OSCEs From The Other Side

This is the second time I've written this entire post, stupid blogger autosave GRRRRR! (anyone who knows where the setting is to turn off word verification for posts will win lots of appreciation)

If you read my last post you'll know that today I volunteered as a patient at the 3rd year OSCEs. I've done this a few times now and its really interesting to see the way things work from the other side.

A new undergraduate centre has just been built at our hospital and by 'just been built' I mean its not actually finished yet. Despite that, for some reason someone decided that the OSCEs would be held in the new skills lab. I arrived early this morning to find the entrance covered in scaffolding, machinery and debris all around the building and a number of workmen sat doing not very much at all - perhaps that is why it wasn't finished yet. The building isn't officially open yet but today went ahead as planned, fortunately they'd just about finished the new skills lab but I swear to god they must have been working until about midnight last night. I arrived early and had a wander round the new building which is much larger than the old (but relatively new itself) one. The new skills lab is huge which is good, but many of the seminar rooms are rather small and won't be much use for group work. Someone with the eyesight of mole obviously picked the carpet, it is absolutely vile, the whole building is covered in these very odd looking carpet tiles which must have been acquired on the cheap from some dodgy bloke down the market as most of them don't even match.

Anyway, enough of that, onto the exam itself. My station was something like this "Please examine this patient for enlarged kidneys. He presented with abdominal pain and weight loss." So it was basically a focused abdominal examination concentrating on the kidneys. This seemed to throw many of the third years who were expecting to have to do a full abdominal examination. I'd forgotten just how young and fresh (that sounds wrong) the 3rd years are, they're all fresh out of pre-clinicals and all so gentle (well, almost all). So I spent the morning with my top off being prodded and poked all over the place. Oh, and it was bloody freezing in this new building, they've obviously not bothered to install the heating yet!

The difference between students was quite remarkable, there were some who were excellent, some who were awful and many in between. There were 3 who stood out, and they were well above the rest, interestingly they were from the same base hospital and my observations were that this hospitals students were significantly better than the others. The better students are easily identified even before they've introduced themselves. The reason for this, and the key to being successful at OSCEs is confidence, or even false confidence. If you approach each station confidently then you can do pretty much anything and still get a good mark. Of course there is a line, which if crossed puts you in the arrogant category, and then you're in trouble right from the start. You don't have to have exceptional knowledge to do well in an OSCE, its much more about confidence and even more about ticking the examiners own requirements.

Because it was really cold, the 30 or so students who examined me today all had freezing cold hands, which was just a tad annoying. Worse than that, having 30 people poke or ballot your kidneys is rather uncomfortable, by the end I swear both of my kidneys were probably enlarged. Some of them didn't actually know where or how to feel the kidneys, and on more than one occasion it was quite painful. In one case I actually winced involuntarily which the examiner noticed, this meant that the person in question failed the station, although to be honest, they were not very good anyway. Thankfully most people didn't bother to palpate my bladder, otherwise i'd have spent the entire time needing to wee. Consultants always say that it is obvious who has actually examined real patients and I always thought that was an exaggeration but today you really could see those who'd examined patients and those who didn't know their kidneys from their ribs. Some of them decided that I did indeed have enlarged kidneys, quite where they got that idea from I don't know.

I once again saw just how objective the OSCEs can be but I don't suppose there is much that can be done about that. On one occasion I almost unconsciously tried to help one of the students by giving them hints (like nodding and shaking my head as they pondered the answers to some of the examiners questions.) I didn't mean to help anyone in particular and the examiner just laughed because he realised it was an accident.

Anyway, it was once again fun, interesting and useful experience. I don't know if I'll get another chance to do it before finals, if not, next time it'll be me. shitters.