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Not to be redistributed or modified in any way without permission.
SUCCEED in OSCEs and
SUCCEED in

SUCCEED in OSCEs and PRACTICAL EXAMS
PRACTICAL EXAMS
An Essential Guide for Nurses
“This is a good companion to students who may be
overwhelmed by the idea of having to take part in an OSCE.
This book provides a fresh view on OSCEs and will be of
OSCEs and
great assistance to tutors about to embark on their use as an
assessment strategy in nursing education, but more
importantly, it is an essential guide for students.”
GUILLAUME ALINIER, NTF, SFHEA, SCHOOL OF POSTGRADUATE MEDICINE,
PRACTICAL
EXAMS
UNIVERSITY OF HERTFORDSHIRE, HATFIELD, UK

NEED HELP TO PREPARE AND SUCCEED IN YOUR
OSCE OR PRACTICAL EXAM?
OSCEs or practical exams are intended to challenge you both personally
and professionally, whilst testing your competence with the key clinical
skills that nurses need to demonstrate to be effective in practice.
This book is designed to be the ultimate companion to help you fly through
OSCEs with ease. It covers:
An Essential Guide for Nurses
• What OSCEs involve and how to prepare for them
• The most common types of OSCE scenarios
• What examiners are looking for
• How to develop your own clinical simulation learning style
• How to learn from your OSCEs
• How reflection can help give you greater understanding of your
clinical simulation practice MERRIMAN & WESTCOTT
The book includes examples of OSCEs for you to work through, inspiring
quotes and plenty of top tips to help you tackle your OSCEs with
confidence!
Succeed in OSCEs and Practical Exams is indispensable reading for nursing
students taking all courses that involve OSCEs or practical exams –
including diplomas, degrees and short CPD courses.

Clair Merriman is the Head of Professional Practice Skills in the School of
Health and Social Care at Oxford Brookes University, UK.
Liz Westcott is Director of
Pre Qualifying Learning and
Development in the School of Health and
Social Care at Oxford Brookes University, UK.

Cover design Hybert Design • www.hybertdesign.com
www.openup.co.uk
CLAIR MERRIMAN & LIZ WESTCOTT

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Succeed in OSCEs and Practical Exams

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62. Copyright © McGraw-Hill Global Education Holdings. Chiangmai University 5. LLC.86] at [07/18/16]. 10 20 30 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 Succeed in OSCEs and Practical Exams: An Essential Guide for Nurses Clair Merriman and Liz Westcott Open University Press . Not to be redistributed or modified in any way without permission.156. 40R Downloaded by [ Faculty of Nursing.

1 Open University Press 2 McGraw-Hill Education 3 McGraw-Hill House 4 Shoppenhangers Road 5 Maidenhead 6 Berkshire 7 England 8 SL6 2QL 9 10 email: enquiries@openup. Glasgow 5 6 Fictitious names of companies. Except for the quotation of short passages for the 8 purposes of criticism and review. characters and/or data that 7 may be used herein (in case studies or in examples) are not intended to 8 represent any real individual. product or event. USA 3 4 First published 2010 5 6 Copyright © Merriman and Westcott 2010 7 All rights reserved. Suffolk 4 Printed in the UK by Bell & Bain Ltd. New York. in any form or by 20 any means.uk 2 and Two Penn Plaza.156. 6–10 Kirby Street.co.openup.co.62. or transmitted. Chiangmai University 5. stored in a retrieval system. photocopying. London. Copyright © McGraw-Hill Global Education Holdings. no part of this publication may be 9 reproduced. 1 without the prior written permission of the publisher or a licence from the 2 Copyright Licensing Agency Limited. EC1N 8TS. NY 10121-2289. Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission. Details of such licences (for 3 reprographic reproduction) may be obtained from the Copyright Licensing 4 Agency Ltd of Saffron House. recording or otherwise. mechanical. LLC. products.86] at [07/18/16]. 5 6 A catalogue record of this book is available from the British Library 7 8 ISBN-13: 978-0-33-523734-0 9 ISBN-10: 0335237347 30 1 Library of Congress Cataloging-in-Publication Data 2 CIP data applied for 3 Typeset by RefineCatch Limited. Bungay. company. electronic.uk 1 world wide web: www. 9 40R . people.

5 mary chapter. 1 2 3 4 5 6 Praise for this book 7 8 9 10 1 “Clair Merriman and Liz Westcott have written this book so it feels like a com. and when one receives their feedback about their 3 performance to correct their practice in the future. Downloaded by [ Faculty of Nursing. but 5 to students from any discipline taking part in assessed practical sessions.62. SFHEA. This book gives just the right emphasis on reflection about the OSCE 2 experience once it is finished. Not to be redistributed or modified in any way without permission. it is an essential guide for students. Hatfield.86] at [07/18/16].” 8 9 Guillaume Alinier. but it also includes some 20 valuable tips to be well prepared for the day as well as some detailed example of 1 stations. Copyright © McGraw-Hill Global Education Holdings. It 4 is a mine of information that is not only applicable to nursing students. even 6 beyond healthcare from my experience in engineering education. LLC. UK 1 2 3 4 5 6 7 8 9 40R . This book provides a fresh view on OSCEs and will be of great 6 assistance to tutors about to embark on their use as an assessment strategy in 7 nursing education. 30 University of Hertfordshire. different OSCE formats and elements they may contain 9 such as patient simulators and simulated patients. 2 panion to students who may be overwhelmed by the idea of having to take 3 part in an OSCE. but more importantly. The structure 7 of the book makes it easy to read and very informative as it covers aspects such 8 as learning theories.156. or being assessed through a simulated practice exercise. Chiangmai University 5. The framed key sentences 4 throughout this book are very pertinent and perfectly complemented by a sum. School of Postgraduate Medicine. NTF.

Chiangmai University 5. LLC.156. Copyright © McGraw-Hill Global Education Holdings. 40R 10 20 30 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 .62.Downloaded by [ Faculty of Nursing.86] at [07/18/16]. Not to be redistributed or modified in any way without permission.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 9 How to use this book . . . . . . . . . 21 9 The simulated learning environment. . . . . . xiii 7 8 1 Introducing OSCEs and the book . . . . . . . . . . . . . . . Not to be redistributed or modified in any way without permission. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156. . . . . . . . . 30 7 Acquisition of skills. . . . . . . . . . . . 1 2 3 4 5 6 Contents 7 8 9 10 1 2 List of tables. . . . . . . . . . . 23 1 What is simulation? . . x 3 4 About the authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 30 Communication skills. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 5 Chapter summary . . . .62. 2 1 Use of simulated learning in nursing courses. . . . . . . . LLC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 4 How does simulation fit into student learning?. . . . . . . . . . . . . . . . . Copyright © McGraw-Hill Global Education Holdings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 8 What is an OSCE? . . . . . . . . . . . . . . . . . . . . . 4 3 Overview of chapters . . . 4 4 How to start . . . 28 5 NMC role in simulated learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Downloaded by [ Faculty of Nursing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Introduction . . Chiangmai University 5. . . . diagrams and photographs . . . . . . . . . . . . . . . . . . .86] at [07/18/16]. . . . . . . . . . 24 3 Experiential learning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 40R . . . . . . . . . . . . . . . . . . . . . . . 36 9 Why use an OSCE? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 6 Advantages of OSCEs . . . . . . . . . . 2 20 Essential skills clusters (ESCs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 Use of terminology . 23 2 Simulation practical consent form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xii 5 6 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 6 7 2 Understanding OSCEs: what you need 8 to know . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 2 Chapter summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 2 Unfairness or discrimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Types of simulated client/model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 7 Advice for students with disabilities including dyslexia and 8 other specific learning difficulties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 2 The importance of exercise. . . . . . . . . . Chiangmai University 5. . . . . . . . . . . . . . . 91 1 Professional skills . . . . . 105 4 Reducing OSCE nerves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 3 Ten simple steps to success . . . . . . . . . . . . . . . . . . . . . . . . 81 9 The examiners’ role and quality assurance . . . . . . . . . 40 3 4 3 Preparing for your OSCE: getting the most 5 out of your learning . . . . . . . . . . . . . . . . . . . Downloaded by [ Faculty of Nursing. . . 69 5 The layout of the room. viii CONTENTS 1 Types of assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 6 Equipment used . . . . . . . . . . . . . . . . . . . . . . 87 20 Your role-behaviour and performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 3 Chapter summary . . 109 5 How to perform well in your OSCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 2 Chapter summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 7 Prior preparation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 4 5 5 Preparing for your OSCE: before and on 6 the day . . . . . . 102 1 Hydration: why you need to keep drinking! . . . . . . 44 9 Information you will receive prior to your OSCE . . . . . . . . . . . 95 8 Stress and your ability to manage it . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Copyright © McGraw-Hill Global Education Holdings. .62. . . . . . . . 48 1 Sample OSCE information sheet . . . . . . . . . . . . . . . 81 8 Types of OSCE . . . .156. . . . . . . . Not to be redistributed or modified in any way without permission. . . . . . . . . . . . . . . . . . . . . . . . 72 7 Computer/web-based OSCEs . . . . . . . 101 30 Nutrition and feeding your brain . . . . . . . . . . . . . . . . . . . 68 3 4 4 What to expect from your OSCE . . . . . . . . . . . . . 110 6 Chapter summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 10 Pre-reading . . . . . . . . . . . . . 113 7 8 9 40R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 6 Understanding your own learning style. . . . . . . . . . . . . . . . . . . . . . . . . . 97 9 How environmental factors will affect you . . . . . . . . . . . . . . . . . . . . . . . . . .86] at [07/18/16]. . . . . . . . . . . LLC. . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . 158 20 How you can contribute to evaluation. . . . . . . . . . . . . 144 1 2 7 After the OSCE has finished . . . .62. . . . . . . . . . . . . . 162 2 3 8 Summary . . . . . . . . . . 1 medicines management and aseptic 2 3 non-touch technique . . . 164 5 3 Preparing for your OSCE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Copyright © McGraw-Hill Global Education Holdings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Not to be redistributed or modified in any way without permission. . . . . . . . . . . . . . . . . . . .86] at [07/18/16]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Assessment marking criteria . . 127 9 OSCE example 3: aseptic non-touch technique . . . . . . . . . . 115 6 Other preparation aids . . . . . . . . . . . . . . . 138 10 Chapter summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Downloaded by [ Faculty of Nursing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 4 5 6 7 8 9 40R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 7 OSCE example 1: adult basic life support. . . . . . . . 157 8 How to reduce the gap between your actual and ideal 9 performance . . . . . . . . . . . . . . 114 4 OSCE examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 5 OSCE checklists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 5 Understanding the information you are given in feedback. . . . . . . . . . . . . . . Chiangmai University 5. . . . . . . . . . 164 6 4 What to expect from your OSCE . . . . . . . . . . . 154 6 How to get the most from dialogue with your tutors . . . . . . . . . . . . . . . . . . . . . . . 171 2 3 Index . . . . . . . . 146 4 How to develop your skills for reflection . . . . . . . . . . . . . . . . . . . . 166 8 6 Sample OSCEs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CONTENTS ix 6 Sample OSCEs: adult basic life support. . . . . . . . . . . . . . . . . . . . . 169 9 7 After the OSCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 1 Chapter summary . . . . . . . . . . . . . . . . LLC. . . . . . . . . . . 155 7 Your motivational beliefs and self-esteem . . . . 165 7 5 Preparing for your OSCE. . . . . . . 163 1 Introducing OSCEs . 145 3 How to identify a good performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 4 2 Understanding OSCEs. . 117 8 OSCE example 2: medicines management . . . . . . . . . . . . . . .156. . . . 169 30 1 References . . . . . . . . . . . . . . . . . . .

. .3 Assessment marking criteria . . . . . . . . . . . .156. . . . . . . . . . . . . . . . . . . . . . . . . Downloaded by [ Faculty of Nursing. . . . . 8 4 Table 1. . . . . . . .1 Example of how professional and communication 1 skills can be assessed as part of an OSCE even 2 when a psychomotor skill is the principal assessment. . . . . . . . . . . . . . . .1 Learning styles questionnaire. . 67 5 Diagram 4. . . . . . . . . . . . . . . . . . . diagrams and 9 10 photographs 1 2 3 Table 1. . . . . . . LLC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 Managing your day. optimal 8 stress and excessive stress and efficiency . . .1 Observation chart . . . .2 Possible reasonable adjustments . 131 7 Table 6.2 OSCE checklist for medicines management . . . . .86] at [07/18/16]. . . . . . .2 Reflection based on Borton’s (1970) framework . . . . . . . . . . . . . . .1 The relationship between under-stress. . . 135 8 Table 6. . . . .1 The conscious competence model and Benner’s 6 stages of clinical competence . . . .2 Blank self-assessment form. . . . . . . . . 153 2 Table 7. . 110 5 Table 6. . . . . . . 14 5 Table 2.4 OSCE checklist for principles of ANTT . . . 150 1 Table 7. . . . . . . . . Not to be redistributed or modified in any way without permission. . . . . . 43 8 Table 3. . . .62. 35 7 Table 3. . . . . . . . . . . . . . 101 4 Table 5. . . . . . . . 122 6 Table 6. . . . . . . . . . . .1 Adult basic life support OSCE checklist. . .1 Illustration of a calculation required in a 6 medicines management software package . . . . . . . . . . .3 Physiological measurement OSCE checklist . . . 82 7 Diagram 5. . . . . . 106 40R . . . . . . . . . . . . . . . . . 159 3 4 Diagram 3. . . . . . . . . . . . .2 Are you prepared for your OSCE? . 1 2 3 4 5 6 7 8 List of tables. . . . . . . . . . . . .1 Stages of the Gibbs cycle (adapted from Bulman 30 and Schutz 2008) . . . 47 9 Table 3. 59–66 20 Table 4. . . . . . . . 92 3 Table 5. .1 The physical and psychological effects of stress . . . Chiangmai University 5.3 Example of feedback from a hand-washing OSCE .1 Sample self-assessment form . . Copyright © McGraw-Hill Global Education Holdings. 99 9 Diagram 5. . . 140 9 Table 7. . . . . . . . . . . . . . . . . . . . . . .

. . . 149 3 Diagram 7. . 148 2 Diagram 7. . . . . . .1 Professional development triangle (adapted from 1 Jasper 2003). . . . . . Jasper 2003 and Bulman and Schutz 2008) . . . . . .86] at [07/18/16]. . Copyright © McGraw-Hill Global Education Holdings.156. . . . . .2 OSCE hand-washing development triangle. . . . . . . . DIAGRAMS AND PHOTOGRAPHS xi Diagram 7. . . . . . . . . . . . Downloaded by [ Faculty of Nursing. . . . . . . . . . . . . . . . . . . . . . . 70 7 Photograph 2 Taking a temperature reading. . . . . . . . . . . . . . . . 152 5 6 Photograph 1 Bed stations with curtains . . . . . LIST OF TABLES. . . . 71 8 Photograph 3 A task trainer arm for cannulation or venepuncture . . 78 9 Photograph 4 A basic manikin . . 79 10 Photograph 5 SimBaby – medium-fidelity simulator . . . 85 6 Photograph 9 An example of a video image . . . . . . . . . . . . . . . . . .3 The reflective cycle (adapted from Gibbs et al. .62. . . . . . . . . Chiangmai University 5. . . . . . . . . . . . . . . 84 4 Photograph 8 Video system: Example shows scotia medical 5 observation and training system (SMOTS). . . . . . . . . LLC. . . . . . 4 1988. . . . . . . . 80 1 Photograph 6 A medium-fidelity manikin . . . . . . . . . . . . 81 2 Photograph 7 ‘Resus Annie’ skills trainer for basic life 3 support assessment . . . . . . . . . . . . . . 90 7 8 9 20 1 2 3 4 5 6 7 8 9 30 1 2 3 4 5 6 7 8 9 40R . Not to be redistributed or modified in any way without permission. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Oxford Brookes University. Oxford Brookes Uni- 4 versity. learning and assessment 6 strategy for professional practice skills in the School. School of Health and Social Care. Liz has led many developments in the School of Health and Social Care 5 including the introduction of the nursing diplomas and foundation degrees.156. BSc.to 9 medium-fidelity simulation. RNT. RGN) is Director of Pre-qualifying Learn- 3 ing and Development. Dip Man. Clair has 5 developed. LLC. 1 2 3 4 5 6 7 8 About the authors 9 10 1 2 3 Clair Merriman (MSc. 6 She is the executive lead for professional practice skills. RGN) is the Head of Professional Practice 4 Skills. service users and practice staff in terms of teaching and learning 8 these skills. She ensures collaboration 7 with students. implemented and evaluated the teaching. 9 30 1 2 3 4 5 6 7 8 9 40R . Chiangmai University 5. 7 recruitment and admissions. Not to be redistributed or modified in any way without permission.62. Downloaded by [ Faculty of Nursing.86] at [07/18/16]. 1 2 Liz Westcott (MSc. practice education. Clair manages 11 skills suites across two sites which support low. School of Health and Social Care. Copyright © McGraw-Hill Global Education Holdings. as well as interprofessional learning and collabora- 8 tive practice. Dip HE. She has a national and international reputation for 20 her work in simulated settings and OSCEs.

Downloaded by [ Faculty of Nursing. Toby. our families. the checklists and marking criteria on which this book is 7 based. Irmgard and Kenny. Andrew. the many lecturers at Oxford Brookes University who have 6 developed the OSCEs. Alice and James.62. and Chris and Emma. 8 for their support. LLC. for their support and 5 understanding. Colleen. Not to be redistributed or modified in any way without permission.156. and our learning technologists.86] at [07/18/16]. Julia. 1 2 3 4 5 6 Acknowledgements 7 8 9 10 1 2 The authors would like to thank the following: Angela Harper and Chris 3 Bulman for their encouragement. 9 20 1 2 3 4 5 6 7 8 9 30 1 2 3 4 5 6 7 8 9 40R . Copyright © McGraw-Hill Global Education Holdings. Chiangmai University 5. support and critical reading. in 4 particular.

LLC.62.Downloaded by [ Faculty of Nursing.156. Copyright © McGraw-Hill Global Education Holdings.86] at [07/18/16]. Chiangmai University 5. 40R 10 20 30 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 . Not to be redistributed or modified in any way without permission.

1 Introducing OSCEs and 2 1 the book 3 4 5 6 7 8 Introduction 9 10 The secret of getting ahead is getting started. Copyright © McGraw-Hill Global Education Holdings. 20 Be aware of which order you will work through this book. 9 • a pre-registration nursing student. and aims to be a practical guide to help you plan and 9 succeed. You can now be reas. 2 3 Up to now you may have been anxious and even alarmed about under. 4 taking clinical skills teaching or simulated learning. as this book is designed to ensure that you are well equipped to succeed 7 in your OSCE or practical exam. The secret of getting started 1 is breaking your complex overwhelming tasks into small manageable 2 tasks. The book does not presume that you know 8 anything about OSCEs. and the prospect of an 5 OSCE or practical examination may have petrified you. LLC. 30 • undertaking continuing professional development (CPD) as a registered 1 nurse and have not taken an OCSE or practical examination before.62.86] at [07/18/16]. and then starting on the first one. 6 sured. 1 Feel a sense of purpose and control in your Objective Structured Clinical 2 Examination (OSCE) preparation. Chiangmai University 5. Not to be redistributed or modified in any way without permission. 3 4 5 This book is for you if you are: 6 7 • needing help to prepare and succeed in your Objective Structured Clinical 8 Examination (OSCE) or practical examination. 40R . Downloaded by [ Faculty of Nursing. 3 Mark Twain (1835–1910) 4 5 6 7 By the end of this chapter you will: 8 9 Be aware of what is on offer in this book.156.

We aim throughout this book 10 to help you to be an active participant in your learning so that you can feel a 1 sense of autonomy and independence in the process. however. Downloaded by [ Faculty of Nursing. There are useful 2 tips. The ESCs are UK-wide generic skills statements set out under the 40R following broad headings: . OSCEs may occur at various points in your course and they 9 will challenge you personally and professionally. and each 3 chapter concludes with a summary of the key points raised. 7 Each chapter. will make reference to the standards of profi- 8 ciency for pre-registration nursing education (NMC 2004) and essential skills 9 clusters (ESCs) (NMC 2007a. 2 OSCEs and practical examinations require you to be self-reliant. key points. examples and case studies throughout the book.86] at [07/18/16]. 6 • understanding how reflection can give you greater insight into your 7 practice. your studies will have challenged you 7 and required you to make changes to your behaviour and attitude during your 8 time at university. The ESCs were introduced by the NMC in September 8 2008 to ensure that students were proficient in the predetermined core require- 9 ments of care. LLC. Not to be redistributed or modified in any way without permission. These types of assessment are used to assess the 6 knowledge. Chiangmai University 5. it will only help if 5 you fully engage with the content. 30 1 2 Essential skills clusters (ESCs) 3 4 The Nursing and Midwifery Council (NMC) requires certain outcomes to be 5 achieved by the end of the first year. Copyright © McGraw-Hill Global Education Holdings. 8 • understanding how you can be empowered to improve your practice. 2007b). and certain proficiencies to be achieved at 6 the end of pre-registration training in order for you to gain your professional 7 nursing qualification.156. 2 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 How to use this book 2 3 In this book we are talking directly to you. Whether you are currently a student nurse 6 or a registered nurse undertaking CPD. where relevant. The book is aimed at helping you 4 succeed in your OSCE and practical examination.62. and this 3 book can be a partner in your journey into: 4 5 • understanding your own learning style. skills and attitudes that are required for safe and effective practice. 4 The book is aimed at preparing you for your OSCE or practical examination 5 as part of a nursing course. 9 20 Each chapter starts with the outcomes you can expect to achieve through 1 your reading. as well as what we hope is an inspiring quote.

