assessing students as though they were at the end of stage 3 – this is new for 2013

Marking You should also give an overall impression of candidate’s global performance independent of numerical score The range of grades to be awarded include: Excellent Clear Pass Borderline Pass Borderline Fail Clear Fail This global mark does not count towards a student’s station score, but is used to establish the ‘pass mark’ for the station Retain marking schedule at the station when candidate moves on

Marking Grading the first few candidates in the first circuit can be difficult – feel free to review their marking schedules when the circuit is complete

External examiner There may be an external examiner watching the FOCP exam at your site today There may also be an Observer present to observe roleplayers They are there to assess how we deliver the FOCP exam and are not there to grade the candidates

Professionalism You should indicate whether the ‘patient’ would be happy for this candidate to treat someone they care about, AND that you are satisfied the candidate demonstrated professional behaviour throughout this clinical encounter by marking YES (Y) or NO (N) on the mark sheet provided.  If you have selected ‘NO’ you must use the yellow cards provided to mark the specific area(s) of concern and describe in the Feedback section what led to the concern. Please highlight the new Professionalism Assessment forms – some of your examiners may not be used to them. Please remind everyone that there are 2 assessment forms for each student –the marking schedule and the professionalism form

Even if you select YES (Y) you can record lower grade concerns on the yellow form which will be provided as feedback to help candidates to improve their performance.   Please refrain from using the professionalism yellow cards for commenting on a candidate’s clinical and/or communication skills.  If you wish to feedback on a candidate’s clinical performance, please use the reverse of the mark sheet.

Professionalism will be assessed at every station

Examiner responsibilities Please switch off electronic devices (Phones, bleeps) Must be able to stay to complete the entire circuit (may give problems with examiner variability otherwise) Please remain at station throughout – if problem attract attention of centre organiser Demands high level of concentration – can be difficult to maintain in later circuits Please ensure adequate view obtained of student’s actions at each station

Examiner responsibilities The candidate will have had 1 minute outside each station to prepare, but you should also allow them to read the written instructions within each station, if required, to avoid misinterpretation Allow candidate to move on promptly after the bell/buzzer If candidate finishes early they should stay at station Do not prompt the candidate or give hints or tips Feedback or comments on performance should not be given during the exam e.g. ‘you’ve just killed the patient’ or ‘would you really do that?’

Remember The level of competence will be that expected of an end of Stage 3 student Detailed feedback will be provided to help plan learning throughout the year There may be students who have been taught to use sterile gloves and sterile field - if students ask for this, please instruct them that for the purpose of the exam they can assume that the gloves/field are sterile.

Feedback Important to learn from each circuit Comments appreciated (both positive and negative) Feedback sheet provided return to centre organiser Thank you for your help!!!

Thank You