Wednesday, May 19, 2010

Bluebells and OSCEs

The May flowers are out: there's blossom on the trees: the sun is shining: so what does this mean?

It meant, this morning, as at about this time in every year recently, I've been walking through the bluebell woods on the way to Chapel Allerton Hospital for the University of Leeds Medical School 5th Year OSCE.

OSCE (which is always pronounced as a word, Oskey) is Objective Structured Clinical Examination. The Wikipedia entry which I've linked to, above, gives a good explanation of it, but a brief explanation is that each student goes round a number of "stations" and in each they are given a task to do - taking blood pressure, interviewing a patient with a particular problem - that kind of thing. Some of the patients are real ones - others are simulated patients, and that's what I am.

A simulated patient is somebody playing the role of a patient with a particular condition or problem. As there are so many student doctors, most universities run identical OSCEs at the same time on different sites, so there'll be several simulated patients all trained and standardised in the same role, working in different places.

Doctors train for five years, so this exam is their final exam before they qualify. Unlike with other degrees where there are different grades, doctors only get Pass or Fail - - someone once told me this is because nobody wants a third-class doctor!

I know that, since I started working as a simulated patient in 1985, I have worked on at least a hundred OSCEs. These few weeks are OSCE season - other year groups apart from the final years have them too - and I'm working on OSCEs in Leeds, Manchester and Hull.

As a simulated patient, working on an OSCE, you see lots of patients, one after the other. Today it was twenty-seven, in three "cycles" of nine patients each, and each had eight minutes. That doesn't sound very long but actually it's amazing how much a good student can do in that time. On other OSCEs though, I have seen far more students than this - my record is seventy-two in one day!

There is an examiner in the room who marks the student, and who has a mark sheet listing what to look out for. The simulated patient usually gives a mark too, assessing empathy and communication skills.

It's crucial, of course, to give each student the same opportunity and hence to keep the way that I play the role the same. Though, of course, how I behave after the beginning will depend on how good the student's communication skills are. It requires a lot of concentration, I know - but I think that giving each student the same chance is one of my strengths - I hope!

So - - what has changed since 1985?

Two things strike me every year. The students are getting better and better, perhaps because there is now a lot more emphasis on talking to patients in their course.

The other thing is that the examiners - many of them consultants - are far more friendly and approachable than they used to be. The three with whom I worked today were lovely: incredibly highly skilled with tremendous responsibility in their work but with none of that "superior" manner that they frequently used to have.

So the improved communication skills are now working their way right to the top! In the early days examiners often used to treat me as a kind of audiovisual aid - they certainly didn't treat me as a person!

OSCE days are long, and tiring, and simulated patients have to work hard. But when the students are good, and you know they're the doctors of the future - well, it's really rewarding work that feels so very worthwhile. I love it.


Anonymous Anonymous said...

You and your fellow 'patients' are to be loudly applauded for doing this.

10:15 pm  
Blogger rhymeswithplague said...

Sounds fascinating!

When you see a doctor for a real reason in real life, do you fall into role-play as well? I'm just wondering....

My verification word is confu, which, with the addition of the letters sed, is what I am most of the time.

2:24 pm  
Blogger Kim said...

I am actually doing this at the moment as a simulated patient (although I get called a healthy volunteer) its quite fun :)

11:16 pm  

Post a Comment

<< Home