Hilton and Pollard 2004. however. Not to be redistributed or modified in any way without permission.and post.156. The dominant assessment model used historically to assess 7 clinical competence was direct observation of clinical skills. there has been an increase in the use of 3 ‘skills laboratories’. 9 lated learning environment have become an accepted part of pre. more 8 recently the NMC (2004. Downloaded by [ Faculty of Nursing.62. The aim is to ensure 1 that when you qualify or complete a CPD course you are fit for purpose 2 and practice. 40R . INTRODUCING OSCEs AND THE BOOK 3 • Care. 4 OSCEs and practical examinations are a form of assessment which allows 5 you to demonstrate your skills. 2007c) has identified a greater need for joint respon. The teaching and assessment of clinical skills in a simu. simulated learning has become more commonplace due to 7 the reduction of practice placements and the increased pressures on the current 8 workforce (Hall 2006). 2005). learning disability and mental 8 health. LLC. Copyright © McGraw-Hill Global Education Holdings.86] at [07/18/16]. and is applicable 7 to all four branches of nursing: adult. Simulation allows you 6 to practise your skills and demonstrate your knowledge and attitude in a 7 safe and professional environment. 9 sibility for teaching and the assessment of clinical competence between the 20 higher education institution (HEI) and clinical practice. 6 In addition. Chiangmai University 5. At Oxford Brookes University we have used simulated learning to 2 develop clinical skills since 1990 and this approach has been heightened by the 3 introduction of ESCs by the NMC. Wilson 1 et al. This book will show you how you can 8 reflect on these experiences and gain the most from the feedback you are 9 given during them. children’s. it shifted 4 away from the apprenticeship model of training and a new type of course 5 was introduced where continuous assessment of theory and practice was 6 recommended. 9 10 1 Use of simulated learning in nursing courses 2 3 When nurse education moved into higher education (HE) in 1989. with the OSCE and/or practical examinations becoming 4 widely employed to contribute to the assessment of clinical competence 5 (NMC 2004. 2007c). As a result of this. 30 registration nursing courses (Chatterjee 2004. compassion and communication 1 • Organizational aspects of care 2 • Infection prevention and control 3 • Nutrition and fluid balance control 4 • Medicines management 5 6 Each of these broad themes is fundamental for best practice. knowledge and attitude.

takes you through 6 an OSCE and details the preparation you need to do before the exam. At each station.62. Copyright © McGraw-Hill Global Education Holdings. 20 Each station is constructed to assess a particular skill.156. We are aware that the OSCE may be new to you. identifying a diagnosis. occupational therapy. 6 The traditional OSCE consists of rotating students through a system of 7 stations simulating a clinical reality (Ross et al. An OSCE 7 is a method of simulating practice in a safe environment. ‘person’ or ‘carer’ as appropriate. 4 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 OSCEs and practical examinations are a form of assessment which allows 3 you to demonstrate your skills. LLC.86] at [07/18/16]. 8 Redfern et al. The term ‘manikin’ will be used 9 to denote mannequins. Disciplines such as dentistry. but can be replaced 8 with ‘client’. The construction and application of the OSCE process vary 5 in relation to the number of stations and the length of time allowed at each 6 station. task trainer and/or a written scenario. Formative and summative OSCEs are explored. The skills performed are assessed 3 against a pre-established detailed checklist developed by a panel of clinical/ 4 education experts. depending on the learning outcomes and objectives being assessed. 2 Harden and Gleeson first introduced the OSCE into medical education in 3 Scotland in 1975 (Carraccio and Englander 2000). knowledge and attitude. 1988. physiotherapy. and so here we 1 provide a simple definition and brief history of this examination. 2002). Downloaded by [ Faculty of Nursing. the student must perform a particular skill 9 using a standardized patient. manikin. Chiangmai University 5. mannikins or dummies – are all terms used to describe 30 life-sized training models. therefore we will 8 explore what a simulated learning environment is and the types of equipment 9 that may be utilized. 4 chiropody. ‘Understanding OSCEs: what you need to know’. radiation therapy and more 5 recently nursing also use OSCEs as a method of assessment. decision-making. client education 2 or the performance of a technical procedure. Not to be redistributed or modified in any way without permission. such as history-taking. Nicol and Freeth 1998. 4 5 6 7 Use of terminology 8 9 The term ‘OSCE’ from this point on will be deemed to include practical exami- 10 nations. 7 The term ‘patient’ will be used throughout this book. 1 physical assessment. Guidance is given . 1 2 3 Overview of chapters 4 5 Chapter 2. including 40R the differences between them and what is expected in both.

which will help you achieve better results in the long term. 4 • members of the public. what to do if the fire alarm goes off or if 7 unsafe practice is observed during your OSCE. ‘manikin 5 alone’. Chiangmai University 5. 1 graphic examples. 8 ing the type of support available if you have a disability such as dyslexia or 9 other specific learning difficulties. and how to find key texts that will inform your knowledge and 1 skills related to the OSCE. as well as the 7 varying approaches you will need to adopt to succeed in them. Downloaded by [ Faculty of Nursing.62. roaming 4 moderators. 8 • computers. ‘observed computer-assisted’.86] at [07/18/16]. possible timings of 7 OSCEs. 5 • practice staff. Finally. for example. 3 • actors.156. or 10 reduced mobility. The chapter 8 goes on to explain what you can expect from the following types of simulated 9 patient and the differences between them. ‘Preparing for your OSCE: before and on the day’. marking criteria and checklists. in addition to the varying approaches 20 you will need to adopt: 1 2 • peers. Examiners’ behaviours. patients and peers. For example. for example. We will explore what you 6 can expect from each type and the differences between them. 3 roles and quality assurance options will also be discussed. INTRODUCING OSCEs AND THE BOOK 5 on pre-reading. both adults and children. 9 30 You will read about the layout of a typical examination room and see photo. ‘computer only’. LLC. ‘manikin plus observed’. The chapter will also help you to assess your own learning 1 style. 6 • manikins. 2 Chapter 4. ‘Preparing for your OSCE: getting the most out of your learning’. It contains useful advice for 40R . 7 • task trainers. The chapter includes a section concern. 2 Chapter 3. 3 will help you to understand what you need to do in order to be successful in 4 your OSCE. The different types of examiner will be discussed. we look at how to main. concerns what your OSCE will 3 require. ‘videoing’. Copyright © McGraw-Hill Global Education Holdings. such as a sight or hearing impairment. academics. 8 Chapter 5. There are many types of OSCE examination: ‘simulated patient plus 4 observed’. simulated patients and examiners through. The written information from academic staff will be discussed so 5 that you will understand what information you should expect to receive to 6 inform you about the process of the OSCE. practitioners. cameras and external examiners. 5 tain health and safety for yourself. for ex. and ‘oral/viva’. will help to 9 ensure that you are fully prepared for your exam. 2 ample. Not to be redistributed or modified in any way without permission. ‘What to expect from your OSCE’. 6 out the examination.

medicines management 1 and aseptic non-touch technique’. 30 The chapter discusses your relationship with other examined students. 8 • how to regroup if you go wrong. and demonstrate that stress can be 3 successfully managed. Not to be redistributed or modified in any way without permission. 2 Chapter 8. LLC. provides a résumé of the chapter content. An anno- 5 tated checklist for each station is provided to show you what the examiner is 6 looking for. ‘Summary’. tips and 3 key points. 7 Chapter 7. 8 • how to relate to the simulated patient or manikin. 9 20 Chapter 6. during and after the 7 OSCE. 7 • relaxing. Chiangmai University 5. We will look at when to arrive. 9 • what to do if you feel unwell. This will act as a quick reference guide when you need to revise your 4 knowledge and understanding of OSCEs once you have read this book. 5 • improving your memory. each checklist and the marking criteria and use this 4 information to help prepare for. 6 • considering the questions you may be asked before. 5 6 7 How to start 8 9 Now that you are aware of what is on offer in this book. and therefore succeed in. Downloaded by [ Faculty of Nursing. The chapter demonstrates how you can 3 break down each station. you can decide in what 40R order you will work through it. 6 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 calming your nerves and we will explain the physiology of stress to highlight that 2 it is normal to feel this way prior to an OSCE. We will also consider: 5 6 • freezing–unfreezing. time-keeping and manage- 4 ment of travel arrangements as well as what to wear. 10 1 The chapter then examines the following strategies to improve your success 2 rate: 3 4 • thinking carefully.86] at [07/18/16].156. ‘Sample OSCEs: adult basic life support. along 1 with what to do if you are referred – or fail – and how to prepare for next time. You may already have some experience of . ‘After the OSCE has finished’. talks about the post-OSCE process 8 and discusses debriefing using feedback and reflection on your experience. The 9 process of reflection is explained as are examples of various reflective models. provides examples of OSCE stations that 2 you may encounter during your course.62. your OSCE. Copyright © McGraw-Hill Global Education Holdings.

10 Dick (2006) have also identified that well-organized self-assessment can result 1 in real benefits in learning and achievement of goals. Chiangmai University 5. etc. In order to assist you in preparing for your OSCE in a timely 2 manner we recommend that you complete the following self-assessment 3 before continuing with this book. it is worth taking the time to practise. 30 When filling in the form. 5 • Attitude: for this part use statements such as: ‘I can respond appropriately’. the easier the process will become. 2 3 4 As with many new techniques. 6 7 8 Once you have completed the self-assessment for each chapter. in italics. or you may have no prior 1 experience. You may like to revisit it once you have completed 9 the book to see how much you have developed your practice. As with many new 8 techniques. This will give you a sense of 3 purpose and control and you will begin the process of becoming a self-reliant 4 and autonomous practitioner and learner. and the more times you 9 evaluate your practice. Table 1. 6 Self-assessment is a useful skill to master as it will enable you to develop the 7 ability to examine and think critically about your practice. and the 5 more times you evaluate your practice.2 is a blank self-assess. 6 ‘act professionally’. describe.156. Copyright © McGraw-Hill Global Education Holdings. of how you might respond.1 as a basis for your self. Not to be redistributed or modified in any way without permission. Nicol and Macfarlane. 7 8 9 40R . 6 assessment. Downloaded by [ Faculty of Nursing. You now need to set 2 aside realistic times to work through each chapter. 4 list. 8 ment form for you to fill in. etc. The chapter with the shortest list is obviously a priority and will 1 take you more time than the chapter with the longest list. ‘recognize the importance of’.86] at [07/18/16]. LLC. review your 9 work and then try to prioritize the time you need to spend working through 20 each chapter. it is worth taking the time to practise. We have put in the main content from each chapter and some 7 examples. INTRODUCING OSCEs AND THE BOOK 7 OSCEs. identify’. think about the type of statements that should be 1 used in relation to knowledge and attitude: 2 3 • Knowledge: for this section use statements such as: ‘I can discuss. the easier the process will become. This will help you decide in which order 4 you should study the chapters and how much time you should spend on 5 each.62. simulated learning or university processes. 5 Use the self-assessment form presented in Table 1.

however. 7 • I have not heard of the term experiential learning list.1 Sample self-assessment form 2 3 Chapter 2 4 Understanding OSCEs: what you need to know 5 6 Self-assessment 7 • Simulated learning 8 • Experiential learning 9 10 • Advantages of OSCEs 1 • Acquisition of skills 2 • What is an OSCE and why use them? 3 4 • Types of OSCE assessment 5 6 KNOWLEDGE • I can describe what is meant by simulated learning. I can discuss. 2 the importance of … 3 • I do have a understanding of ‘acting professionally’ 4 as we are bound by the NMC code of conduct. I am not sure what the different types of OSCE are. describe.156. 1 2 • I know an OSCE is an practical exam.86] at [07/18/16]. 5 6 7 8 9 40R . Chiangmai University 5. 3 4 5 6 7 8 9 ATTITUDE • Due to my lack of understanding of the above I am 30 I can respond appropriately. 8 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Table 1. Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing. LLC. 9 • I am not sure why OSCEs are used as an 20 assessment instead of an essay or exam. recognize this.62. not sure how my attitude or behaviour influences 1 act professionally. identify … 8 before. Copyright © McGraw-Hill Global Education Holdings.

Chiangmai University 5. 1 2 3 4 5 6 7 8 ATTITUDE • I am aware that at university the ethos is that of I can respond appropriately. identify … was called. recognize that I understand what I am expected to achieve 30 the importance of … throughout my course. I cannot remember what my learning style 3 list. Not to be redistributed or modified in any way without permission. INTRODUCING OSCEs AND THE BOOK 9 1 Chapter 3 2 Preparing for your OSCE: getting the most out of your learning 3 Self-assessment 4 5 • What is my learning style? 6 • What types of OSCE do I know about? 7 • What knowledge is expected of me in an 8 OSCE? 9 10 • What behaviour is expected of me in an OSCE? 1 KNOWLEDGE • I have completed a learning style questionnaire 2 I can discuss. 5 6 • I currently cannot describe any OSCEs. describe. I do remember I was someone 4 who was motivated. adult learning. however. LLC. Copyright © McGraw-Hill Global Education Holdings. Downloaded by [ Faculty of Nursing. so I am aware that I need ensure 9 act professionally.86] at [07/18/16]. 8 9 • I currently do not know what knowledge is 20 expected of me. before. 4 5 6 7 8 9 40R . 1 2 • I need to ascertain the behavioural and attitude 3 traits I am required to demonstrate during the OSCEs.156.62. although I am aware that I will have to complete OSCEs as 7 part of my course.

act 30 act professionally. identify … this! 20 1 2 3 4 5 6 7 8 ATTITUDE • Once I am aware of what is expected of me I 9 I can respond appropriately. I am hoping this book will help me with 9 list.62. recognize professionally and of course understand the 1 the importance of … importance of this type of assessment. however. 2 3 4 5 6 7 8 9 40R . describe. feel I will be able to respond appropriately. Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission. LLC. 8 I can discuss.86] at [07/18/16]. Chiangmai University 5.156. 10 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Chapter 4 2 3 What to expect from your OSCE 4 Self-assessment 5 • What layout of the room can I expect for my 6 examination? 7 8 • What types of simulated clients/models will 9 be used during my assessment? 10 • What types of examiners will I be assessed by? 1 • What role-behaviour and performance are 2 required of me in order to prepare me for this 3 type of examination? 4 5 • What mechanisms are used to ensure quality 6 assurance? 7 KNOWLEDGE • I do not have any knowledge of the above as yet. Copyright © McGraw-Hill Global Education Holdings.

but I do not 2 have specific strategies to do so. recognize experience has not been at a university. INTRODUCING OSCEs AND THE BOOK 11 1 Chapter 5 2 Preparing for your OSCE: before and on the day 3 Self-assessment 4 5 • How should I prepare for my OSCE? 6 • How can I perform to the best of my ability? 7 8 • How will stress affect my performance? 9 • How can I make the most use of the stress I am 10 under to enhance my performance? 1 • What are the 10 steps for preparation? 2 3 KNOWLEDGE • I have prepared for my A-level exams before. Not to be redistributed or modified in any way without permission. Copyright © McGraw-Hill Global Education Holdings. Downloaded by [ Faculty of Nursing. Chiangmai University 5. however. identify … differs.62. support when I need it.156. so this 2 the importance of … may be different! 3 4 5 6 7 8 9 40R . 4 I can discuss. I am not sure how preparing for an OSCE 5 list. describe. my past 1 act professionally. 7 • I think I know how I prepare for assessments. 3 4 5 6 7 8 9 ATTITUDE • I think I can act appropriately and prepare and seek 30 I can respond appropriately. 1 • I am aware how I cope with stress. I recently had an assessment on my level 9 of fitness prior to being accepted onto the regional 20 hockey team. so I am hoping that working through this 6 book will help me with this. LLC. for 8 example.86] at [07/18/16]. however.

across. I think 7 list. describe. Chiangmai University 5. 12 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Chapter 6 2 3 Sample OSCEs: adult basic life support.86] at [07/18/16].62. medicines management and 4 aseptic non-touch technique 5 Self-assessment 6 • What types of OSCE will I come across in my 7 training? 8 9 • What type of marking criteria will I be assessed 10 against? 1 • What level of knowledge and skills do I need to 2 display during the OSCE? 3 • How many stations will I be examined at? 4 5 KNOWLEDGE • I do not know what type of OSCE I will come 6 I can discuss.156. Not to be redistributed or modified in any way without permission. 8 • I cannot answer any of the rest. I guess I need to do 9 some investigating! 20 1 2 3 4 5 6 7 8 ATTITUDE • I am aware that I lack of knowledge about this area 9 I can respond appropriately. recognize 1 the importance of … 2 3 4 5 6 7 8 9 40R . and I need to do something about it! 30 act professionally. Copyright © McGraw-Hill Global Education Holdings. identify … my first OSCE will be on CPR. Downloaded by [ Faculty of Nursing. LLC. I just know that I will have them.

identify … • I know good feedback should be constructive and 7 direct me to how I can improve my work. 6 list. try and use the feedback I am given and act upon it. 8 9 20 1 2 3 4 5 6 7 ATTITUDE • I feel I have a good attitude to feedback as I always 8 I can respond appropriately. Downloaded by [ Faculty of Nursing. 9 act professionally.86] at [07/18/16]. Chiangmai University 5.156. Copyright © McGraw-Hill Global Education Holdings. INTRODUCING OSCEs AND THE BOOK 13 1 Chapter 7 2 After the OSCE has finished 3 Self-assessment 4 5 • What is good performance? 6 • What is good feedback? 7 8 • How can feedback empower me to improve my practice? 9 10 • How can I reflect on my practice? 1 • Which model should I use to help my 2 reflection? 3 4 KNOWLEDGE • I do not know what a good performance is in 5 I can discuss.62. recognize 30 the importance of … 1 2 3 4 5 6 7 8 9 40R . describe. relation to an OSCE. Not to be redistributed or modified in any way without permission. LLC.

86] at [07/18/16]. 14 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Table 1. Chiangmai University 5. 7 list. Not to be redistributed or modified in any way without permission. Copyright © McGraw-Hill Global Education Holdings.62. 9 act professionally. recognize 30 the importance of … 1 2 3 4 5 6 7 8 9 40R . Downloaded by [ Faculty of Nursing. identify … 8 9 20 1 2 3 4 5 6 7 ATTITUDE 8 I can respond appropriately. describe.156.2 Blank self-assessment form 2 3 Chapter 2 4 Understanding OSCEs: what you need to know 5 Self-assessment 6 7 • Simulated learning 8 • Experiential learning 9 • Advantages of OSCEs 10 1 • Acquisition of skills 2 • What is an OSCE and why use them? 3 4 • Types of OSCE assessment 5 KNOWLEDGE 6 I can discuss. LLC.

recognize 8 the importance of … 9 30 1 2 3 4 5 6 7 8 9 40R .156. describe. INTRODUCING OSCEs AND THE BOOK 15 1 Chapter 3 2 Preparing for your OSCE: getting the most out of your learning 3 Self-assessment 4 5 • What is my learning style? 6 • What types of OSCE do I know about? 7 8 • What is knowledge expected of me in an OSCE? 9 10 • What behaviour is expected of me in an OSCE? 1 2 KNOWLEDGE 3 I can discuss. Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission.86] at [07/18/16]. list. identify … 4 5 6 7 8 9 20 1 2 3 4 5 ATTITUDE 6 I can respond appropriately. 7 act professionally. Copyright © McGraw-Hill Global Education Holdings. Chiangmai University 5. LLC.62.

86] at [07/18/16]. Chiangmai University 5. describe.62. Copyright © McGraw-Hill Global Education Holdings. 9 list. Downloaded by [ Faculty of Nursing. 16 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Chapter 4 2 3 What to expect from your OSCE 4 Self-assessment 5 • What layout of the room can I expect for my 6 examination? 7 8 • What types of simulated clients/models will 9 be used during my assessment? 10 • What types of examiners will I be assessed by? 1 • What role-behaviour and performance are 2 required of me in order to prepare me for this 3 type of examination? 4 5 • What mechanisms are used to ensure quality 6 assurance? 7 KNOWLEDGE 8 I can discuss. 30 act professionally. LLC. identify … 20 1 2 3 4 5 6 7 8 ATTITUDE 9 I can respond appropriately.156. recognize 1 the importance of … 2 3 4 5 6 7 8 9 40R . Not to be redistributed or modified in any way without permission.

5 list.156. INTRODUCING OSCEs AND THE BOOK 17 1 Chapter 5 2 Preparing for your OSCE: before and on the day 3 Self-assessment 4 5 • How should I prepare for my OSCE? 6 • How can I perform to the best of my ability? 7 8 • How will stress affect my performance? 9 • How can I make the most use of the stress I am 10 under to enhance my performance? 1 • What are the 10 steps for preparation? 2 3 KNOWLEDGE 4 I can discuss. LLC. Chiangmai University 5. Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing. 8 act professionally. recognize 9 the importance of … 30 1 2 3 4 5 6 7 8 9 40R .86] at [07/18/16]. describe.62. identify … 6 7 8 9 20 1 2 3 4 5 6 ATTITUDE 7 I can respond appropriately. Copyright © McGraw-Hill Global Education Holdings.

18 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Chapter 6 2 3 Sample OSCEs: adult basic life support.62. Not to be redistributed or modified in any way without permission. medicines management and 4 aseptic non-touch technique 5 Self-assessment 6 • What types of OSCE will I come across in my 7 training? 8 9 • What type of marking criteria will I be assessed 10 against? 1 • What level of knowledge and skills do I need to 2 display during the OSCE? 3 • How many stations will I be examined at? 4 5 KNOWLEDGE 6 I can discuss. recognize 30 the importance of … 1 2 3 4 5 6 7 8 9 40R . 9 act professionally. Chiangmai University 5. Copyright © McGraw-Hill Global Education Holdings.156. LLC. describe.86] at [07/18/16]. 7 list. Downloaded by [ Faculty of Nursing. identify … 8 9 20 1 2 3 4 5 6 7 ATTITUDE 8 I can respond appropriately.

INTRODUCING OSCEs AND THE BOOK 19 1 Chapter 7 2 After the OSCE has finished 3 Self-assessment 4 5 • What is good performance? 6 • What is good feedback? 7 8 • How can feedback empower me to improve my practice? 9 10 • How can I reflect on my practice? 1 • Which model should I use to help my 2 reflection? 3 4 KNOWLEDGE 5 I can discuss.156.86] at [07/18/16]. describe. Chiangmai University 5. 9 act professionally.62. Not to be redistributed or modified in any way without permission. Copyright © McGraw-Hill Global Education Holdings. LLC. 6 list. recognize the importance of … 30 1 2 3 4 5 6 7 8 9 40R . Downloaded by [ Faculty of Nursing. identify … 7 8 9 20 1 2 3 4 5 6 7 ATTITUDE 8 I can respond appropriately.

LLC. 9 20 7 There is a wide variety of simulated patient types. 7 6 The teaching and assessment of clinical skills in a simulated learning 8 environment have increased. 1 • understand how you can be empowered to improve your practice. 1 8 There is a wide variety of simulated settings. Downloaded by [ Faculty of Nursing.86] at [07/18/16]. 4 10 Self-assessment is a useful tool to master as it will enable you to develop 5 the ability to examine and think critically about your practice. Chiangmai University 5. 9 • understand how reflection can provide greater understanding of your 10 practice. 4 4 There are a variety of top tips throughout the book. 6 7 8 9 30 1 2 3 4 5 6 7 8 9 40R . 2 3 3 The book is divided into eight chapters. Copyright © McGraw-Hill Global Education Holdings. Not to be redistributed or modified in any way without permission.62. 2 3 9 Try to undertake a self-assessment of your current knowledge and skills. 5 6 5 Each chapter has a chapter summary. 7 2 This book will help you to: 8 • understand your own learning style. 20 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Good luck in your OSCE! We hope that you will find this book useful 2 3 4 5 Chapter summary 6 1 OSCE means Objective Structured Clinical Examination.156.

psychomotor and 30 affective – which we will now explain. Copyright © McGraw-Hill Global Education Holdings. Not to be redistributed or modified in any way without permission. 1 Understanding OSCEs: 2 2 what you need to know 3 4 5 6 7 8 There are no secrets to success. Downloaded by [ Faculty of Nursing. such as clinical 6 skills laboratories. 9 and learning from failure. LLC. home environments and communication 7 suites. hard work. 1 2 • Cognitive (knowing) domain: this focuses on knowledge acquisition and 3 intellectual skills and abilities (e.156. Chiangmai University 5.g. 5 • Psychomotor (doing) domain: this is related to clinical skills that require vary. including attitudes for personal and professional development 40R .62. 6 Be clear about the purpose of an OSCE assessment as part of your 7 nursing course. 8 clinical and decision-making skills. mindsets and 9 values.86] at [07/18/16]. 8 • Affective (feeling) domain: this deals with feelings. 20 1 2 3 The simulated learning environment 4 5 Simulated learning environments utilized by your university. interpreting and acting upon a patient’s 4 vital signs). emotions. 10 Colin Powell (1937–) 1 2 3 4 By the end of this chapter you will: 5 Be prepared for learning in the simulated learning environment. taking a patient’s blood pressure).g. It is the result of preparation. simulated wards. will provide you with the opportunity to develop your psychomotor. 6 ing levels of well-coordinated physical activity and precise manipulative 7 procedures (e. The nursing profession makes extensive 9 use of the three major learning domains/skills – cognitive. 8 Have read a range of practical tips and advice on what you need to do in 9 order to be successful in your OSCE.

86] at [07/18/16]. In the 5 case of nursing. depend- 8 ing on the learning objectives being addressed and the facilities your university 9 has access to. friendly and structured environment. they may become unconscious or have a respiratory arrest. if a patient is hypoxic and you fail to apply 3 oxygen therapy. For example. 22 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 (e. LLC. 7 The sophistication of these rooms can vary from basic to high-fidelity. a classroom or via virtual computer-generated programs. such as caring for a patient whose health is 30 deteriorating. Copyright © McGraw-Hill Global Education Holdings. separately or together. communication 6 suite. restraining and sedating a patient who has been sectioned under the 40R Mental Health Act. However. 4 5 6 The simulated learning environment will give you the opportunity to learn 7 clinical skills such as how to take a manual blood pressure and/or work through 8 scenarios that are based on real-life situations and that resemble authentic 9 experiences in the practice setting. 10 Spending facilitated learning time in the simulated learning environment 1 will enable you to apply practice knowledge and develop critical thinking as 2 well as increase your confidence. taught or assessed via an 6 OSCE. . In some instances the simulated learning environment will enable 8 you to learn skills related to training in complex or challenging procedures – for 9 example.156. Simulated learning gives you the opportunity 3 to practise skills and develop your knowledge of and attitude to real-life health 4 and social care situations in a safe. Downloaded by [ Faculty of Nursing. 20 1 2 Simulation allows you to practise clinical and communication skills in a safe 3 environment. Within the nursing documentation these 8 domains or skills are often referred to as ‘knowledge’. Not to be redistributed or modified in any way without permission.62. and 9 from now on that is how we will refer to them. such as 2 gaining informed consent prior to taking a patient’s blood pressure). they will be facilitated. The scenarios in a real-life or a virtual setting may respond to your 1 actions so that a patient’s condition/behaviour can improve or worsen following 2 your interventions. this environment can be a skills laboratory. Chiangmai University 5. a suite of rooms. displaying appropriate behaviour when caring for a patient. depending on the learning outcomes of the ses- 7 sion and the stage of your course.g. 3 4 In order for you to deliver effective patient care you will need to intertwine all 5 three of these skills. ‘skill’ and ‘attitude’. This allows you to work through such situ- 6 ations in a safe environment before practising them in your clinical practice 7 placement. 4 This facility has the great advantage of being able to bring uncertainty and 5 unpredictability into your scenarios.

you take part in any practice simulated sessions 30 that your university offers. you will become familiar with: 2 3 • the environment. 5 • being observed by academic staff or peers. LLC. Therefore it is essential that. 8 fully integrated with the theoretical and practical aspects of the course. Downloaded by [ Faculty of Nursing. Within this 40R . other. In nursing. it must be care. This aids your reflec- 2 tion and reinforces your learning of the experience. 4 slow down or speed up. UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 23 1 Simulation allows you to learn skills related to complex and/or challenging 2 situations in a controlled setting. pause. 9 wise this learning will be less meaningful and not appear relevant. or all of the components of. 4 • any equipment you will be required to use. An OSCE is a form of simulated practice that takes 8 place in the university or formal academic setting. to 10 observe you and provide feedback. a clinical situation so 6 that you will be better able to understand and manage the situation if/when it 7 occurs in clinical practice. 6 7 8 The simulated learning environment allows video-recording to aid feedback 9 and reflection.62. Copyright © McGraw-Hill Global Education Holdings. 6 7 For learning to be effective in the skills laboratory setting.156. because you can repeat the scenario. Not to be redistributed or modified in any way without permission. You have the opportunity 3 to review decisions and alter them. 9 as part of your preparation. simulated practice learning 5 aims to replicate an aspect of.86] at [07/18/16]. as well as your tutors. In many settings your interventions can be 1 video-recorded and viewed later by you and your tutors. 3 4 5 6 Communication skills 7 8 Communication skills may be developed using a suite of rooms with two-way 9 mirrors or video systems. This allows other students. Chiangmai University 5. You will have almost instant feedback from your tutors 5 and peers and a chance to reflect on your practice in the OSCE. By undertaking learning in these environments 1 prior to your OSCE. 20 1 2 What is simulation? 3 4 ‘Simulation’ means resembling reality.

4 5 6 7 Simulation practical consent form 8 9 A very valuable part of learning in the simulated learning environment is 20 putting yourself in the role of the patient. 24 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 environment you will be exposed to a range of equipment.86] at [07/18/16].156. as you may be examined and be 4 subject to non-invasive investigations such as recording blood pressure. Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing. students will 5 take part in practical procedures as part of their training during the academic 6 components of their courses. This will include 2 ‘task trainers’. In this case you 2 act as the patient for your peers.62. a specific torso to learn the skill of urinary 4 catheterization. ‘standardized patients’ – individuals who are trained 9 to act as a patient – can be used. For the . for non-invasive procedures or physical examination. 6 ‘MetiMan’. Chiangmai University 5. It is therefore a condition of any offer 8 that the university makes of a place on one of its health and social care courses 9 that you agree to take part in these activities and to the following terms and 40R conditions in relation to your participation by signing this form. which are parts of a manikin designed for you to learn a particu- 3 lar clinical skill – for example. including 2 3 role play and practical procedures 4 As is the normal practice in health and social care education. interview- 8 ing or patient education. It 7 also emphasizes the fact that you may find an abnormality in yourself or others 8 when engaging in simulation and you need to know how to report this. Copyright © McGraw-Hill Global Education Holdings. You will learn more about how and when they 10 will be used in your OSCE in Chapter 3. It may also include very sophisticated high-fidelity manikins 5 that can be programmed to respond to affective clinical changes – for example. 1 2 3 Simulation must integrate theory and practice to be effective. 7 However. Students will take part in these activities both as 7 practitioner and as patient/service user. An 9 example of such a form is shown below. Prior to your course starting you may be asked 3 to sign a ‘simulation practical consent form’. 30 1 Consent form for simulation of practice. This 5 form is an important part of the health and safety component of the course as 6 it alerts you to the need to undertake simulation and what this may entail. This will help you to begin to make 1 sense of and understand what it may feel like to be a patient. LLC.

it is my responsibility to be aware of any precautions 7 and contraindications for each of the practical procedures. or if I am studying the following post. The 2 aim of this is to provide students and lecturers with the opportunity to record 3 students’ activities for the purpose of feedback and assessment. These record. loose 1 clothing and flat. 5 poses of auditing students’ work and parity of lecturers’ marking. The video stream 6 can be watched live or retrospectively at the viewing station in the labs. 4 This footage may be accessed by the external examiner of the module for pur. any reference in this form to a practical procedure/s is the 2 simulation of practice. LLC. Video footage will be automatically destroyed after seven days unless a 8 student specifically requests that it is downloaded. Downloaded by [ Faculty of Nursing. religious and cul- 9 tural beliefs. Appropriate 10 clothing and footwear should be worn for all practical sessions (i.156. UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 25 1 avoidance of doubt. 6 ings will be destroyed when results have been ratified by the examination 7 board. 3 registration courses: nursing and midwifery. In this case the module 9 leader will keep the recording on a password-protected file and in a locked 40R . whilst an experienced lecturer will introduce each prac- 5 tical session and the known risks and limitations of the practical procedures 6 will be explained to me. moral. case presentations. Copyright © McGraw-Hill Global Education Holdings.62. including role play. minor illness and 6 injury management. 5 registration/graduate courses: non-medical prescribing. occupational therapy. Chiangmai University 5. Not to be redistributed or modified in any way without permission. Students do not have independent access to video 30 streams and will only be shown these for learning purposes at their own request. For the avoidance of doubt. These will be downloaded and stored securely 3 by the module leader on a password-protected file and in a locked cupboard.86] at [07/18/16]. social work. 20 4 A video-recording system has been installed in the communication suite 1 and some of the skills laboratories in the School of Health and Social Care. it will not 2 be necessary for me to remove clothing if I am studying the following pre. operating 4 department practitioner. it may be necessary for me to remove cloth. 9 ing which may otherwise prevent observation and/or examination. 5 The recording equipment operates on a continuous cycle. 3 4 1 I understand that. Access to the recordings is restricted to named academic staff and 9 skills laboratory technicians. 7 8 3 Every effort will be made to respect my dignity. The system is 4 called SMOTS – Scotia Medical Observation and Training System. enclosed shoes). OSCEs and 2 practical exams will be recorded.e. 8 2 Depending on the procedure. 1 It is anticipated that practical procedures. The 7 centrally stored video stream is automatically destroyed after approximately 8 seven days.

4 Given the sensitive nature of recording students acting as models/patients/ 5 service users it is anticipated that students and lecturers will accord with the 6 same standards as is expected by professional and regulatory bodies and prac- 7 titioners towards patients and colleagues in practice.156. or other- 7 wise. and the exercise 9 of that right shall be without prejudice. 3 8 I understand that I have the right to withdraw from a practical procedure at 4 any time and that. 9 I understand that if I am participating in a practical procedure in any of the 10 skills laboratories with SMOTS. 6 social work. which might affect my ability to act as a patient/service user or undertake 8 clinical practices safely. Not to be redistributed or modified in any way without permission. after 9 discussion with me. prior to any practical procedure.62. . 8 9 7 I understand that I must inform the member of staff who is facilitating the 20 session should I experience any symptoms of being unwell or injury during a 1 practical procedure and that he or she must stop the procedure immediately 2 should I indicate such symptoms or request that it should be stopped. I must inform the member of staff who is 4 facilitating the session at the earliest opportunity. after which time it will be destroyed. Downloaded by [ Faculty of Nursing.86] at [07/18/16]. recording may take place. I also understand that in the 5 event of such information being discovered. LLC. operating department practitioner. 30 1 9 In the event of something being discovered with regard to my health during 2 a practical procedure. make a referral to occupational health and I must inform 40R my personal tutor of the outcome of such a referral. including the measures 8 taken to store securely the data described above. 26 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 cupboard until the student and base group leader concerned have finished 3 with it. occupational therapy. or if I am studying the following post-registration/graduate courses: 7 non-medical prescribing or minor illness and injury management. the member of staff facilitating the session may. 1 2 5 In circumstances where I feel unable to take part in any of the practical 3 procedures for whatever reason. I understand that I must inform the member of staff who 3 is facilitating the session and that it is my responsibility to seek further spe- 4 cialist advice from appropriate medical sources. I exercise my 8 right to withdraw in respect of my role as patient/service user. Copyright © McGraw-Hill Global Education Holdings. I must inform the mem- 6 ber of staff who is facilitating the session of any health condition that may 7 affect my participation. 5 6 I understand that. if I am studying the following pre-registration courses: nurs- 5 ing and midwifery. Chiangmai University 5. whether as a result of a practical 6 procedure or my responsibilities under any paragraph of this form.

86] at [07/18/16]. In 7 the event of any complication arising. 3 dure will be stopped and/or not repeated on that occasion. Downloaded by [ Faculty of Nursing. I understand that. UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 27 1 10 I understand that. subject to Paragraph 8 above. the member of staff facilitating the 8 session undertakes to inform the relevant university personnel and make 9 an appropriate entry in the incident book of the university’s School of Health 10 and Social Care. Experiential learning 9 occurs in two forms in nursing education: 40R . the proce. 9 13 I acknowledge that the university will not be liable in circumstances 20 where I have failed to abide by these terms and conditions. 1 2 11 I understand that I must inform the university of any change in my health 3 status occurring during the course subsequent to my initial occupational 4 health screening. With the mutual 4 agreement of myself and the member of staff who is facilitating the session the 5 procedure may be undertaken at a later date. in the event of the development of any recognized 2 complication either during or subsequent to a practical procedure. 1 2 Declaration 3 4 I have read and fully understand the above. 7 8 Signature: 9 30 Full name: 1 2 Date: 3 4 5 Experiential learning 6 7 The ethos of the simulated learning environment is based upon experiential 8 learning (Studdy et al. Chiangmai University 5. Not to be redistributed or modified in any way without permission.156. 5 12 While the university will make reasonable adjustments to accommodate 6 me. I agree to take part in the practical 5 procedures and to the terms and conditions in relation to my participation as 6 a practitioner or patient/service user. 2001). The university will give formal 6 advice regarding the management of any complication in the first instance. if a discovery is made as 7 indicated in Paragraph 9 of this form or I withdraw from a practical procedure. Fry et al. Copyright © McGraw-Hill Global Education Holdings. Quinn 2000.62. 8 I may not be permitted to complete my course. 1994. LLC.

they are still an invaluable learning opportunity for you. they are also essential experiences for learning 9 and reflection. as 8 throughout history representations in clay and stone have been used to demon- 9 strate clinical features of disease states and their effects on humans. including your OSCE. 2 Simulation has developed into sophisticated computer-generated programs 3 to enable. for example. 6 Simulation of practice also came to the forefront due to changes in the 7 health needs of hospitalized patients as a result of different illness patterns 8 (Bujack et al. skills and attitude to the examiner. 28 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 • in the form of structured and pre-planned practical work incorporating 2 reflection on your experience in the laboratory. 10 because you can use the feedback given by the examiner in order to improve 1 your knowledge. is said to be the most valuable part of the experience. for example. Downloaded by [ Faculty of Nursing. 6 7 8 Although OSCEs are exams. Not to be redistributed or modified in any way without permission. skills and attitudes. surgeons to practise and perfect techniques before try- 4 ing them on real patients. 6 surgeons and aircraft pilots. 20 1 2 3 How does simulation fit into student learning? 4 5 You may well have heard of simulators used in the training of. 1991). simulation is not a recent invention. Chapter 7 dis- 4 cusses in greater detail how to utilize both feedback and reflection to help you 5 succeed in your OSCE. Although 9 OSCEs are exams. Along 9 with this there was an increase in clinical sophistication and an increase of 40R critically ill patients in hospitals. The feedback that you should receive dur- 2 ing any simulated learning. and the reflection this should 3 prompt. Copyright © McGraw-Hill Global Education Holdings. LLC. or pilots to experience complex situations before 5 meeting them in a real-life crisis scenario. paralleled by a shift in patient care to the .62. Examples 30 have been found from many cultures and continents. the first medical 1 simulators were simple models of human patients.156.86] at [07/18/16]. which led to shorter stays as inpatients in hospitals. indeed. However. and a similar principle has been adopted in the 7 training of nursing students. 5 6 The OSCE examination takes place in the simulated learning environment 7 and is a structured practical experience that is used as an opportunity for you to 8 demonstrate your knowledge. 3 • when you reflect on real experiences from the clinical environment and 4 re-enact these in this environment. Chiangmai University 5.

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UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 29

community. This resulted in nursing students having less access to patients. At 1
the same time, it was found that increasing numbers of nursing students were 2
spending more time in academic settings. 3
By the mid-1990s this resulted in students having fewer opportunities to 4
gain essential skills to enable them to progress to being independent, compe- 5
tent practitioners (Studdy et al. 1994). Added to this, the White Paper, Making a 6
Difference clearly stated that the National Health Service (NHS) needed practi- 7
tioners who were fit for purpose, with excellent skills, and the knowledge and 8
ability to provide the best care possible (DoH 1999). 9
To try and respond to these changes the new century saw universities set up 10
skills laboratories or skills centres to help bridge the gaps identified. Since then, 1
evaluation of this method of teaching, learning and assessment has confirmed 2
that clinical skills laboratories and simulation of practice have become an 3
important component of nurse training (Bradshaw and Merriman 2008). 4
5
6
7
Simulated learning has been with us for hundreds of years. It is used more
8
than ever in this century to enable students to gain the most from their prac-
9
tice experience.
20
1
2
3
NMC role in simulated learning 4
5
The use of simulated learning and assessment has more recently been given 6
greater credibility by the NMC (2007a, 2007b, 2007c), with the publication of 7
the ESCs and the following statement: ‘Nursing students will have more varied 8
opportunities to develop direct care skills, following the Nursing and Midwifery 9
Council’s (NMC) decision to promote simulated practice learning for better 30
preparing students for practice.’ 1
This declaration followed a project involving more than 6,000 students 2
from 13 pilot sites in UK universities. It tested out principles for the safe and 3
effective use of simulated practice learning, using some of the time normally 4
spent learning in the clinical area. Consequently, simulated learning opportu- 5
nities may now be incorporated into pre-registration undergraduate nursing 6
programmes. A maximum of 300 hours of the compulsory 2,300 direct practice 7
hours may be taken up by simulated learning. As the NMC states, this environ- 8
ment cannot replace clinical practice experience but, if used correctly, can 9
complement it. 40R

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30 SUCCEED IN OSCEs AND PRACTICAL EXAMS

1
2 In the pre-registration nursing curriculum the NMC allow for up to 300 hours of
3 the 2,300 hours of direct patient care to be experienced in simulated learning.
4
5
6 Advantages of OSCEs
7
8 The following are some of the advantages of OSCEs and why the OSCE has
9 been chosen as an assessment strategy as opposed to other forms of assessment.
10
1 • OSCEs convey a strong message to you about why clinical skills are
2 important.
3 • OSCEs have been extensively researched and found to have academic rig-
4 our for both formative and summative assessment in health professional
5 education because they are conducted using robust processes (number of
6 stations, preparation of simulated patients/examiners, global judgement
7 alongside checklist).
8 • OSCEs provide you, your clinical placement and the university with useful
9 information about your knowledge, skills and attitude in relation to identi-
20 fied clinical skills.
1 • The assessment of predetermined essential skills is a requirement for you to
2 demonstrate that you have met the NMC ESCs.
3 • OSCEs encourage a collaborative approach between HEIs and practice in
4 the creation of nurses who are ‘fit for purpose’.
5 • OSCEs are adaptable across professions, clinical skills and academic levels.
6 • OSCEs have potential for self-, peer and academic feedback.
7 • OSCEs promote development of functioning knowledge.
8
9
30
OSCEs allow you to demonstrate knowledge, skills and attitude related to a
1
particular clinical skill in a safe environment.
2
3
4
5 Acquisition of skills
6
7 When you are working in a simulated learning environment and preparing for
8 your OSCE, you will be acquiring new skills and refining skills you have already
9 learned in practice. Having ownership of the acquisition of new skills and the
40R related knowledge that goes alongside this is key to you succeeding in your OSCE.

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UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 31

One model you may find useful to help make sense of your acquisition of 1
skills is the conscious competence model. This model’s origins are not certain, 2
however, some sources have indicated that its formal structure and develop- 3
ment stem from the Gordon Training International organization in the USA 4
(1970). This approach is also referred to by Howell and Fleishman (1982) and 5
you will find it has some similarities with Bloom’s taxonomy of learning (1956) 6
in terms of the acquiring of cognitive, affective and psychomotor skills. Further 7
development of the model (Baume 2004) has resulted in the five-stage process 8
we will introduce you to here. 9
10
Stage 1: Unconscious incompetence 1
2
When you first start learning your clinical practice skills you will be at Stage 1, 3
deemed unconscious incompetence: you are not aware of the skills you need to 4
learn. It is clearly essential when you begin the process of skill acquisition that 5
you understand the need for skills to be learned and it is as a result of this that 6
you will become receptive to new learning. For example, you may not realize 7
why numeracy is important for nurses because you are unable to put it into 8
context. It is not until you use your numeracy skills that you understand the 9
importance of them – for example, when calculating medication requirements, 20
when assessing a patient’s body mass index (BMI), when completing a fluid 1
balance chart or when taking and recording vital signs. 2
3
4
Stage 1: unconscious incompetence – you are not aware of the skills you need 5
to learn. 6
7
8
In practice or the simulated learning environment your mentors and tutors 9
recognize this stage and therefore do not assume prior knowledge. However, it 30
is essential that you develop awareness of which skills you are not confident 1
with, whether prior to learning a new skill or once you think you have learned 2
one but are not competent in it. 3
You could also interpret Stage 1 behaviour as a mind-set you may adopt after 4
your OCSE if you reach the stage of thinking you do not need to improve at 5
all. This could still be thought of as unconscious incompetence, in that you 6
may not have insight into the fact that you are not competent. Often students 7
will have that ‘lightbulb moment’ when they finally understand all the com- 8
ponents of a skill and the need to learn it, and this can occur at any stage of 9
this model. 40R

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32 SUCCEED IN OSCEs AND PRACTICAL EXAMS

1 Benner’s stages of clinical competence
2
3 The learning stages model has many similarities with Benner’s stages of clinical
4 competence in her ‘Novice to Expert’ model (1984). Benner based her model on
5 the work of Dreyfus and Dreyfus (1986). They drew on their different outlooks
6 as a computer scientist and a philosopher and developed a useful five-stage
7 model. Benner’s work has been instrumental to nurses understanding how to
8 develop their levels of competence and therefore you will find it useful to look
9 at the two models in parallel.
10 The stage of unconscious incompetence is similar to Benner’s ‘beginners’
1 stage. A beginner does not have any experience of the situations or skills that
2 they are expected to undertake. Novices learn rules to help them undertake a
3 new skill and these rules do not have a context and are not related to anything
4 the student has undertaken before. Therefore the rules tend to be applied across
5 the board. This rule-governed approach to practice is therefore often very inflex-
6 ible and limited. In relation to an OSCE this stage would be represented by you
7 not knowing what an OSCE is or what skills are required to undertake it.
8
9
20 Stage 1 (Benner): no experience of the situations or skills you are expected to
1 undertake.
2
3
4
5
Stage 2: conscious incompetence
6 Stage 2 is deemed ‘conscious incompetence’ and is where you begin to under-
7 stand the need to develop a skill and recognize your own lack of knowledge and
8 skills. You also realize that by developing this skill, your practice will improve. For
9 example, you have an OSCE testing your ability to carry out a manual blood pres-
30 sure measurement. Although you are able to carry out the clinical skill of taking
1 a blood pressure and inform the examiner of the correct reading, when you are
2 questioned on the physiology of blood pressure you are unable to give a concise
3 and correct answer and therefore fail the OSCE. Following feedback you recog-
4 nize the need to increase your knowledge of the anatomy of the heart and the
5 physiology of blood pressure. Conscious incompetence is an important water-
6 shed in understanding your ability and recognizing how much you need to learn.
7 It can be a little scary when you realize that you may have been undertaking skills
8 incorrectly for a while without knowing it, as in Stage 1. However, you have now
9 recognized that you need to learn how to be competent and you are now able to
40R start on the journey to competence in whichever skill you are learning.

learn it well and thoroughly. This is when you 6 can demonstrate just about acceptable performance of a skill. However.62. You are able to undertake the skill and have knowledge of the 4 need for the skill. At this stage you will be more able to 40R .86] at [07/18/16].156. and 20 in time it will become second nature. 5 6 7 Stage 4: unconscious competence 8 At Stage 4 you will be able to undertake a skill without having to think through 9 exactly what you are doing all the time. UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 33 1 Stage 2: conscious incompetence – you understand the need to develop a skill 2 and recognize your lack of knowledge. The competent student may 3 not yet have enough experience to be able to translate all their skill to another 4 similar situation but is well on the way to doing this. Take 9 your time when performing a particular skill. 3 4 5 This stage is also akin to Benner’s ‘advanced beginner stage’. In the above example. Copyright © McGraw-Hill Global Education Holdings. Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing. 5 6 This stage is a little like learning to drive when you are able to change gear 7 but are thinking about when to do this all the time rather than just driving on 8 instinct and experience. You are also starting to use a set of principles to guide your performance. Chiangmai University 5. 1 2 3 Stage 3: conscious competence – you can undertake a skill and have some 4 knowledge base behind it. LLC. at this stage you are able provide a 5 concise and correct answer concerning the physiology of blood pressure and 6 therefore pass the OSCE. You are starting to 7 base your practice on previous experience and learned skills rather than just the 8 ‘rules’. It is akin to Benner’s ‘competence’ stage and can be 9 illustrated by a student who has been undertaking a skill for quite a period of 30 time and has a conscious understanding of how they are performing that skill. that of ‘unconscious 8 competence’. 1 As a result the student will tend to consciously analyse their actions and 2 enhance their efficiency and organizational ability. 9 10 Stage 3: conscious competence 1 2 Stage 3 may well be the stage you reach for the OSCE and is deemed ‘conscious 3 competence’. Now is the time to really refine your skills and knowledge. this knowledge is not yet ‘second nature’ to 7 you and so you may not have reached the fourth stage.

30 1 2 Stage 5: reflective competence – able to use reflection to delve more deeply 3 into your competence. You will also be more adept at 3 picking up on non-verbal clues from your patient as you will have the ability to 4 concentrate more fully on their needs. Whatever level you are being assessed at. 9 20 1 Stage 5: reflective competence 2 Reflective competence encourages the practitioner to delve more deeply into 3 their abilities and review the literature and theory in terms of the skill con- 4 cerned. 9 it’s good to always aim to perform above the level required.62. 4 5 6 This stage is paralleled by Benner’s ‘expert performer’. and this understanding has been gained from repeated experi- 9 ence and reflection. Downloaded by [ Faculty of Nursing. Chiangmai University 5. 34 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 interact with your patient as you will not be thinking about every step you need 2 to take when performing a particular procedure.156.86] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings. skills 5 and attitudes. 6 7 8 Stage 4: unconscious competence – you can undertake the skill without think- 9 ing about what you are doing all the time. As a result you will move to a higher level of performance than 6 that expected of you in a pre-registration OSCE but highly desirable for post- 7 registration studies or postgraduate courses such as non-medical prescribing or 8 minor illness and injury management. Stage 5 is an opportunity for deeper analysis of your knowledge. LLC. You may also act more intuitively in your practice. Not to be redistributed or modified in any way without permission. You would pass the OSCE and the exam- 5 iners’ feedback would be very complimentary. Here you are able to 7 grasp intuitively most skills situations. You will 40R still be guided by protocols but your understanding is such that you are now . The proficient practitioner 5 has learned from experience how to modify their behaviour and skills in rela- 6 tion to differing situations. You will have a deeper understanding of 8 what is required. 10 1 This stage is akin to Benner’s ‘novice to expert’: you are proficient and under- 2 stand skills as complete entities rather than in terms of sections and tasks. At this stage you will be able to modify your practice 7 to allow for the unexpected. This is particularly useful in OCSEs when they are 8 based on a clinically changing situation. When 3 you are proficient you can comprehend a situation in its totality because you 4 recognize its meaning in respect of long-term goals.

6 7 Table 2.86] at [07/18/16]. Chiangmai University 5.1 The conscious competence model and Benner’s stages of clinical 8 competence 9 10 Incompetence Competence 1 Unconscious Stage 1 Stage 4 2 You are not aware of the need You are able to undertake the 3 to learn a skill skill without thinking about 4 or it all the time 5 you think you have learned 6 You are able to multi-task the skill and have no insight 7 while undertaking the skill that you are not yet competent 8 This is the stage ideally you 9 will want to be at on 20 completion of your course or when undertaking an 1 advanced OSCE 2 3 Benner: novice Benner: proficient 4 Conscious Stage 2 Stage 3 5 You are aware of the need to You are able to be proficient 6 learn a skill but do not have in the skill but need to think 7 the knowledge base about each stage 8 You know that your practice You will need to have at least 9 will improve if you learn reached this stage to succeed 30 the skill in your OSCE 1 Benner: advanced beginner Benner: competent 2 3 Reflection Stage 5 4 You are able to reflect on your competence level and identify 5 how you can improve your 6 knowledge base and attitude 7 by using literature and analysis 8 9 Benner: expert 40R .156. UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 35 able to question practice and ask why skills are being undertaken in a particular 1 way. Not to be redistributed or modified in any way without permission. Copyright © McGraw-Hill Global Education Holdings.62. 3 4 Table 2. At this level you will also be able to use analytical skills to think about 2 situations you have not come across before. Downloaded by [ Faculty of Nursing. LLC.1 illustrates the conscious competence model stages and Benner’s stages 5 of clinical competence.

Copyright © McGraw-Hill Global Education Holdings. It was also felt that this approach had 1 significantly contributed to both the risk management of the service and public 2 protection. Not to be redistributed or modified in any way without permission. Reznick et al. 1998. As a result. Marshall and Harris 2000. to assess clinical competence of trainee doctors by rotating 8 them through a range of ‘stations’ where they were assessed on a simulated 9 clinical situation using precise sets of criteria. 40R 1991. Major . 1998). 5 6 7 The student’s perspective 8 Several studies have explored the student’s perspective to ascertain whether 9 OSCEs motivate students to learn clinical skills (Ross et al. Khattab 4 and Rawlings 2001. 2001. Mossey et al. 1988. The application of the OSCE to nursing has been positively evalu- 3 ated in numerous studies (Knight 1998. 2005.156. such 5 as continual clinical assessment. 5 It is from this underlying assumption – that medical clinical competence 6 could finally be tested in a precise and reproducible way – that Ross et al. in the 3 late twentieth century. 4 we are going to explain the role of the OSCE in the assessment of that know- 5 ledge and those skills. LLC. 2001. NMC 2007a. Govaerts et al. Bujack et al.62. 2007b. extensive research began to demonstrate the excellent statistical prop- 2 erties of this approach (Regehr et al. debate continues as to 4 whether this model of assessment is superior to more traditional models. Bramble 1994. Chiangmai University 5. 2 The OSCE is thought to be a rigorous way of identifying your strengths and 3 limitations in clinical competence. Walters and Adams 2002. Furlong et al. Within the literature. Alinier 2003). Since then it has been subject to extensive research with many papers 9 applauding it as a reliable and valid assessment of clinical skills for nursing stu- 20 dents (Hulett and Gilder 1986. Europe and North 1 America. 7 A document published by the Commonwealth of Australia (National Review 8 of Nurse Education Australia 2002) argued that the use of OSCEs within pre- 9 registration nursing programmes produced students who were more ‘compe- 30 tent’ to learn in and from practice. O’Neill and McCall 1996. OSCEs were said to represent the ‘gold standard’ for 4 medical student assessment (Hodges 2003).86] at [07/18/16]. 1988. multiple choice papers or the essay (Nicol and 6 Freeth 1998. 2007c). Knight and Mowforth 1998. 36 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 What is an OSCE? 2 3 Now that you have thought about how you acquire your skills and knowledge. Shortly after Harden first described 10 and introduced the OSCE into medical education in Britain. Ross et al. Downloaded by [ Faculty of Nursing. Nicol 1 and Freeth 1998. Alinier 2003. 6 The OSCE was originally developed in Dundee in the mid-1970s by Harden 7 and Gleeson (1979). Shanley 2001). (1988) 7 concluded that the OSCE could be a valuable tool in assessing clinical skills in 8 nursing.

The OSCE is 2 also found to send a strong message to students that the acquisition of practical 3 skills is important to becoming a competent professional nurse (Ramsden 2002).62. (2002) and Brookes 7 (2004) who suggest that professional practice is multi-dimensional and com. As a result the OSCE 5 examination is increasingly being incorporated into pre-registration pro. 8 bining multiple methods of assessment adds breadth and depth. Not to be redistributed or modified in any way without permission. 2 3 4 5 Why use an OSCE? 6 7 OSCEs are just one of the types of assessment that may be used to assess you. Major 2005). 6 grammes (Nicol and Freeth 1998. 30 • to create learning opportunities. 4 However. UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 37 2005). 1 ination motivated them to learn the clinical skills being examined. 3 • to act as a quality assurance mechanism (both for internal and external 4 systems). Redfern et al. Chiangmai University 5. Other reasons why this approach is used include 40R .156. 2 • to provide you with a grade.86] at [07/18/16]. usually because when it comes to practical outcomes the only sensible 8 way of really assessing whether an outcome has been learned is through watch. Redfern et al. 1 • to provide feedback (for you and your tutors). NMC 2004. Downloaded by [ Faculty of Nursing. 7 2007c. it could also be argued that this is a weakness of the OSCE exami. 9 Students also commented that they felt safe with this approach because all 10 expectations of them are clear and up-front. 5 6 An OSCE will have been chosen as the assessment strategy for a number of 7 reasons. 2002. They all concluded that the majority of students agreed that the OSCE exam. 8 You are assessed for a number of different reasons: 9 • to motivate you. This is acknowledged by While (1994). 5 nation as students may choose to focus on these clinical skills and ignore 6 others. 9 ing you actually perform it. 2007b. They know exactly what they are 1 being tested on from the first day of the course and have opportunities to prac. 2007a. 3 Advocates of the OSCE as an assessment strategy have argued for its 4 implementation into the pre-registration curriculum. Copyright © McGraw-Hill Global Education Holdings. 8 9 20 Students feel safe with OSCEs because all expectations of them are clear and 1 up-front. 2 tise the skills and learn the concepts deemed to be critical. LLC.

Such an assessment will involve your receiving feedback on your 5 current skills. so that you have enough time to act on the 5 feedback that is provided by the examiners. 9 You will gain valuable feedback about your performance and what and how 30 you can improve in order to gain as good a mark as possible in your summative 1 OSCE. which are mainly 7 intended to help you learn. The formative OSCE. if needed. 20 1 2 Formative OSCE assessments 3 Formative OSCEs are usually undertaken part of the way through your course 4 or module. knowledge 2 and attitude before undertaking a skill in your area of practice. You should use the time between the formative attempt and the summa- 2 tive attempt to build on your strengths and learn from your limitations through 3 the feedback you are given. 3 • it will focus your approach to learning. and an OSCE final exam- 8 ination which is intended to identify how much has been learned by you and 9 is called summative. The OSCE also 3 eases the burden of assessment from the practice area.156.62. 5 6 There is a difference between OSCE practice assessments. if it precedes a summative OSCE. and are called formative. 4 • it is an indication of which aspects of the course are valued most highly. Not to be redistributed or modified in any way without permission. measures your fitness for 4 practice and assesses a skill that is essential for you to be competent in patient 5 safety. 38 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 ensuring that you are adequately prepared with the relevant skills. Copyright © McGraw-Hill Global Education Holdings. Chiangmai University 5. knowledge and attitude. 6 7 8 Formative OSCEs give you constructive feedback and allow you to make 9 improvements before the final summative attempt. 40R . which you can use to improve your 6 future performance. Downloaded by [ Faculty of Nursing. Ideally your formative attempt(s) should be staged 4 throughout your course or module. 7 will also give you invaluable guidance and the time. 6 7 8 Types of assessment 9 10 Assessment will play a crucial role during your time at university. It is important 1 because: 2 • it will determine much of the work you undertake.86] at [07/18/16]. LLC. to improve on 8 any weak areas identified by you and the tutor.

40R . 1 2 3 Summative OSCEs usually come at the end of a period of study or module and 4 may contribute to your final course mark. Some students find the presence of an observer is suffi. it allows you to experience the OSCE process prior to the high stakes 9 summative exam. You will also be able to assess your own 9 learning style. 7 8 9 Summative OSCE assessments 20 Summative assessments typically come at the end of the course/module or 1 section of learning and you will be awarded a final mark or grade for this sec. So this ‘dry run’ will help you to think about how you will prepare 6 and cope with the summative exam.156. which will help you to achieve better results in the long term. until you have gone through this experience. UNDERSTANDING OSCEs: WHAT YOU NEED TO KNOW 39 The formative OSCE is therefore an assessment that is used to help you and 1 your tutors gauge the strengths and limitations of your performance. Chiangmai University 5. 5 Many people say that formative assessment is more important and useful 6 than summative assessment. Downloaded by [ Faculty of Nursing. This information will be used to inform you and the course leaders about 3 your current abilities. you will not know 4 how you are going to react and feel. 2 ence of an observer can enhance their performance. some students find that the pres. 5 6 7 Chapter 3 provides a range of practical tips and advice on what you need to do 8 in order to be successful in your OSCE. There are two reasons for this: 7 8 • First. you may not be allowed to undertake your placement if you fail. Typically you will receive 3 feedback expressed in words and/or in written form and you are not normally 4 given a mark or grade. 10 cient enough to raise their anxiety levels so that their level of performance 1 is adversely affected.62. 2 tion. Copyright © McGraw-Hill Global Education Holdings. LLC. Not to be redistributed or modified in any way without permission. You should be aware of what the pass mark is prior to the 4 OSCE and the consequences of not achieving this. 3 • Second.86] at [07/18/16]. it may mean 5 that you have to resit the exam or it may mean that you cannot progress further 6 in your course until you have passed this exam. For example. If you are required in your 7 course to be able to safely undertake a skill prior to commencing a practice 8 placement. and therefore how you are going to 5 perform. On the other hand. 9 Chapter 7 discusses what you should do after your formative or summative 30 OSCE. while 2 there is still time to take action for improvement.

6 7 2 Will enable you to demonstrate your knowledge.156. Copyright © McGraw-Hill Global Education Holdings. skills and attitude in 8 real-life health care situations. 2 3 4 5 6 7 8 9 30 1 2 3 4 5 6 7 8 9 40R . 1 4 Will enable you to work through scenarios. 8 9 9 Have quality assurance mechanisms built in.86] at [07/18/16]. Downloaded by [ Faculty of Nursing.62. Not to be redistributed or modified in any way without permission. 7 8 Are time-limited. 4 6 Are well researched as a validated method of assessment. 2 3 5 Can give you instant feedback. 5 6 7 Allow you to practise and be examined in a safe environment. LLC. simulated learning and OSCEs: 5 1 Are a rigorous way to identify your strengths and limitations. 40 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Chapter summary 3 4 Skills teaching. 9 3 Can be undertaken in a clinical skills laboratory. 20 10 Will help you to be a more competent professional learning in and from 1 practice. computer-generated 10 program or classroom. Chiangmai University 5.

156. Downloaded by [ Faculty of Nursing. The purpose of this is to demon- 7 strate to you how to use this information to its full potential in your OSCE 8 preparation. it must be sought for with ardour and 9 attended to with diligence. It is important to find a style that suits you rather than trying fit yourself 8 into a style. 6 Be aware of the support available for students with disabilities including 7 dyslexia and other specific learning difficulties. this chapter will look at learning styles in order to help you 9 identify what type of learner you are and how this can affect your preparation 30 for and performance in the OSCE. LLC. 2 3 4 5 This chapter will largely be dedicated to an annotated OSCE guide.62.86] at [07/18/16]. similar to 6 the one you may be given by your own tutor. 8 Be able to understand the written information you may be given in 9 preparation for your OSCE. 1 Preparing for your OSCE: 2 3 getting the most out of 3 4 5 your learning 6 7 8 Learning is not attained by chance. First. 9 40R . visual and kinaesthetic. 1 2 3 Understanding your own learning style 4 5 There are lots of different learning styles that you will come across when you 6 read further. 10 Abigail Adams (1744–1818) 1 2 3 4 By the end of this chapter you will: 5 Be able to understand your own learning style. or extroverted and intro- 7 verted. such as auditory. 20 Have a range of practical tips and advice on what is being looked for in an 1 exemplar OSCE. Copyright © McGraw-Hill Global Education Holdings. Chiangmai University 5. Not to be redistributed or modified in any way without permission.

4 In order to use the questionnaire you need to place ticks in the boxes next to 5 the statements that you feel most apply to you.156. see which section you have most ticks in and then look through 7 the areas for development within that category.62.learning-styles-online. Once you have completed the 6 questionnaire. if you have placed 8 most of your ticks in the category entitled ‘the jumper’. You may also find that there are areas you can develop from all 3 four sections – do not worry if this is the case.86] at [07/18/16]. 8 9 The following links take you to some of the most recognized questionnaires 10 available online: 1 2 www.vark-learn. and the purpose is to get you to think about the way you learn and give 20 you some tips on how to get the most from your learning. There is no ‘good’ or 1 ‘bad’ style and you may find that you are a mixture of the four styles used in the 2 example below. After you have identified your main style you can use 30 this information to help you to revise more effectively. 1 2 3 4 5 6 7 8 9 40R . Chiangmai University 5. 7 • get the best out of your preparation.com/english/page. use those study tips and 9 areas for development. 6 • tailor your preparation to your needs. it is perfectly normal. Copyright © McGraw-Hill Global Education Holdings. Not to be redistributed or modified in any way without permission.1 8 is an example of a learning style questionnaire to ascertain your typical learning 9 style. 4 • recognize the impact that your learning style has on your preparation and 5 performance. Table 3.com/ 6 7 Knowing your learning style will make your learning more efficient. Downloaded by [ Faculty of Nursing. For example. LLC.asp?p=questionnaire 3 and 4 5 www. 42 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 There is a range of learning style questionnaires to help you to: 2 3 • understand your own learning style.

156. Not to be redistributed or modified in any way without permission. they may not all be whatever you do as organized as you 7 You like to solve very complicated • Aim to be more creative in your 8 problems thinking 9 You like things to be perfect 40R once you’ve done them Total .1 Learning styles questionnaire 1 2 Tick Study tips and areas for development 3 ‘The jumper’ 4 You dive in and have a go at 5 • Aim to plan more and try reflection things 6 • Try stretching your mind to think You would rather get things over 7 more broadly and creatively with quickly and not delay • Consider a variety of alternatives 8 You are interested to see if before making a decision 9 things work • Try listening to peers 10 • Try to increase your interest so that 1 You want to get on to the next task quickly you maintain your concentration 2 for longer 3 You prefer short bouts of activity 4 Total 5 ‘The day-dreamer’ 6 You think a great deal about 7 what you are doing 8 You like to look into things very • Try to keep to your timings and 9 thoroughly once you’ve organized your work.86] at [07/18/16]. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 43 Table 3. Chiangmai University 5. LLC. 20 stick to your plan 1 You delay getting started on • Set yourself priorities and action 2 things such as revision or them 3 writing • Take decisions rather than 4 Time just seems to pass quickly procrastinating without you noticing 5 • Try to be assertive and aim to take a few more risks 6 You take time to do a time 7 planner but like to rewrite it often as well 8 9 Total 30 ‘The rationalist’ 1 You prefer it if things make 2 sense to you • Try to take time to be reflective 3 • Aim to work with others rather than You like an explanation for 4 trying to do everything yourself things 5 • Try to be accommodating of You tend to be very organized in 6 others’ styles. Copyright © McGraw-Hill Global Education Holdings. Downloaded by [ Faculty of Nursing.62.

An important factor to enable university staff to 2 be able to support you appropriately is your need to disclose your disability to 3 the relevant department/staff.156. 8 To ensure students with a disability have equal access to teaching and learn- 9 ing opportunities and appropriate support. This will have specially trained staff to help you identify 1 the support or adjustments you require in order to perform your best in your 2 OSCE. with guidance on the type of adaptations/sup- 1 port they can expect to receive. 44 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 ‘The explorer’ 2 You find an interest in 3 everything 4 You have the ability to see the • Try to set goals and priorities 5 bigger picture • Aim to take time to analyse things 6 7 You know about lots of things and think more critically You want to know lots of details • Try to categorize things 8 but don’t often remember them • Aim to develop your memory for 9 smaller details 10 You are so interested in things 1 you aren’t sure what is the main 2 priority 3 Total 4 5 6 Advice for students with disabilities including dyslexia 7 and other specific learning difficulties 8 9 This section will provide any student who has disclosed a disability. Chiangmai University 5.86] at [07/18/16]. these adjustments cannot be made. 7 8 If you don’t declare your disability. every university will have a disabil- 30 ity support department. 4 In 2001 the Special Educational Needs and Disability Act 2001 (SENDA) 5 extended the Disability Discrimination Act 1995 (DDA) to cover post-16 educa- 6 tion and introduced the need for a more proactive approach to anticipating and 7 responding to the needs of students with a disability. dyslexia or 20 other specific learning difficulty.62. Disability services also work closely with the university staff to ensure 3 that everything is put into place. Copyright © McGraw-Hill Global Education Holdings. 4 5 6 Declare your disability as early as possible to gain maximum support and help. LLC. The 9 legislation covering reasonable adjustments is considered in the light of the 40R professional requirements of the health and social care qualification that you . Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing.

6 7 8 The rest of this section will look in more detail at one of the commonest 9 forms of learning disability – dyslexia. Chiangmai University 5. a student with dyslexia. had met with the university student disability 8 service to discuss. including dyslexic learners. As a student with dyslexia you should also 5 make use of your own university student disability service to ensure they notify 6 module/course leaders how they can best support you in your learning. LLC. 2 The following case study is an example of the type of support you might 3 expect to get if you were a student studying with a disability. 2 the information was distributed to module/course leaders to provide informa. 30 1 2 Talk to your tutors about how you manage your disability. It also states that 6 an institution should not treat a disabled person less favourably than others for 7 a reason that relates to their disability without justification. 1 Once Carrie and her disabled student adviser had agreed on a support plan. 4 For exams. 4 5 6 Case study: support for a student with a disability 7 Carrie. Not to be redistributed or modified in any way without permission. Copyright © McGraw-Hill Global Education Holdings. Every 7 student with dyslexia will have different strategies to aid their learning and 8 overcome their disability.62. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 45 are undertaking.86] at [07/18/16]. The Quality Assurance Agency (QAA) 40R . We need to carry out continuing risk assessments to ensure 1 that you and/or the patients are not put at risk. learning and work placement 10 environments. explore and put together detailed information about how 9 lecturers could best support her in the teaching.156. Downloaded by [ Faculty of Nursing. 8 If the student is at a substantial disadvantage the educational provider is 9 required to make reasonable adjustments. 4 ing adjustments for your OSCE. 20 1 2 Dyslexia 3 If you are assessed and registered as having dyslexia. 3 4 SENDA requires HEIs to provide reasonable adjustments to enable disabled 5 students. 3 tion on how best to support her. Carrie would be given information in alternative formats and 5 extra time allowed for reading and documentation during the OSCE. you can expect the follow. It is therefore very important that you ensure that 9 you communicate how you do this with your tutors. to access the curriculum.

in the 2 course/module handbook.2. practices and proce- 3 dures should provide disabled students with the same opportunity as their peers to 4 demonstrate the achievement of learning outcomes’ (Section 3. LLC. Whichever format is used. ideas and critical acumen. 7 Recommendations by the Singleton Report. Dyslexia in Higher Education 8 (1999) supported the view that academic staff should discount as far as possible 9 errors in spelling. 7 • preparation for the OSCE. 5 While taking into account that these assessments may vary in format. reasonable adjustments may reflect good practice for all students. or as a 3 presentation. 8 • the OSCE examination itself (what you will be assessed on and how). Downloaded by [ Faculty of Nursing. individual room. 6 reader (to read out questions and answers to you as required). either electronically or as a paper copy. you can expect to receive the following 4 information: 5 6 • introduction to the OSCE. Copyright © McGraw-Hill Global Education Holdings. 9 • the OSCE examination timings (when the OSCE will take place. For example. Precept 13).156. grammar and punctuation in dyslexic students’ work. for example. Not to be redistributed or modified in any way without permission. 1 2 3 4 Information you will receive prior to your OSCE 5 6 In order to help you prepare for your OSCE and to aid communication 7 you should be provided with the following information from your academic 8 staff. the 6 assumption is that they will comprise five main elements for which appropriate 7 reasonable adjustments are made and these are shown in Table 3. how long 40R you will have to complete the exam). scribe (to write your dictation).62. In 4 many cases. 8 9 There is lots of help available to support you if you have dyslexia or other 20 specific learning disability.86] at [07/18/16]. Chiangmai University 5. This 1 information can be given to you in a number of ways. . 1 A principle of SENDA is that any accommodation made for the dyslexic candi- 2 date should not undermine academic standards. learning outcomes 3 should not be compromised even though the process of assessment may differ. Ideally this should be given to you at the beginning of the semester in 9 which your OSCE is going to take place. and 10 that marking instead should be based on content. This will allow you plenty of time 30 to prepare as you will know in detail what you are being assessed on. 46 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Code of Practice for the Assurance of Academic Quality and Standards in Higher Education 2 (1999) confirms that: ‘Assessment and examination policies. 5 Possible additional provisions include: computer.

Downloaded by [ Faculty of Nursing.156. Copyright © McGraw-Hill Global Education Holdings. Not to be redistributed or modified in any way without permission.62.2 Possible reasonable adjustments 1 2 Possible reasonable A text to An Information An A written 3 adjustments read activity to be assessment justification 4 documented interview of action 5 in patient records 6 7 25% extra time to √ √ √ 8 read and process the written 9 information 10 1 Use of a reader √ 2 where appropriate 3 4 Use of a pen and √ 5 paper to take notes and/or 6 highlighter pen 7 8 Information √ presented on a 9 range of coloured 20 paper and using 1 Arial/Century 2 Gothic or 3 Verdana fonts 4 (recommended 5 minimum 12pt) 6 Provision of √ √ 7 laptop for writing 8 up notes 9 Provision of √ √ 30 coloured paper 1 Blue marking √ √ 2 cards to indicate 3 the work is that 4 of a dyslexic/ 5 specific learning 6 disabilities 7 student 8 9 40R . PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 47 Table 3. Chiangmai University 5. LLC.86] at [07/18/16].

such as documentation.86] at [07/18/16]. The normal type is what you will receive from the university and italic 40R type is the explanatory text that we have added. 4 • access to typical resources you will be using. Not to be redistributed or modified in any way without permission. which will help you determine what level you are 5 required to perform at to receive certain grades. you will also be assessed on your attitude and knowledge. Chiangmai University 5. LLC. which will have criteria related to the knowledge. 8 9 10 Pre-reading 1 2 Even though a major part of the OSCE will be assessing your performance of a 3 skill. 3 • the OSCE mark sheet. 4 • OSCE marking criteria.62. The information 7 has been supplemented with written text by us. Therefore it is 4 essential that you have a good understanding of the theory behind the skill. 2 • the OSCE checklist. 7 • some tips on how to be successful in your exam. skills and attitude and you will ned 9 to demonstrate competency in all of these areas. . 2 • OSCE checklists. 48 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 • the OSCE scenario/station. 30 1 2 3 Sample OSCE information sheet 4 5 Below you will find an example of the type of written information you could 6 receive from your university to help prepare for your OSCE. skills 3 and attitude against which you will be assessed. skills and attitude required for safe 1 practice. 5 The following list will give you some ideas of which resources you should utilize 6 to support your pre-reading: 7 8 • reading lists from your course/module handbooks as these will highlight 9 key texts and other resources that may have relevant information in order 20 for you to gain the key knowledge.156. Copyright © McGraw-Hill Global Education Holdings. Downloaded by [ Faculty of Nursing. designed to help you gain a 8 greater understanding and be able to use the information to inform your prepa- 9 ration. 6 7 8 Remember your OSCE is about knowledge. 5 • related theory such as anatomy and physiology that may help you succeed 6 in the exam.

Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.156.86] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 49

1
Introduction to the Observed Structured Clinical 2
Examination (OSCE) 3
4
An OSCE is a key component of the assessment strategy for module X. As a 5
registered nurse you are personally accountable for ensuring your patient 6
receives safe and competent care (NMC 2008a), therefore, the ability to 7
perform clinical procedures with skill and confidence is essential. 8
This paragraph is setting the context and identifying the link that the OSCE 9
has with the NMC’s code of conduct, standards for proficiency and ESCs. 10
Success in the OSCE will contribute to the requirements of your course. 1
2
An OSCE allows us to assess more than just knowledge. During the
3
examination process the assessor is able to observe the following skills:
4
• interpersonal and communication skills; 5
• technical skills; 6
• observational skills; 7
• interpretation of data; 8
• documentation skills; 9
• initiative. 20
1
This list gives you guidance on what the examiner is looking for. It is clear 2
that you are not just going to be assessed on a clinical skill but also on: 3
• the way you interact and communicate with the patient; 4
• your ability to be able to perform the technical skills; 5
• your ability to observe and interpret the data. 6
7
Imagine you are applying the above list to recording a patient’s respiratory 8
rate. The examiner is not only assessing whether you have the technical 9
skill of being able to count your patient’s respiratory rate (technical skills) 30
but that you have the ability to ascertain if their breathing is regular, sym- 1
metrical and effortless and that the rate is within the normal limits (obser- 2
vational skills and ability to interpret data). An example of this could be 3
undertaking an OSCE with an 8-year-old child. The normal respiration 4
rate range for a 5–8-year-old child is 15–25 with an average of 20. If dur- 5
ing your OSCE the respiratory rate of the 8-year-old child you are examin- 6
ing is 28, you would need to inform the examiner and parent or carer that 7
this reading is slightly higher than normal. To demonstrate that you have 8
a true understanding you would need to highlight to the examiner what 9
40R

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50 SUCCEED IN OSCEs AND PRACTICAL EXAMS

1
2 you consider to be the normal range for this particular patient (as this may
3 be normal for them). You need to consider whether there has been any
4 recent events that could have caused the increase, for example, has the
5 child just run down the corridor, or recently been crying, which could
6 cause an increase in their respiratory rate. You need to state what you are
7 going to do about this; a typical response would be that an increase in
8 respiratory rate in isolation is unlikely to be anything significant. In this
9 case you would need to consider the other observations and state that you
10 would report this to your mentor or a senior member of staff.
1 You will then need to document your findings accurately, ensuring
2 that the documentation meets the standards prescribed by the NMC
3 (documentation skills). In respect to initiative, the examiner is assessing
4 your ability to act appropriately during the scenario, as mentioned above.
5
The OSCE also allows for self-evaluation through video-recording and
6
constructive feedback, and promotes student confidence.
7
8 This tells you that the OSCE is going to be recorded and you can expect
9 feedback from the examiners, but you should also use the experience to carry
20 out a self-evaluation. Chapter 7 gives you further guidance on how to make
1 the most out of the feedback you receive during and following your OSCE.
2
3
Preparation for the OSCE
4
5 The OSCE examinations will be held in the skills centres at your campus.
6 Please refer to your module timetable on the virtual learning environment for
7 this module for the week/days that have been allocated for these examinations.
8 Notification of the specific date and time of your examination will be displayed
9 two weeks prior to the week that the exams are being held.
30
This tells you about the venue for the OSCE and where you need to go to
1
find out the exact date and time of your exam. It is therefore your respon-
2
sibility to follow this up. If you fail to turn up for the OSCE, as you have
3
not found out this information, the consequence could be failing the
4
module or even being asked to leave the course.
5
6 Please bring the following to your OSCE exam:
7
• ID badge with photo and student number;
8
• watch with second hand;
9
• pens as required;
40R
• full uniform as per uniform policy.

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PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 51

1
The above list is to ensure that you have everything you need to perform 2
in the OSCE. It tells you that the university will provide any other equip- 3
ment that might be required in the OSCE. A note of caution, however: if 4
you fail to have your university identification badge with you and your 5
OSCE is a summative exam, many universities will not allow you to go 6
ahead, so this really is an essential item not to forget! 7
8
9
The OSCE examination
10
Please arrive for your OSCE at least five minutes before your allocated exam 1
time. Upon arrival report to the designated room and please have your student 2
ID badge ready to be checked. 3
4
Universities have very strict regulations about examinations and entering
5
after the exam has started is usually forbidden. Therefore, if you are late
6
and unable to commence your OSCE this is often counted as a ‘non-
7
submission’. Once again, depending on the type of assessment, the conse-
8
quences of this could be extreme. Therefore you should plan your journey
9
to the university very carefully to ensure that you arrive in adequate time.
20
However, do not go to the designated room until your allocated time. This
1
is for two reasons:
2
• first, you do not want to block the surrounding area as you will often 3
not be allowed in early, as students who are being examined before 4
you will still be there; 5
• second, it could increase your nerves! 6
7
As mentioned earlier, you may not be able to enter the OSCE without your
8
student ID badge, so do not presume that the person checking you in will
9
know you; this may not be the case. Universities often bring in extra staff
30
during exams to help run them smoothly.
1
You will then be given 10 minutes to prepare for your OSCE. During this 2
time you will be given a copy of the OSCE scenario, and an OSCE checklist for 3
you to read. 4
5
This informs you that you will have some time prior to entering the exam-
6
ination to remind you of what is required during the OSCE. If you have left
7
it until this time to ascertain what is required of you it is unlikely that you
8
will perform well in the exam! However, if the OSCE is assessing a number
9
of skills at different stations it is here that you are told which stations/
40R
skills you will be assessed on. This 10 minutes is very useful as a short,

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52 SUCCEED IN OSCEs AND PRACTICAL EXAMS

1
2 quiet and reflective period before you enter the exam. Chapter 5 expands
3 on how to cope with pre-OSCE nerves.
4 The OSCE checklist is once again just a reminder and you should
5 have studied this is great detail prior to arriving at the exam. Below is an
6 example checklist that we have annotated to help you ascertain what the
7 examiner is looking for.
8
At the end of 10 minutes you will be escorted to the simulation ward X and
9
directed to the corresponding patient’s bed space.
10
1 This informs you where the actual OSCE will take place and indicates that
2 there will be a number of stations running simultaneously.
3
You will have 15 minutes in total for the examination. During this time you
4
will be asked to complete three out of a possible four procedures. You need to
5
complete all three procedures to be in a position to gain a pass in the OSCE.
6
7 You have 15 minutes to complete three out of the possible four procedures
8 listed. This time allowance will help you with your practice and rehearsing.
9 When you are practising the skills and as you get more confident and pro-
20 ficient in them, you will need to ensure that you can fit different combina-
1 tions of the procedures into 15 minutes. It is very clear from the above
2 statement that not only do you have to meet the requirements on the OSCE
3 checklist but you also have to complete the task. This is not always the
4 case for some OSCEs, where you may only have to complete certain aspects
5 before the examiner is able to assess you. It is important that you ask the
6 leader of your OSCEs what happens if you do not complete in the allocated
7 time if this is not explicit in the information given to you.
8
The possible procedures are as follows:
9
30
1 Adult/mental health/learning disability fields
2
• Temperature measurement
3
• Pulse rate measurement
4
• Respiratory rate measurement
5
• Blood pressure measurement
6
7
8 Child field
9
• Temperature measurement
40R
• Pulse rate measurement

Chiangmai University 5. Universities will often have an independent skills 30 laboratory where students can go either individually or in groups to prac- 1 tise clinical skills. 4 Clinical practice offers essential opportunities to prepare for your 5 OSCEs. It is therefore essential that you attend 6 all of these sessions. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 53 1 • Respiratory rate measurement 2 • Apex beat measurement 3 4 The above lists are informing you about which clinical skills you are being 5 assessed on. 9 You need to use every opportunity to practise the skills required: this 40R could be supervised practice in the clinical area with your mentor. 9 Following the initial session. remember you are not doing yourself or your 2 peers any favours by saying they did well if they did not and vice versa! 3 Therefore constructive criticism is essential. However. When the 2 assessment is an OSCE. Share as much information as possible with your mentor so they 6 can help you with your preparation. If your OSCE is summative you 2 will be given the opportunity of a formative OSCE. You will never 1 be assessed on anything that you have not been taught. the fact that you are not aware of 7 which you will be assessed on until you report to the OSCE means that you 8 still need to learn all four procedures.86] at [07/18/16]. or in . 8 Self-assessment and peer assessment can also help you prepare and 9 succeed in your OSCE. The usual reason why you are not being assessed on them all 6 is due to time and resources. However. Not to be redistributed or modified in any way without permission. but also because it will 4 give you the opportunity to experience what it is like being watched so 5 closely. and what is expected of you in the OSCE. not 3 only because of the feedback you will be given. Copyright © McGraw-Hill Global Education Holdings. This is invaluable. you are usually taught the skills during simulated 3 learning in the simulated learning environment for the practical element. Make sure you are aware 1 when and where these are taking place. most universities will facilitate further 20 practice sessions nearer the time of the exam.62. LLC. Ask them to use the OSCE checklist 7 provided by the university to assess you whenever you carry out the 8 activities on which you are going to be examined. you need to utilize the learning oppor- 10 tunities provided by the university and clinical practice. the related knowledge/theory may well be gained via a lecture/ 5 seminar or recommended reading.156. Downloaded by [ Faculty of Nursing. Chapter 2 discusses the difference between formative and sum- 6 mative OSCEs while Chapter 7 discusses types of feedback in greater 7 detail and gives you advice on how to act upon your feedback. 9 To ensure you are fully prepared. otherwise you may miss not only the practice time 7 but also the demonstration and other important information such as 8 related knowledge. 4 However.

skills 4 and attitude. if you have taken 10 minutes to only complete one of 6 the skills being assessed and you have two further skills to complete. However. not only do you need to be able to carry out the 1 physical assessment. 5 6 Concise and accurate documentation of any care that you have given.62.156. should be a recorded in the patient’s notes. 3 In all instances you will be expected to accurately and correctly document 4 your findings on the charts provided. The follow- 8 ing statements from the NMC code of conduct for nurses and midwives (2008) 9 set the standards and this is what you will be assessed against. Downloaded by [ Faculty of Nursing. 1 The examination timekeeper will alert you when you have five minutes of 2 the exam time remaining. 54 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 the simulated learning environment with university staff. This will not only give you pointers as to what components will 5 be tested but you can ascertain at what level you are required to perform to 6 receive certain grades. or providing 40R greater explanation to the patient. Confidently discriminate between normal and 20 abnormal findings. Not to be redistributed or modified in any way without permission. or self-directed. For example. 5 Even though a major part of the OSCE will be assessing your perform- 6 ance of a skill. there will be a marking criteria sheet attached. if you are on your last skill you may 8 feel you can slow down a bit and try and improve your OSCE by providing 9 further information to the examiner about what you are doing. It is therefore essential that 8 you have a good understanding of the theory behind a skill. you will be assessed on other aspects such as related 7 knowledge/theory. LLC. gaining access to physiology texts is essential. The sections 30 that are relevant to this OSCE are in bold type to help you pick them out. Chiangmai University 5. the better they do.86] at [07/18/16]. For example. in order to obtain an A grade or distinc- 7 tion under the knowledge section of a physical assessment OSCE. you 7 risk of running out of time. 3 4 The rationale for this is to give you an indication if you need to speed up 5 at all. You should use 9 the reading lists from your course/module handbooks as these will high- 10 light key texts and other resources that may have relevant information. . includ- 7 ing taking observations. you will 8 need to: ‘Demonstrate a detailed and accurate knowledge of key aspects of 9 relevant underpinning theory. you need also to have a wide depth of knowledge of 2 pathology. Copyright © McGraw-Hill Global Education Holdings. as discussed previously. hence. if an OSCE is being graded and is not just a 2 pass/fail.’ Therefore. 1 As well as the OSCE checklist. This is another valu- 3 able source of information as it will have criteria related to knowledge. 3 Students have found that the more confident and competent they are with 4 the skills prior to entering the exam.

if you forgot to inform the patient if their 3 observations were within the normal ranges you could do this. Your university may utilize another 7 system of recording the OSCE. For example. viewing and reflecting on your performance 1 will help you develop further. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 55 1 Once the 15 minutes has elapsed the timekeeper will announce the end of 2 the examination and you will be escorted from the examination room. 3 4 Even if you finish your OSCE prior to the 15 minutes you will not be able 5 to leave the room. 4 5 This informs you that the OSCE will be recorded using a video-recording 6 system that the university has in place. Downloaded by [ Faculty of Nursing. 3 All OSCE assessments will be video-recorded using SMOTS. including rechecking 9 any documentation you have completed. however. 9 20 This is a quality assurance process to ensure that every student is being 1 assessed equally. Not to be redistributed or modified in any way without permission. you suddenly remember something that you 1 should have done. and as long as you complete it within the 15 minutes 2 you can continue. if this is one of the essential criteria 6 it is better that you gain a lower mark than fail. LLC. Reflective practice is discussed further in 2 Chapter 7. 4 you will probably be marked down as your OSCE performance would not 5 have been fluent. If you do finish the OSCE early. They will not be examining you but observing the examination process. so ensure that you are aware of this 8 system. Please document 9 all measurements on the observation chart provided.86] at [07/18/16].62. This information is provided to make you aware that there 2 will be more people in the examination room than just the examiners.156. The reason for this is so that you do not disturb any 6 student who has not completed. you 7 should sit down and go through the process in your head to ensure you 8 have completed everything you were required to do. Chiangmai University 5. temperature. On the other hand. It does not matter if you 30 pass or fail the OSCE. 7 ing procedures (you will be told to perform three out of the following four pro. 7 A quality assurance person and timekeeper will be present during the 8 OSCE. 8 cedures. Please explain to the 40R . It may be that even if you say you 10 have finished your OSCE. pulse. 3 4 5 The OSCE scenario 6 ‘Your patient is in hospital for tests and I would like you to perform the follow. respirations or blood pressure). The recording of the OSCE is for quality assurance purposes 9 and also to help you reflect upon the process. Copyright © McGraw-Hill Global Education Holdings.

3 Ensure you place the tympanic thermometer probe carefully into the ear 4 canal and make sure you angle the probe towards the patient’s nose to ensure 5 you are not taking a reading from the skin of the ear canals. 5 Every clinical area has slightly different documentation. presence of ear wax). Chiangmai University 5. This is where the tutors are assessing 3 your knowledge base and whether you can interpret the observations that 4 you have taken and take appropriate action.86] at [07/18/16].’ 4 This scenario is very explicit and as soon as you have received this written 5 information you can start to prepare for your OSCE.62. 5 6 OSCE ‘top tips’ 7 8 Taking a patient’s temperature 9 Ensure you insert the tympanic thermometer probe into the ear nearest to you. 8 • why they are there. It informs you that: 6 7 • your patient is in a hospital setting. completed to the standard required in order to pass the OSCE. Downloaded by [ Faculty of Nursing. In the above scenario the key 2 aspects are the skills you will be assessed on and the fact that you not only 3 have to take and interpret the observations but you also need to document 4 them on the observation chart provided. If it is not provided. then make sure you 2 walk around the bed/chair and approach the patient from the other side. Copyright © McGraw-Hill Global Education Holdings. 9 • what you are expected to do. so ensure you get 6 a copy of the documentation you will be expected to use. 7 8 Taking a patient’s pulse 9 When taking the patient’s pulse. You 1 are asked to explain to the patient if the patient’s observations are within 2 the normal range of that individual. Not to be redistributed or modified in any way without permission.156. A sample OSCE checklist is provided on 20 page 67. the rhythm and amplitude should be assessed 40R as well as the rate. 56 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 patient whether their observations are within the School of Health and Social 3 Care recommended normal range for that individual. 10 When you receive a scenario. You can then 7 become familiar with it and the OSCE will not be the first time you have 8 seen it.g. . LLC. Incorrect insertion 6 can lead to an inaccurate reading. ensure you break it down and highlight the 1 key aspects to help with your preparation. 30 If you need to record the temperature in the other ear because you are worried 1 the reading was not accurate (e. ask for sample documentation so that you can 9 see what you are expected to do.

Chiangmai University 5. Take it off and 6 turn it the right way. 8 If you have difficulty seeing the rise and fall of the patient’s chest then it 9 may be helpful to ask them to place their arm across their chest. check you have inserted the stetho. 1 • failing to complete the radial check to establish the approximate systolic 2 pressure. If you cannot 2 hear this sound. 30 • failing to support the arm in the correct position. 8 If you cannot hear the blood pressure. Copyright © McGraw-Hill Global Education Holdings. If you need to stop to write the 6 respiratory rate down on a piece of paper or your observation chart then you can 7 always ask the patient if you can take their pulse again. this 10 may increase their awareness that their respirations are being counted and 1 alter their breathing rate. then tap the diaphragm of the stethoscope again. Not to be redistributed or modified in any way without permission. You should be able to read the writing on the cuff. turn the stethoscope around so that the ear pieces fit in the 3 other way.62. . PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 57 1 Taking a patient’s respirations 2 3 The patient may alter their breathing rate if they are aware their respirations 4 are being counted. date/month and time. You can 7 then start the procedure again. you should hear a ‘drum’ 1 sound when you tap the diaphragm (flat end) of the stethoscope. 4 Make sure the end of the stethoscope is turned so that the hole is not visible 5 when you look at the bell side. 3 • deflating the cuff too fast or too slow. along with the year. 4 • failing to record the diastolic reading at the disappearance of the Korotkoff 5 sound (Phase V).156. 2 3 Taking a patient’s blood pressure 4 If the blood pressure cuff ‘blows up’ while you are inflating it or you hear a 5 ‘ripping’ sound. 9 scope ear pieces into your ears correctly. They should be angled towards your 20 nose. you have probably put the cuff on inside out. Downloaded by [ Faculty of Nursing. However. 6 Common mistakes when taking a patient’s blood pressure include: 7 8 • the patient is talking while you are taking the blood pressure – this can 9 cause an increase in the systolic pressure by up to 17mmHg. You can reduce this risk by pretending to count the pulse 5 but instead count the patient’s respiration rate.86] at [07/18/16]. LLC. If you have inserted the ear pieces correctly. 6 7 Documentation 8 9 Make sure you complete your patient’s full name (surname and first name) and 40R hospital number on the observation chart.

.. LLC........156............ 8 9 And finally… 10 1 Make sure you read the OSCE checklist carefully. 5 If you need to make an alteration...... 20 1 2 The checklist below informs you about what you are required to do in order to 3 pass the OSCE................... 3 The above sections are just some top tips/reminders to help you succeed 4 in your OSCE... 58 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Take care to record your readings accurately on the observation chart..... Not to be redistributed or modified in any way without permission.. It is hoped that you can then apply the same principles to the 5 OSCE checklist that has been provided by your university............................................. Please see the observation chart on page 67 for an example of how 7 observations should be correctly documented........ it provides you with what the minimum 9 requirement is for you to pass the OSCE.................... Downloaded by [ Faculty of Nursing.......................... 3 DATE ....................... what have 9 been found to be the common mistakes that students make.62. etc............. Chiangmai University 5................... 7 8 This is a very important statement........86] at [07/18/16]... All items in bold on the 2 checklist must have been demonstrated in order to pass the OSCE.. 6 7 8 Physiological measurement OSCE checklist 9 30 EXAMINER’S NAME .... 4 5 Achievement of a pass grade requires all components in 6 bold to be demonstrated as a minimum....... make sure these are dated....................................... These tips have normally been developed utilizing the 8 examiners’ experiences of previous OSCEs – for example.................... Make 3 sure your recordings are all on the same line and place dots/crosses...... Copyright © McGraw-Hill Global Education Holdings. If you do not achieve one or more 40R ......... timed and 6 signed......... or by 7 electronic means.... Do not forget that the examiners want you to succeed! 5 These tips may not always be provided in a written format but may be via 6 a presentation given during a lecture/seminar/simulated session. 1 STUDENT LABEL ........................................... in the 4 middle of the box not on the vertical lines... 2 STATION . We have annotated it to help you identify what the examiners 4 are looking for.............

156. you have either breached professional standards. and against the patient’s/ client’s ID bracelet 4 5  Clearly explains all of the procedures to the patient/ 6 client/carer using language appropriate to the patient/ 7 client/carer 8  Checks patient’s/client’s/carer’s understanding of 9 procedures 40R (Continued) .62. By achieving all of the bold items to the required 5 standard you will pass the OSCE. however. This may be a clinical uniform 6 or simulated practice uniform. In addition. You may feel this is a bit harsh. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 59 bold item you will automatically fail even if you achieve the rest of the 1 OSCE perfectly. or carried 4 out practice unsafely. Chiangmai University 5. 6 bold items you will pass the OSCE with a higher mark/level of perform. 7 8  Introduces themselves to patient/client/carer giving name and status 9 30  Asks what the patient/client/carer would like to be 1 called 2 3 Communication skills  Checks patient identity verbally. LLC. 3  Adheres to the school professional dress code 4 This tells you that you are expected to complete the 5 OSCE in your uniform. Not to be redistributed or modified in any way without permission.86] at [07/18/16]. You should never aim to just pass! 8 9 10 Table 3. the rationale is 2 that without achieving any of the bold items to the standard set in the 3 statement. 2007b). 8 privacy and dignity 9 20 This relates once again to the NMC Code (2008a) but 1 also the NMC ESC and standards of proficiency 2 (2007a. 7 ance. if you complete the non. Downloaded by [ Faculty of Nursing. Copyright © McGraw-Hill Global Education Holdings.3 Physiological measurement OSCE checklist 1 2 Activity Performance expected 3 Professional  Behaves in a professional manner consistent with professional 4 behaviour standards 5 You need to refer to the NMC Code (2008a) to 6 ascertain what these professional standards are. 7  Performs the activity with due respect to patient safety.

Not to be redistributed or modified in any way without permission..156. The remaining 2 statements are also important. LLC.. however..86] at [07/18/16]. 60 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Activity Performance expected 2 3  Offers clear answers to any questions the patient/client/ carer may ask 4 5  Gains the informed consent from the 6 appropriate individual/s 7  Verbally concludes the procedure and ensures the 8 comfort of the patient/client/carer 9  Demonstrates appropriate positioning/body language/eye 10 contact/use of touch while explaining/performing the 1 procedures 2 3  Speaks clearly 4  Uses open-ended questions 5 This section is assessing your communication skills.62.... 5 6  Explains to the patient/client/carer the purpose of the 7 procedure 8 9 Tympanic  Covers the speculum with disposable cover without thermometer contaminating it 30 1  Gently inserts into the ear canal.. they do not 3 make you unsafe by not completing them.5 degrees of 8 examiner’s reading) 9 Examiner’s reading .. adjacent to but not touching 2 tympanic membrane 3  Leaves thermometer in for correct amount of time – indicated 4 by a bleeping sound 5  Removes thermometer without contaminating hands 6 7  Reads temperature accurately (within 0. Downloaded by [ Faculty of Nursing. Chiangmai University 5. 40R . Copyright © McGraw-Hill Global Education Holdings. If this OSCE 4 was just assessing your communication skills they would be in bold... 6 There are two elements that you are required to carry 7 out as a minimum in order to pass the OSCE. These 8 are requirements of the NMC Code (2008a) and in 9 your preparation you need to ensure you fully 20 understand what is required and why it is deemed 1 essential in order to pass the OSCE.

3 however. Not to be redistributed or modified in any way without permission. 1 The order that the actions are listed in is usually the 2 most coherent way of carrying out each of the skills.86] at [07/18/16]. LLC. it is not always the only way. 7 Pulse rate recording  Explains to the patient/client/carer the purpose of the 8 procedure 9 30  Checks for recent exercise 1  Checks that the patient’s arm is resting comfortably 2 3  Locates radial pulse accurately 4  Using watch with second hand and counts for 5 60 seconds 6  Heart rate noted correctly (within 6 of the examiner’s 7 reading) 8 9 (Continued) 40R .62. Downloaded by [ Faculty of Nursing. Copyright © McGraw-Hill Global Education Holdings. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 61 1 Student’s reading 2 Examiner’s checked reading 3  Discards probe mindful of infection control risks 4 5  Informs the patient/client/carer if the reading is within an 6 acceptable range 7  Informs the patient/client/carer of the normal ranges for 8 temperature measurement for the client group as taught by the 9 School of Health and Social Care 10  Replaces equipment appropriately 1 2 This section and the sections below are intended to inform you how you are expected to carry out the 3 procedures that you have been asked to perform. Chiangmai University 5.156. 4 You will be assessed against each of the statements 5 and a tick or cross will be placed in a box next to 6 the statement depending on whether you perform 7 the action. If you attempt to perform an action 8 and you either do this incorrectly or not to the 9 required standard. a cross will be inserted into 20 the box. For example if 4 you prefer to inform the patient about the normal 5 ranges of temperature at the beginning of the OSCE 6 this will not affect the outcome.

62. Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing. 2 3 Respiratory rate  Explains to the patient/client/carer the purpose of the 4 recording procedure 5  Checks for recent exercise 6 7  Observes/feels/ listens for respirations for 8 60 seconds 9  Respiratory rate noted correctly (within 2 of the examiner’s 30 reading) 1 Examiner’s reading 2 3 Student’s reading 4 Examiner’s checked reading 5  Informs the patient/client/carer if the reading is within an 6 acceptable range 7 8  Informs the patient/client/carer of the normal ranges for 9 temperature measurement for the client group as taught by the 40R School of Health and Social Care . LLC. The 5 rationale for asking this question is related to you 6 understanding that recent exercise can increase the 7 pulse rate. Copyright © McGraw-Hill Global Education Holdings. This will show the examiner that you have not just memorized the checklist but 20 have an understanding of why that element of the 1 assessment is important. 62 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Activity Performance expected 2 3 Examiner’s reading 4 Student’s reading 5 Examiner’s checked reading 6 7  Informs the patient/client/carer if the reading is within an 8 acceptable range 9  Informs the patient/client/carer of the normal ranges for 10 temperature measurement for the client group as taught by the 1 School of Health and Social Care 2 When recording the patient’s pulse. checking for recent 3 exercise is an example of best practice. If you do ask such questions.86] at [07/18/16]. it is advisable 8 to explain to either the patient or the examiner why you 9 have asked that question. Chiangmai University 5. but not asking 4 the patient this question will not make you unsafe.156.

cuff deflated immediately 8  States estimated systolic pressure 9 30  Stethoscope ear pieces inserted into ears correctly 1  Brachial pulse palpated and stethoscope placed directly 2 over it 3  Cuff inflated to 20–30mmHg above the stated estimated 4 systolic 5 6  Cuff deflated at an approximate rate of 2–4mmHg 7 per second 8  Promptly releases cuff at the end of the procedure 9 (Continued) 40R . 3 cubital fosse 4 5  Cuff applied firmly but not too tightly 6  Radial pulse palpated and cuff inflated until pulse 7 disappears. LLC.86] at [07/18/16]. Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing. Chiangmai University 5.156. Copyright © McGraw-Hill Global Education Holdings.e. you need to 2 question the statement to increase your knowledge 3 base. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 63 1 If any of the statements conflict with what you have seen in practice or read in the literature. cuff covers 80% of the circumference 9 of the upper arm 20  Brachial pulse palpated and the centre of the bladder placed 1 over it 2  Bottom edge of cuff placed about 2. However. until recently it was documented 4 and common practice that if a respiratory rate or pulse 5 rate was regular you need only to observe/feel for 30 6 seconds and then double your reading. 9 10 Blood pressure  Explains to the patient/client/carer the purpose of the 1 recording procedure 2  Checks for recent exercise 3  Ensures that tight or restrictive clothing is removed from the 4 arm 5 6  Ensures the patient’s arm is well supported at the patient’s heart level with the palm of the hand facing upwards 7 8  Cuff size selected – i. more 7 recent evidence suggests that it should be observed/ 8 felt for 1 minute.5cm above the ante.62. For example.

This is assessing your knowledge base and 5 informs you that you need to have a certain level of 6 knowledge related to the skills you are performing 7 in order to pass this OSCE.. 10 1  Informs the patient/client/carer if the reading is within an 2 acceptable range 3  Informs the patient/client/carer of the normal ranges for 4 temperature measurement for the client as taught by the 5 School of Health and Social Care 6  Stethoscope ear pieces cleaned with an alcohol wipe 7 8  Clothing replaced and patient left comfortable 9 This section provides you with the procedure for 20 reading a blood pressure. 64 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Activity Performance expected 2 3  Systolic and diastolic pressures correctly noted (student’s systolic reading to be within + or – 10mmHg of the examiner’s 4 systolic reading and student’s diastolic reading to be within + 5 or – 6mmHg of examiner’s diastolic reading) 6 7 Examiner’s reading..... You are expected in all the 1 procedures to inform the patient/carer if their readings 2 are within an acceptable range for them (therefore 3 taking into account their age and any pathology they 4 may have)............. Copyright © McGraw-Hill Global Education Holdings...........156.......... Downloaded by [ Faculty of Nursing. LLC.............62...... below nipple for children over 7 7 years) 8 9  Uses watch with second hand to count apical pulse for 60 40R seconds . 9 Examiner’s checked reading............................. 8 9 Apex beat (to be  Explains to the patient/client/carer the purpose of the 30 carried out on sim procedure 1 newby or sim baby)  Checks the stethoscope is working and set to use the 2 diaphragm 3 4  Places the diaphragm of the stethoscope in the correct position for the child’s age (fourth intercostal space 5 slightly left of nipple line for children under 7 years/ 6 fifth intercostal space... 8 Student’s reading... Not to be redistributed or modified in any way without permission................... Chiangmai University 5.. and also if they are within the normal range..86] at [07/18/16]..

.. Not to be redistributed or modified in any way without permission.. because all criteria are set by 8 the NMC.. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 65 1  Heart rate noted correctly (within 6 of the pre-set reading) 2 3 Pre-set reading. articulates how levels of 8 activity might influence this 9 10  Informs the patient/client/carer of the normal ranges for 1 child/infant’s age as taught by the School of Health and Social Care 2 3  Stethoscope ear pieces cleaned with an alcohol wipe 4  Clothing replaced and patient left comfortable. 4 Student’s reading........ timed and 1 signed 2  The record is written in black ink 3 This section states how you need to record your 4 observations on the observation chart provided...... 9 (Continued) 40R ......... 2 3 Documentation  Patient’s full name and hospital number clearly written 4 on the observation chart and can be easily read 5 by others 6  All observations are dated (date... sleeping/crying)... Copyright © McGraw-Hill Global Education Holdings...156.... It also clearly states 8 that you will be carrying out this skill on a manikin 9 (sim newby or sim baby). 5 There is an example of an observation chart on 6 page 67 to help you apply this..... Therefore you should 20 ensure you have practised using such a 1 manikin. well-being 5 of patient ascertained 6 7 This section demonstrates how you need to find and listen to the apex beat. month and year) 7 and timed 8  All observations are charted accurately 9 30  All alterations or additions are dated.... You will see that all 7 elements are bold...g. Downloaded by [ Faculty of Nursing.. 5 6  Informs the patient/client/carer if the reading is within an acceptable range with reference to child/infant’s level of 7 activity (e..86] at [07/18/16]....62.. LLC. Chiangmai University 5...

Please refer to Chapter 7 where feedback is 4 discussed in greater detail. or why infection causes pyrexia. Not to be redistributed or modified in any way without permission. 66 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Activity Performance expected 2 3 PASS/REFERRAL This section will be used by the examiner to indicate if you Feedback have passed the OSCE or have been referred (need to resit or 4 retake the OSCE). 5 6 The checklists are one of the most valuable pieces of information in helping you 7 prepare for your OSCE. if you were asked to carry 4 out the same OSCE towards the end of your training. just a pass or referral. For example. This will vary depending on where 20 you are in your training. you would probably be expected 5 to explain how abnormal pathology would affect observations – for example. You need only 2 know if they are within normal ranges and be aware of those normal ranges. 9 There is also an example of an OSCE which includes a 10 checklist not dissimilar to this one. 7 8 9 30 1 2 3 4 5 6 7 8 9 40R . the amount of knowledge this OSCE is expect- 1 ing you to have in relation to interpreting your findings is minimal. The scores are 8 added up and then converted into a percentage and grade.86] at [07/18/16]. As mentioned previously. so this 3 exam could be taken very early in your training. what 6 would increase a patient’s blood pressure. It informs you that you will not be given a 5 mark for this OSCE. LLC. 2 This section will also give you feedback as to how you can 3 improve.62. In Chapter 6 we 6 have provided you with an example of an OSCE showing that 7 after each statement you can gain a score. Downloaded by [ Faculty of Nursing.156. Chiangmai University 5. Copyright © McGraw-Hill Global Education Holdings. not only does the checklist inform 8 you of what you will be expected to do in order to pass the OSCE. it gives you an 9 indication of the standard that is expected of you. However. but is converted into a 1 percentage by utilizing marking criteria.

Not to be redistributed or modified in any way without permission. LLC.62. Downloaded by [ Faculty of Nursing. PREPARING FOR YOUR OSCE: GETTING THE MOST OUT OF YOUR LEARNING 67  1  . Copyright © McGraw-Hill Global Education Holdings. Chiangmai University 5.86] at [07/18/16].156.

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62. What we suggest you do is. so you can get the answers. 6 7 4 Make use of any additional information the lecturers provide to help you 8 succeed in your exam. 5 6 8 Ensure you know how many attempts you are able to undertake. 7 9 Aim to work out your own learning style. early on. 9 5 If you have a disability. 68 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 We hope that you have found the sample OSCE information that we have 2 annotated for you useful. 9 10 Chapter 4 will help you to understand the expected layout of the room for 1 your OSCE and the types of simulated clients/models or manikins that will be 2 used during your OSCE. ensure that the module/course leader is aware so 30 that any reasonable adjustments can be made. This important task will help you ascertain: 5 6 • which clinical skills you are required to perform during your OSCE. 5 6 7 Chapter summary 8 1 Ensure you take every opportunity possible to undergo supervised simu- 9 lated practice so that you get used to the environment and equipment that 20 will be used in your exam. Not to be redistributed or modified in any way without permission. 4 3 Ensure you have the adequate level of knowledge and skills to undertake 5 the OSCE by making use of lecture notes and other resources. make notes not dissimilar to ours in order to 4 help you start your preparation. Chiangmai University 5. 1 2 6 Aim to let your module/course leader know as early as possible if you have 3 a disability. Downloaded by [ Faculty of Nursing. 1 2 2 Attend formative OSCEs and act upon the feedback that the examiners 3 give you.86] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings. once you receive this type 3 of information from your tutors. 7 • the level of knowledge and skills you need to display. LLC. 8 9 10 Identify which areas from your learning style analysis you can develop further. 4 7 Be sure about whether you are taking a formative or summative attempt. 40R . You will learn to recognize the role and behaviour of 3 your assessors/examiners and be aware of the role-behaviour and performance 4 required by you in order to prepare for your OSCE.156. 8 • any queries or questions you may have.

LLC.86] at [07/18/16]. 7 Recognize the role and behaviour of your assessors/examiners. the photographs throughout this chapter will 1 give you an idea of what to expect. Chiangmai University 5. Not to be redistributed or modified in any way without permission. taking 9 and recording vital signs and urinary catheterization. 7 istration of medicines. cameras and external examiners). 9 John Lubbock (1834–1913) 10 1 2 3 By the end of this chapter you will: 4 Understand the expected layout of the room for your OSCE. 8 Be aware of the role-behaviour and performance required in order to 9 prepare for your OSCE. admin. 2 3 4 5 6 The layout of the room 7 8 When you enter your examination the layout of the room should be fairly 9 familiar to you. 1 roaming moderator. 20 Understand the mechanisms used to ensure quality assurance (e. 4 The room may look slightly different to how you are used to seeing it. simulated ward. 2 Depending on the focus of the examination. 5 Understand the types of simulated clients/models or manikins that will be 6 used during your OSCE. Copyright © McGraw-Hill Global Education Holdings. 1 What to expect from 2 4 your OSCE 3 4 5 6 7 8 What we see depends mainly on what we look for. simulated home setting or classroom. These stations may all 6 be identical if you are all being tested on the same skills – for example.62. Alternatively.g. such as hand-washing.156. If not. it may take place in a computer 3 room. as there 5 will probably be a series of examination stations set up. assuming you have undertaken simulated learning in a practice 30 skills laboratory before. there may be a number of different sta. skills laboratory. 40R . 8 tions which you are required to rotate around. Downloaded by [ Faculty of Nursing.

70 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Whichever format is used. The reason for this is to give you privacy throughout your 3 exam (see Photograph 1). Not to be redistributed or modified in any way without permission. a pen and/or fob watch. All the equipment that you are required to use should 4 be available at the station. Chiangmai University 5. documentation 7 8 9 20 1 2 3 4 5 6 7 8 9 30 1 2 3 4 5 6 7 8 9 40R Photograph 1 Bed stations with curtains .86] at [07/18/16]. Downloaded by [ Faculty of Nursing. 10 1 2 Equipment used 3 4 The equipment used in the OSCE will depend on the type of exam you are 5 undertaking. Copyright © McGraw-Hill Global Education Holdings.62. You can see that each station is separated by curtains to 8 ensure privacy for you and also to ensure that privacy and dignity can be main- 9 tained for your patient throughout the examination. 6 Photograph 1 shows you the layout of a room set up for several stations run- 7 ning simultaneously. each station will normally either be behind cur- 2 tains or screened off. other than those items that you have been asked to 5 bring with you – for example.156. observation recording equipment. You should be familiar with any equipment you are using during 6 the OSCE – for example. LLC.

However. and manikins. Not to be redistributed or modified in any way without permission. it could faze you and cause 3 errors. LLC. therefore different clinical areas may have 10 different thermometers from the type that the university uses. Therefore. 1 eter works in a slightly different way and if you come across a piece of equip. Downloaded by [ Faculty of Nursing.156. as a health care professional. WHAT TO EXPECT FROM YOUR OSCE 71 such as medication charts.86] at [07/18/16]. Please remember that the university will give 3 you the opportunity to practise using the equipment and if you do not take up 4 this offer you cannot report in the OSCE that you have not used or seen this 5 equipment before. 8 9 20 1 2 3 4 5 6 7 8 9 30 1 2 3 4 5 6 7 8 9 Photograph 2 Taking a temperature reading 40R . Copyright © McGraw-Hill Global Education Holdings. Chiangmai University 5. it is essential that you 7 find out what equipment you will be using during the OSCE. You should not be required to use any 1 equipment that you have not been shown before or had the opportunity to 2 practise using before the OSCE. 2 ment in the OSCE that you are not familiar with. 5 that you are confident and competent in using any appropriate equipment to 6 support the care that you give to your patients. 7 Photograph 2 shows a student taking a patient’s temperature. 9 panic thermometer on the market.62. This is an added reason why it is important that you take 6 every opportunity offered to practise in the simulated learning environment. There are several different types of tym. Each thermom. You can see 8 she is using a tympanic thermometer. not being used to the equipment is not a valid excuse for 4 under-performing in an OSCE and it is expected.

a volunteer. Copyright © McGraw-Hill Global Education Holdings. compassion and 4 communication’. 2 The different types of simulated client you may come across are: 3 4 • members of the public.86] at [07/18/16]. 5 • colleagues/peers.156. both adults and children. LLC. 9 20 With any live model in a simulated setting you need to ensure you adhere to 1 the main professional principles that would guide you in your professional life. a fellow student 40R or a tutor? Never presume who will be your patient – it may unnerve you if . 1 Either way they will have been well prepared by the academic team as to their 2 expected performance/behaviour during your OSCE. 4 5 6 7 Types of simulated client/model 8 9 This section details what is to be expected from the following simulated clients 10 and the differences between them. 8 • manikins. There are a range of live 3 models that could be used as a simulated patient and they will now be dis- 4 cussed. you should find out who will be acting 9 as your patient: will it be a professional actor. 7 • practice staff. or it may be their first time. the most important point for you to remember is whatever 5 the type of live model or situation. Chiangmai University 5. You will also be 6 adhering to the NMC standards for proficiency. 30 Your models may be used to acting as patients. and in particular: ‘make the care 7 of people your first concern. 2 In particular. which comes under the broad heading of ‘care.62. Not to be redistributed or modified in any way without permission. Professional behaviour is just as important in a simulated learning envi- 9 ronment as it is in a practice area and your behaviour should mirror this. 6 • actors. treating them as individuals and respecting their 8 dignity’. and to avoid any nasty surprises 8 before you turn up for your OSCE. you need to behave towards them as you 6 would towards any patient you work with in your professional life. 72 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Ensure you are familiar with any equipment that you will be required to use in 3 your OSCE. However. the ESC that states: ‘treat them with dignity and respect them as 3 individuals’. Downloaded by [ Faculty of Nursing. as well as the varying approaches you will 1 need to adopt. 7 To help you with your performance. 5 Confidentiality and ethics should guide your behaviour.

3 If the OSCE requires you to carry out any type of assessment. You 30 also need to outline a potential action plan. Chiangmai University 5. they 9 can see immediately if you have undertaken a correct assessment. 5 However. Copyright © McGraw-Hill Global Education Holdings. Not to be redistributed or modified in any way without permission. there is a note of caution when your patient is a live model. They are usually adults but may occasionally be chil. The key factor is that all 3 students should have the same experience as each other when undertaking 4 the OSCE. This ensures that 1 no student is disadvantaged by a ‘patient’ asking more questions than 2 required for the level of OSCE. Will it be a live model or a manikin. or may be retired health and 7 social care practitioners. both adults and children 2 Members of the general public are often used as simulated clients for OSCEs. Many volunteers will undertake the assessments on a 8 regular basis and so will be well skilled in their roles. This will ensure that any abnormality will have been 7 identified beforehand but will also give the examiner an indication of what the 8 patient’s examination results are so that when you assess and record them. taking and recording their blood pressure manually – it is 8 very important that if you detect any observations which are outside the ‘nor. 9 mal’ range for that client group.62. you report your findings to the examiner. 9 All volunteers will undergo some formal training to ensure they perform 20 consistently to the same level and act in the same manner. 5 dren if specialist knowledge is required. 3 4 5 Ensure you find out prior to the OSCE what type of simulated patient you will 6 have to perform your OSCE on. 3 These people are volunteers who will either be paid a minimal sum and/or have 4 their travel expenses paid. and if a 7 live model. you will not be 4 informing the volunteer or examiner of anything new. what type? 8 9 10 1 Members of the public.86] at [07/18/16]. This will form part of the OSCE 1 and is your opportunity to demonstrate to the examiner your knowledge base 2 and decision-making skills. as it is good practice that 5 all volunteers used in OSCEs will have a baseline assessment undertaken prior 6 to you examining them. or overacting their role. 40R . LLC.156. Downloaded by [ Faculty of Nursing. WHAT TO EXPECT FROM YOUR OSCE 73 you were expecting a patient volunteer and when you are introduced to 1 your patient you find that it is one of your tutors or a student from the 2 university. These volunteers are often people who 6 have been service users or carers of service users. Every 6 patient is different and if you are asked to perform any kind of assessment on 7 them – for example.

9 20 Abir checks that Becky understands what she has to do for the OSCE and 1 runs through her role as tutor. R 22.62.156. It gives her a 6 chance to see what new practice is being taught and to see her fellow 7 ‘patients’. 5 6 Molly settles herself into the bed space area and awaits the first-year stu- 7 dent.86] at [07/18/16]. 3 4 Becky explains the procedure to Molly and takes her observations. The tutor re-records 8 Molly’s BP and finds that it has dropped to 142/85 and so Becky’s record- 9 ing can be deemed accurate. Copyright © McGraw-Hill Global Education Holdings. 8 9 40R . LLC. 74 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Example 1: a volunteer’s experience of 3 being a ‘patient’ 4 5 Molly is a retired nurse and enjoys participating in OSCEs. Abir asks Molly to start when the bell sounds.7. T 36. Not to be redistributed or modified in any way without permission. 30 1 Becky will in particular have adhered to the following ESCs when under- 2 taking this OSCE: 3 4 • ‘treat them with dignity and respect them as individuals’. the 3 OSCE examiner who is working with Molly for that session. Downloaded by [ Faculty of Nursing. When Molly arrives for the OSCE she is given instructions by 9 the OSCE tutor about the OSCE for the session. Becky is nervous but Molly tries to put her at ease by smiling 8 at her and looking encouraging. Becky. 5 • ‘ensure that their consent will be sought prior to care or treatment 6 being given’. Becky 5 records the observations on the standard sheet. 10 1 Molly is required to have her vital signs taken prior to the session so that 2 a baseline is ascertained. Her observa- 4 tions are: BP 145/85. Today Molly is being an OSCE patient having vital signs 8 recorded. 2 indicating the start of the OSCE for all the students in that session. Following the end of the 6 OSCE Abir compares the observations and finds that they are all the 7 same except that Becky recorded the BP at 140/85. 7 • ‘ensure that their rights will be respected’. Chiangmai University 5. Molly’s observations are recorded by Abir. P 80.

You should not discuss the actions of the student with 10 anyone except the examiner and definitely not with fellow students. In this case Tom is a 70-year-old man with depression 6 and long-standing asthma. 5 fessional manner and ensure you behave as if you were in a full examination 6 setting. WHAT TO EXPECT FROM YOUR OSCE 75 Colleagues/peers 1 2 Your colleagues and peers may be used in simulated learning sessions as models 3 that you can practise on and occasionally be examined on. Below is an example so 3 you can see when and how you might be asked to act as a patient for your peers. 40R . However. Copyright © McGraw-Hill Global Education Holdings. 3 sion is ‘administration of medicines’. The OSCE being examined on this occa. 6 7 The OSCE enabled Tom to practise the following ESCs: 8 • ‘protect and treat as confidential all information relating to them. It is very important to remember that you are acting as a professional 7 when undertaking an OSCE and as such you are required by the NMC Code to 8 maintain confidentiality. LLC. 4 5 6 7 Example 2: students’ experiences of undertaking 8 an OSCE and being a ‘patient’ 9 Tom is a third-year mental health student and he is being a ‘patient’ for 20 a formative OSCE for Sanjay. Tom 1 has undertaken this role before and finds it very rewarding to help fellow 2 peers to improve their practice. 1 2 Tom participates in the OSCE and at the completion of it gives feedback 3 to Sanjay with the OSCE examiner. Tom is given an information sheet 4 by the OSCE tutor. If you are simulating 4 a patient for one of your peers during their OSCE. 7 8 Tom works with the OCSE tutor to make sure the bed space is set up cor. you need to act in a pro. Not to be redistributed or modified in any way without permission. 9 rectly for the OSCE and is standard to all other bed spaces being used for 30 OSCEs that day.156.62. a second-year mental health student. 9 selves and their care’. Chiangmai University 5. He explains what it felt like to be a 4 patient being treated by Sanjay and suggests how Sanjay could improve 5 his practice. 1 acting as a patient for one of your peers is an excellent learning opportunity 2 and can help you with your OSCE and clinical practice. This applies whether you are in a student role or act. Downloaded by [ Faculty of Nursing. 9 ing as a model patient. This sheet details what type of patient Tom is to be 5 for the session.86] at [07/18/16].

4 • ‘safely delegate care to others and respond appropriately when a task 5 is delegated to them’. including control- 5 led drugs’. 2 • ‘ensure safe and effective practice through comprehensive know- 3 ledge of medicines. 8 • ‘use and evaluate up-to-date information on medicines management 9 and work within national and local policies’. in a non-medical prescribing OSCE. 4 • ‘through simulation and course work demonstrate how to supply 5 and administer via a patient group direction’. demonstrate knowledge and 1 application of the principles required for safe and effective supply 2 and administration via a patient group direction including an under- 3 standing of role and accountability’. They are trained to portray a 4 patient and are used during exams that are assessing non-invasive physical 5 examinations. assessment of a 8 mental health condition or breaking bad news. 6 • ‘safely lead. you will probably 9 not often see this type of patient used in pre-registration OSCEs as they are very 40R costly. They will be very realistic and will be 3 ‘in role’ throughout the examination period. Downloaded by [ Faculty of Nursing.62. 4 • ‘administer medicines safely in a timely manner. 76 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 • ‘respond appropriately to feedback from patients/clients. They are normally used in OSCEs when the patient needs to play a com- 7 plex role – for example. actors are trained to perform in a par- 2 ticular role and are paid by the university.156. 20 • ‘through simulation and coursework. . the public 3 and a wide range of sources as a vehicle for learning and development’. interviewing skills. Copyright © McGraw-Hill Global Education Holdings. 7 8 This OSCE enabled Sanjay to practise the following ESCs: 9 10 • ‘work within the legal and ethical framework that underpins safe 1 and effective medicines management’. their actions. 6 • ‘work in partnership with patient/clients and carers in relation to 7 concordance and managing their medicines’. Chiangmai University 5. Therefore. coordinate and manage care’. patient education and/or communication 6 skills. risks and benefits’. 6 7 8 9 30 Actors 1 Also known as ‘standardized patients’. Not to be redistributed or modified in any way without permission.86] at [07/18/16]. LLC.

The facilitator suggested to Daniel that the best 9 way would be to become involved in the OSCE as a patient so he could 20 gain some understanding of what the OSCE required and the level of 1 knowledge and skills his student would be expected to demonstrate. 5 ment OSCE during his placement.62. So do not be 5 intimidated if you have a practice staff member to use as a model. 6 7 8 Example 3: a practice staff member as a ‘patient’ 9 10 Daniel is an experienced mentor. however. WHAT TO EXPECT FROM YOUR OSCE 77 Practice staff 1 2 Professional practice staff may be used and they will play a similar role to stand. Not to be redistributed or modified in any way without permission. 3 ardized patients.86] at [07/18/16].156. Copyright © McGraw-Hill Global Education Holdings. LLC. Chiangmai University 5. 3 4 5 6 Manikins 7 Lifelike manikins. 2 He is due to mentor a third-year learning disability student nurse in the 3 next semester and during his mentor update the facilitator informed 4 him that the student will be required to undertake a medicines manage. 2 3 Daniel found the experience interesting and it provided him with some 4 very valuable CPD. 9 motor skills. He was fully aware of what would be expected from 5 his student and consequently he felt in a better position to support them 6 when they arrived in his practice area. Daniel suggested that during the administra. They will not ask you any more detailed questions than any 4 other model. 6 7 Daniel wanted to find out what this involved so he could support the stu. 40R . critical thinking skills and psycho. Downloaded by [ Faculty of Nursing. anatomical models and clinical simulators may be used 8 during the OSCE to assess problem-solving. he has just moved to a new 1 NHS trust and the students he is now mentoring attend a different HEI. 7 8 When the student arrived. even though their knowledge base will be greater. 8 dent with their learning. 9 tion of medicines they would use the university checklist as an aid to 30 ensure that the student undertook the correct practice. This meant that 1 his student was continually being assessed using the same criteria and 2 they could work on any gaps in knowledge and skills together.

used to demonstrate your cardio-pulmonary 5 resuscitation (CPR) skills. LLC.86] at [07/18/16]. 4 such as a ‘resuscitation Annie’.62. Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission.156. Chiangmai University 5. etc. or a simulated arm to demonstrate venepuncture 6 or cannulation (see Photograph 3). 7 • Basic manikin: a full body simulator without human qualities such as 8 breathing sounds or pulses. 78 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 There are a range of manikins available: 2 3 • Task trainer: part of a manikin designed for a specific psychomotor skill. inserted (see Photograph 4). 10 1 2 3 4 5 6 7 8 9 20 1 2 3 4 5 6 7 8 9 30 1 2 3 4 5 6 7 8 9 40R Photograph 3 A task trainer arm for cannulation or venepuncture . but with the ability to have a urinary catheter 9 NG tube. Copyright © McGraw-Hill Global Education Holdings.

62. 4 5 6 7 If you are required to perform any aspect of your OSCE using a manikin or task 8 trainer.g. 3 4 Task trainers and manikins are normally used when the OSCE requires you to 5 perform an invasive procedure which would not be appropriate to perform on a 6 ‘live volunteer’ as it would cause them unnecessary harm and hence would be 7 unethical. ascertain which one you will be using and ensure you are familiar with 9 it and have practised performing the skills using it. Downloaded by [ Faculty of Nursing. 20 1 2 3 4 5 6 7 8 9 30 1 2 3 4 5 6 7 8 9 Photograph 4 A basic manikin 40R . Each task trainer/ 10 manikin will have its strengths and limitations and it is therefore essential that 1 you practise with the task trainer/manikin that you will be using during your 2 exam. breathing and cardiac sounds) (see Photographs 5 and 6). Not to be redistributed or modified in any way without permission. Copyright © McGraw-Hill Global Education Holdings. Therefore.156. LLC. There is now a large range of these available and it will depend upon 9 your HEI’s resources as to what type you will come across.86] at [07/18/16]. Task trainers and manikins will be chosen to meet the requirements of 8 the OSCE. WHAT TO EXPECT FROM YOUR OSCE 79 • Patient simulator: a full body simulator that can be programmed to respond 1 to affective and psychomotor changes and has installed human qualities 2 (e. Chiangmai University 5. and if so which type. as with all equipment. ensure you find out if you will be required 3 to use a task trainer or manikin during your OSCE.

LLC. 4 When using a basic full body manikin the examiner may be looking for evi- 5 dence of behaviour as well as performance on the manikin. Copyright © McGraw-Hill Global Education Holdings. you are being assessed only on 3 your psychomotor skills and not your communication and interpersonal skills. 8 When a medium-fidelity simulator such as ‘SimMan’. Therefore. Chiangmai University 5.156. Not to be redistributed or modified in any way without permission. A scenario may have 6 been designed for you to work through which will involve the manikin and 7 possibly supplementary equipment.86] at [07/18/16]. 80 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 20 1 2 3 4 5 6 7 8 9 Photograph 5 SimBaby – medium-fidelity simulator 30 1 The ‘resuscitation Annie’ and simulated arm may be used when the OSCE is 2 assessing a psychomotor skill only. The manikin will record what actions you take . Downloaded by [ Faculty of Nursing.62. this will entail you working through a scenario and interpreting 40R what responses the manikin makes. ‘SimBaby’ or high-fidelity 9 ‘MetiMan’ is used.

The manikin will have been pre-programmed to give 2 you a set of results/responses to interpret. 3 Diagram 4. Not to be redistributed or modified in any way without permission. 4 5 6 Computer/web-based OSCEs 7 8 Web-based OSCEs are becoming increasingly common and as such you need to 9 know what will be required. you will be assessed on your 3 attitude and behaviour as well as performance of the required psychomotor skills.62.86] at [07/18/16]. 4 5 6 Types of OSCE 7 8 This section will discuss what is to be expected from the various types of OSCE 9 and the differences between them. Copyright © McGraw-Hill Global Education Holdings. or a stand-alone program. 30 mation accessed from around the world.1 illustrates how a computer question may be laid out. WHAT TO EXPECT FROM YOUR OSCE 81 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 Photograph 6 A medium-fidelity manikin 20 1 for marking after the OSCE. 40R .156. Downloaded by [ Faculty of Nursing. Common 1 computer-based examinations are multiple choice questions or drug calculation 2 examinations where software packages such as ‘Authentic World’ can be utilized. Chiangmai University 5. Once again. LLC. They can include multimedia and interactive infor.

156. during the first year of a pre-registration 8 course you may be asked to carry out a simple skill such as temperature reading 9 and recording and explain to the examiner your findings. For example. 8 We found. Not to be redistributed or modified in any way without permission. explaining the procedure but at the same time providing rationale and 2 knowledge related to the skill. Copyright © McGraw-Hill Global Education Holdings. The examiner is also holding a clip- 6 board which will have the checklist for her to make comments and assessments 7 during the OSCE. 5 You may be asked to demonstrate a wide range of skills and the level of com- 6 petence and knowledge you will be expected to show depends on which stage 7 you are at in your course. You will see that the examiner is 4 standing in close proximity to the student so that she can carry out a compre- 5 hensive assessment of her performance.86] at [07/18/16]. in research of student nurses’ experiences of OSCEs. the .62. It may involve stations or 1 areas where you are examined on a one-to-one basis with an independent exam- 2 iner and live models or manikins as patients. 30 In your second year you may have to teach this skill to a first-year nursing 1 student. Chiangmai University 5. that both 9 the fact that the student was being watched so closely and the examiner was 40R taking notes increased the student’s anxieties and nerves. Photograph 2 on page 71 shows a student being 3 observed carrying out a temperature reading. Downloaded by [ Faculty of Nursing. However. The whole process is standardized 3 so that you can be assessed objectively and complex skills and associated know- 4 ledge can be assessed without endangering any patient’s health or well-being. 82 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 Diagram 4.1 Illustration of a calculation required in a medicines management soft- 6 ware package 7 8 9 Observed OSCE 20 This is currently the most common type of OSCE. LLC.

WHAT TO EXPECT FROM YOUR OSCE 83 students fully understood why it was necessary and commented that if you are 1 fully prepared for your OSCE in relation to knowledge. or the ‘resuscitation Annie skills trainer’. 8 An alternative computer-assisted OSCE station might use an advanced mani. 7 8 9 Video-recording 30 Video-recording may be used in any OSCE situation to help the examiners in 1 determining the level of your performance. attitude and what 2 to expect. and whether you approach the situation in a systematic 5 way. however. If the 6 examiner is not present. for example. The fact that video-recording is tak. 2 ing place during your OSCE can often increase your nerves. At the same time they record 1 your actions and this record will be used to support your assessment. Photograph 2 7 shows a resuscitation Annie skills trainer used to assess your CPR skills. 20 as they require computer software for them to work. Copyright © McGraw-Hill Global Education Holdings. 7 enced examiner who will then make a judgement as to the level of your per.86] at [07/18/16]. 5 Recording can take place with or without the examiners present. 7 8 9 Computer-assisted OSCE 10 This method can be formatted in several ways. 7 plete the task. These types of station may well be undertaken 5 under exam conditions in a computer room rather than a skills laboratory. internal and external moderation – and for 40R . Not to be redistributed or modified in any way without permission.156. being well prepared helps you 6 overcome any nerves this may cause. one of the OSCE 1 stations could be a computer-generated multiple-choice questionnaire testing 2 your level of knowledge of the anatomy and physiology related to the skills you 3 have just performed. The computer software gives the examiner feedback on the accuracy of your 6 CPR skills – for example.62. Chapter 7 offers advice on how to make the 4 best use of video footage. 9 kin such as ‘SimMan’. Chiangmai University 5. The video can also be used 9 for quality assurance – for example. 8 formance using the predetermined marking criteria. LLC. if your compressions are the correct rate and depth. The examiner would assess 4 your attitude and skills. skills. the video will be reviewed at a later stage by an experi. Such a 3 trainer could also be used in a basic life support OSCE. It could also be medicine calculation software. You 6 will be shown how to log onto the relevant program and then be asked to com. 3 4 5 Although you are being watched closely. it is an 3 excellent learning resource for you. Downloaded by [ Faculty of Nursing. described earlier. or practice 4 area management scenarios. these nerves can can be overcome (Merriman 2007).

which will be explained in more detail later in this 5 chapter.62. 84 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 20 1 2 Photograph 7 ‘Resus Annie’ skills trainer for basic life support assessment 3 4 external examiner purposes. It is often small and away from the eye-line 2 and most students say that they forget it is there.156. Chiangmai University 5. It may be that there is video equipment 8 already installed in the rooms in various places. LLC. 6 7 8 Find out if your OSCE will be video-recorded and if so whether an examiner 9 will be there as well. Not to be redistributed or modified in any way without permission. 3 The alternative is a traditional video camera on a tripod which requires 4 someone to operate it. 6 There is a range of different video equipment available and the type that you 7 see will depend on your university. This type of equipment is less intrusive for you as a student 30 as it is operated remotely and therefore you do not have someone operating the 1 camera in the examination room. Copyright © McGraw-Hill Global Education Holdings. This type of equipment can be quite intrusive for you as 5 a student so it is suggested that you gain experience of this prior to your OSCE. such as above the bed spaces 9 (see Photograph 8).86] at [07/18/16]. 40R . Downloaded by [ Faculty of Nursing.

Copyright © McGraw-Hill Global Education Holdings. 10 20 30 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 Photograph 8 Video system: Example shows scotia medical observation and training 85 WHAT TO EXPECT FROM YOUR OSCE system (SMOTS) .86] at [07/18/16]. Chiangmai University 5. LLC.62. 40R Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission.156.

The exam- 7 iner has a list of areas they expect to cover and prepared answers which will be 8 used to assess your responses. during or following a medicines mangement OSCE. LLC.156. Chiangmai University 5.62. in order to provide 5 the student with an opportunity to further demonstrate their knowledge 6 or attitude. These 40R assessment strategies are often used as they can measure a range of levels of . Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission. This means they are 9 quick to mark and in some cases computer software can mark them. Copyright © McGraw-Hill Global Education Holdings. 1 2 3 Examiner questions 4 Any or all of the following questions may be asked. If you have a viva/oral as one of your stations it 9 is advisable to ascertain what type of questions you will be asked and the level 10 of answers you are expected to provide. 7 8 • What is meant by the term ‘informed consent’ and how can this be 9 achieved? 20 • What information do you need to obtain from the British National 1 Formulary (BNF) and the patient before administering any medicines? 2 • What is meant by the term ‘concordance’ and how can this be 3 achieved? 4 • Why is it important to confirm and document if a patient has any 5 allergies? 6 • What checks would you make in order to confirm the correct identi- 7 fication of a patient? Why would you use these approaches? 8 • What are the professional and legal responsibilities of the nurse in 9 relation to clinical records? 30 1 2 3 4 Multiple choice questions/short answer papers 5 As with a viva/oral exam a multiple choice or short answer paper may be also 6 be the sole examination technique or may be used to further test your know- 7 ledge during or after the OSCE. The 5 examiner will ask you pre-set questions to test your knowledge and attitude 6 related to one or more of the stations you have just rotated around. Multiple choice questions and short answer 8 papers are objective tests as the answers are predetermined.86] at [07/18/16]. 86 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Oral/viva 2 3 An oral examination or ‘viva’ may be the sole examination technique or it may 4 be used to further test your knowledge both during and after the OSCE.

This is 6 especially important during OSCEs when two or more circuits of the same 7 stations are required. however. the follow. This structured 9 marking criteria will enable consistency among examiners.156. The predeter. Not to be redistributed or modified in any way without permission. They will all have a set format which includes 3 predetermined marking criteria to work to. 7 ing criteria to ascertain if you have met the required standard. 8 9 10 If you are required to sit a multiple choice or short answer paper as part of your 1 OSCE.62. 2 ple of a multiple choice paper that is used as a station during a basic life support 3 OSCE. but they may also be trained patients. 3 4 5 6 The examiners’ role and quality assurance 7 8 Quality assurance is an area that you may not think of initially. 8 • Examiners who are assessing the same station in different circuits are required 9 to liaise with each other to ensure consistency in their approach. 4 • All examiners will have been briefed on the format of the OSCE they 5 are examining so that internal reliability can been demonstrated. This ensures 40R .86] at [07/18/16]. If your OSCE involves multiple choice questions or a short answer 4 paper. 4 tions will be minimized. 8 mined checklist is discussed in detail in Chapters 3 and 6. and as such any bias and unusual ques. LLC. such as knowledge in relation to anatomy and physiology. 1 2 • All examiners will have received a copy of the predetermined marking 3 criteria well in advance and have had an opportunity to ask questions. 1 All examiners will be fully prepared for the OSCE station they are to examine 2 prior to you undertaking the process. ensure you get hold of and complete some practice papers prior to 2 the exam. The examiners may be known to you and may be 5 academic or professional practice staff. Copyright © McGraw-Hill Global Education Holdings. thus enabling you to 7 bring your own knowledge up to that standard (or above!). and decision-making. Chapter 6 provides an exam. but it is of great 9 importance in terms of fairness of approach and the mechanisms by which you 20 can assess the quality of your experience. Downloaded by [ Faculty of Nursing. 6 The purpose of the examiner is to assess you against the predetermined mark. WHAT TO EXPECT FROM YOUR OSCE 87 function. Chiangmai University 5. Such practice is essential as it will help you with your preparation by 6 making you aware of the level of knowledge required. principles 1 of evidence-based practice. 30 ing strategies will also be in place to ensure reliability and aid quality assurance. most universities will have some sample papers for you to access in order 5 to practise.

The exam- 30 iner is not trying to be intimidating. Ben. or incorrect. They do not want to 2 give you any false feedback.62. Do not be alarmed by this. He asks Ben what he 1 expected the student to know and finds that Ben was requiring too much 2 detail. They agree that what the student said was in fact sufficient and 3 the student was then passed. 9 10 1 2 Example 4: examiners’ role in undertaking OSCEs 3 Jill. ask 8 you the predetermined questions. Downloaded by [ Faculty of Nursing. they will just say ‘thank you’ and not give 5 you any indication that may suggest you have given a correct. This role 6 requires David to make sure he checks that all four staff are asking the same 7 questions of students and that they are marking to the same standard. Darren. do not automatically think 40R that if you see them writing something you have done something wrong! . if appropriate for that OSCE station. They will not be able to help you beyond 9 reasonable support. This ensures that all examiners 8 are performing their role correctly. The first four are all examining the same station but on differ- 5 ent circuits. Chiangmai University 5. 8 9 David notices that Ben has marked a student down on the knowledge 20 they showed when being asked about a condition. 7 As the examiner assesses your performance against the predetermined mark- 8 ing criteria they will be making notes and/or ticking/crossing the relevant boxes 9 on the assessment sheet. if they were to ask you to clar- 4 ify something or ask you a question. so will not give non-verbal gestures as one would 3 normally do during conversations. but they have to act professionally during 1 the OSCE and ensure that they treat each student equally. For example. 4 5 6 The examiners will not be able to engage in conversation with you other 7 than to give you instructions and. as all examiners must behave in the same way. Stacey and David are all tutors undertaking OSCE assess- 4 ments today.156. Not to be redistributed or modified in any way without permission. 6 answer. thereby 2 promoting internal moderation and inter-observer reliability. 88 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 that examiners are not influenced by their own values and beliefs.86] at [07/18/16]. 3 • Instructions that examiners give to you as students for the station they are 4 examining will have been agreed beforehand and will often be read from 5 script to ensure consistency. LLC. 6 • It is also good practice to have a moderator who moves around the exami- 7 nation room and observes the examiners. and David is acting as a roving moderator for the day. Copyright © McGraw-Hill Global Education Holdings.

Once Jerrome and the other 5 students had left the room Madhur watched the video recording of the 6 OSCE to be completely sure of Jerrome’s technique. If this is the case.156. as it allows you to learn from 7 your mistakes. he passed. 30 ard for a pass. The video may also be used by the examiner 1 to check back on your performance if they are seeking advice from another exam. Chiangmai University 5. It is especially important if you fail. as illustrated in Photograph 9. WHAT TO EXPECT FROM YOUR OSCE 89 1 The examiner is not trying to be intimidating: they have to act professionally 2 during the OSCE and ensure that they treat each student equally. thereby developing your practice. the OSCE 3 examiner. The video may also be accessible to you to show how 4 you performed. Chapter 7 will discuss in 7 greater detail how you can use video footage to support your development. 3 4 5 Recording OSCEs 6 As discussed earlier in this chapter. Copyright © McGraw-Hill Global Education Holdings. Following the release of the results Madhur was able to go 1 through the video with Jerrome and show him in detail where he had 2 not met the standard required for safe practice. 7 8 In the video she was able to see that Jerrome did not wash his thumbs 9 correctly and so was quite sure that he had not met the required stand. and reflection is a critical component following an 6 OSCE. 8 9 When Jerrome undertook the OSCE on the next occasion. Not to be redistributed or modified in any way without permission. 8 The system is very useful for examiners to show to external examiners. External 9 examiners are staff from another HEI and are employed to monitor quality proc.86] at [07/18/16]. assessed Jerrome and was unsure whether he had undertaken 4 all the parts of the hand-washing correctly. 8 9 20 1 Example 5: video feedback 2 Jerrome had undertaken an OSCE in hand-washing. You will find this particularly useful 5 if you have not performed as well as you had hoped and wish to see in more detail 6 where you could have improved your performance. 40R . many settings have a video system in place 7 recording the OSCE process. 3 4 It is well documented that watching our self-performance is a valuable 5 aid in reflection. LLC. you will be alerted to it beforehand. or if they want to check whether 3 or not you did something. Downloaded by [ Faculty of Nursing. 2 iner regarding your actions or something you said. 10 esses and ensure parity and fairness. Madhur.62.

Photograph 9 An example of a video image 90 40R 10 20 30 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 . Not to be redistributed or modified in any way without permission.62.156.Downloaded by [ Faculty of Nursing.86] at [07/18/16]. Chiangmai University 5. Copyright © McGraw-Hill Global Education Holdings. LLC.

1 tial part of the criteria. In particular. and a live model is being utilized. 5 such as asking what the patient would like to be called. act with 8 integrity and uphold the reputation of your profession’. Chiangmai University 5. There is also a commentary in italics to illustrate in more 8 detail what the examiner will be looking for in these areas. if unsure. 6 7 8 Professional skills 9 20 As indicated earlier.156.1 illustrates the performance expected of the student by the examiner. 9 Health and safety is also paramount and it is essential that you listen to 10 the advice you are given prior to commencing the OSCE. most checklists will have an outcome 30 related to professional behaviour and communication.86] at [07/18/16]. you will fail the OSCE even if you perform the blood pressure correctly. 1 ity once you leave the examination setting. Your behaviour is also 7 determined by these standards of proficiency: ‘be open and honest. and ‘listen. that you seek assistance. 4 You may have heard or observed your peers when they were being examined 5 but you are not allowed to disclose what you saw or heard. Therefore. 7 You should only disclose any details to the examiners present. the examiner will stop the exam 4 immediately. WHAT TO EXPECT FROM YOUR OSCE 91 Your role-behaviour and performance 1 2 Your role in an OSCE is to primarily undertake safe practice. 9 urement. In this example the 6 achievement of a pass grade requires all components in bold to be demon. The importance of confidentiality 2 in particular relates to the ESC ‘protect and treat as confidential all information 3 relating to themselves and their care’. Any breach in this 6 could affect the models used but also adversely affect the students taking part. if you fail to meet the required standard in this 2 section. This is normally an essen. 8 Even if your OSCE is assessing a particular skill such as blood pressure meas. and provide information that is clear. sensitive and compassionate 5 way’. it is of utmost importance that you maintain confidential. which will normally result in you failing that particular OSCE 5 station.62. and of course to be 3 as successful as possible! Your behaviour in the exam is also encompassed in the 4 ESCs ‘provide care that is delivered in a warm. Copyright © McGraw-Hill Global Education Holdings. 3 You can see from the example below how these aspects may be assessed. if 1 you are using any electrical equipment you must ensure you are able to use it 2 safely and. Downloaded by [ Faculty of Nursing. 9 40R . 7 strated as a minimum. accurate and meaningful 6 at a level at which the patient/client can understand’. Not to be redistributed or modified in any way without permission. LLC. If at any time during the OSCE 3 you are putting yourself or anyone else at risk. 4 Table 4.

prejudices. Chiangmai University 5. LLC. respecting standards of proficiency and ESCs. giving name 30 and status These two areas ensure that you take a 1 person-centred approach. It will 6 through their be visible also through the sensitive way 7 practice you treat your patient. This has important health 5 and safety considerations and so is not 6 written casually. attitudes 10 and beliefs do not compromise the care 1 you give during the OSCE. 92 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Table 4. values. You others and adopting will be expected to treat the patient with 8 non-discriminatory respect and ensure that personal 9 behaviour judgements. Asks what patient 2 would like to be called 3 Clarity of voice These sections are where the examiner is 4 looking for clear interactions with the 5 patient. Not to be redistributed or modified in any way without permission. 3 Demonstrates This is evidence of your ability to act as a 4 understanding of professional through your communication 5 professionalism skills.86] at [07/18/16].1 Example of how professional and communication skills can be assessed as part 2 of an OSCE even when a psychomotor skill is the principal assessment 3 Activity Performance expected Explanation of performance expected 4 5 Professional Behaves in a This is a key component of professional 6 behaviour professional behaviour and is a core area in the 7 manner. Communication which is clear 6 and easily heard is what the examiner is 7 looking for – so don’t mumble!! 8 9 40R .156. 8 Communication Introduces themselves 9 skills to patient. Downloaded by [ Faculty of Nursing.62. Copyright © McGraw-Hill Global Education Holdings. 2 Adheres to the Each university will have worked with 3 university professional local trusts to write a suitable dress code 4 dress code for students. both verbal and non-verbal. It is important when 7 you undertake the OSCE that you wear 8 the correct uniform so that you can 9 illustrate that you understand the 20 importance of the policy and implica- 1 tions for health and safety for you and 2 your clients.

Make sure you sound authoritative and 1 appropriate use of touch knowledgeable even if you are nervous! 2 Uses open-ended 3 questions 4 5 Offers clear answers to any questions the 6 patient may ask 7 8 Seeks patient’s This area is classed as essential as it 9 permission/consent demonstrates an ability to treat the to carry out patient as an individual who has rights 10 observations to be treated only if they wish to be. 1 2 3 4 5 6 7 8 9 40R . Copyright © McGraw-Hill Global Education Holdings. 30 sity policy concerning how to lodge an appeal or complaint. LLC. 1 Checks patient This section is paramount to ensure you 2 identity: verbally. WHAT TO EXPECT FROM YOUR OSCE 93 Good eye contact. no 1 may not have come across.156. Chiangmai University 5. Not to be redistributed or modified in any way without permission. 6 Checks patient’s In this section the examiner is looking for 7 understanding of you to check that the patient has 8 procedures understood what you have told them and 9 this will be assisted if you have not used Clear explanation 20 jargon and terminology that the patient given throughout. jargon used 2 3 4 Unfairness or discrimination 5 6 If you feel you have not been treated fairly you may be able to access a video.62. You need to refer to your univer. Downloaded by [ Faculty of Nursing. are undertaking practice on the patient 3 and/or with ID you are expecting to and that 4 bracelet observations recorded or medication 5 given is administered to the right person.86] at [07/18/16]. 7 recording of the exam and review how you performed. If there is no recording 8 you will need to seek the view of the examination lead to ascertain how you can 9 lodge your concerns about unfair behaviour.

LLC. 4 5 Your models may be members of the general public. 6 7 2 You should be aware of and familiar with any equipment or documentation 8 you will be required to use. Chiangmai University 5. 5 6 10 If you feel you have not been treated fairly. you may be able to access a 7 video recording of the event and review how you performed. 1 2 8 You may be videoed during the examination for quality assurance and also 3 for feedback for you to learn from. 9 7 The examination process is governed by strict quality assurance mechan- 20 isms to ensure objectivity. 1 2 4 You need to behave in a professional manner at all times during 3 your OSCE. 94 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Chapter summary 3 4 1 You should have an idea of the room and station layout before you start 5 the OSCE. staff. Not to be redistributed or modified in any way without permission. 9 10 3 You should understand the set guidelines and protocols for your OSCE. 4 9 Try not to use jargon that the patient may not understand.156.62. 8 9 30 1 2 3 4 5 6 7 8 9 40R . Copyright © McGraw-Hill Global Education Holdings.86] at [07/18/16]. manikins or 5 task trainers. 6 7 6 All patient models will be working to the same ground rules to ensure 8 parity. Downloaded by [ Faculty of Nursing.

Within this section sug. 20 1 2 This chapter will provide you with guidance on how to prepare for your OSCE 3 and also how to perform to the best of your ability during the exam. Chiangmai University 5. 7 Have gained insight into how to make the most use of the stress you are 8 under to enhance your performance. it 4 will look at how to prepare to ensure you have the relevant knowledge. in terms of dress code.156. 9 Benjamin Franklin (1706–90) 10 1 2 3 By the end of this chapter you will: 4 Understand how to prepare for your OSCE. in order to ensure that you 3 perform to the best of your ability on the day. Copyright © McGraw-Hill Global Education Holdings. 2 ing mechanisms. 30 mum and sub-optimum stress levels. 1 Preparing for your OSCE: 2 5 before and on the day 3 4 5 6 7 8 Diligence is the mother of good luck. This mnemonic 40R . First. 9 Have worked through the 10 steps for preparation. skills 5 and attitude to meet the criteria set by the examiners.62. 6 gestions will be given to help you identify when and how you learn and work 7 most effectively. During any exam a certain amount of stress is normal and 8 essential in order to give you the motivation to learn and perform – therefore. cop.86] at [07/18/16]. 4 5 6 Prior preparation 7 8 Whenever you are preparing for an important event it is useful to remember to 9 address the five ‘Ps’: ‘prior preparation prevents poor performance’. travel arrangements. and so on. Downloaded by [ Faculty of Nursing. LLC. The remainder of the chapter will help 1 you prepare for the day of the exam – for example. 6 Have gained insight into how stress will affect your performance. 9 a discussion will take place to help you identify the differences between opti. Not to be redistributed or modified in any way without permission. 5 Understand how to perform to the best of your ability.

7 Students undertaking OSCEs have said to us that. Gibbs and 9 Simpson 2004). knowledge and attitude.156. are strong motivating factors. including OSCEs. 2 will assess several components – for example. which is a factor that is almost always present and will also help 30 you succeed. 2 Therefore. whereas if you know your 9 “stuff”. 40R . you need to have what is called ‘intrinsic 7 motivation’.62. Ideally. It is a well-known fact within educational theory that assess- 7 ment methods and requirements have a greater influence on how and what you 8 as a student learn than any other single factor (Boud and Brew 1995. 3 Both forms of motivation are useful. 3 4 5 It is the desire to pass the OSCE that will give you the motivation to learn 6 the required skills. skills. but you have not chosen to master this subject area – 5 it has been chosen for you. LLC. Copyright © McGraw-Hill Global Education Holdings. ‘If you do not know your 8 “stuff”. 6 To be successful in your OSCE. Find out as much as you can about the format and content of your exams 5 and how they will be assessed. This is not to say that you are not inter- 4 ested in the subject matter. This includes a desire to get a ‘good pass’ because others want you 1 to be successful. Chiangmai University 5. 96 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 will give you every chance to be successful. It’s important to know what is required from 6 you. either by your professional body or the HEI itself. and the fact that you want to qualify as a nurse or pass the 2 particular course you are undertaking in order to get a good job. Every assessment. as much as intrinsic 1 factors such as authentic interest and involvement in the subject matter. That is. it is the motivation of not wanting to fail that will drive and direct 3 your behaviour as much as anything else. There will also be an element of extrin- 9 sic motivation. The external rewards and punishments for not passing the 20 OSCE are probably what are motivating you to learn. then you are not going to pass the OSCE. Not to be redistributed or modified in any way without permission. then the OSCE will not be a problem. you feel you want to be successful because it makes you 8 feel good and you want to achieve a goal. but try to be both 9 intrinsically and extrinsically motivated. a combination of both is 4 best – your interest in a topic along with pressure from outside sources. such as 5 the HEI or peers to be successful.’ 10 1 2 Prior preparation prevents poor performance. 6 7 8 Your motivation to learn may be just to pass the OSCE. 3 Therefore you will have to prepare yourself for all of these areas to ensure you 4 pass. so there are no nasty shocks on the day. Downloaded by [ Faculty of Nursing.86] at [07/18/16].

Excess cortisol is known to increase catabolism (protein 4 breakdown in muscles): the cortisol leads to muscle breakdown through pro. In order to ensure 5 that you are aware of this. However. So don’t compare yourself 2 with others but be aware of your own stress and more importantly of how you 3 find it best to manage this. You will 9 have different stress levels to your peers. Downloaded by [ Faculty of Nursing. Chiangmai University 5. The main role of cortisol is to activate the immune system. it is important that the body can 8 return to normal following stressful events. 4 5 6 How stress is manifested in the body 7 Some people can lead busy. and can cause elevation of the 3 blood sugar level. where the 6 amino acids are converted into glucose (Waugh and Grant 2006). 8 You need to ensure that you have the optimum level of stress for you. you can map out your time and effort with 2 greater efficiency. the body’s stress response is activated so frequently that 40R . 5 moting a release of muscle amino acids for transport to the liver. and 1 among other things your personal circumstances. tightly-scheduled lives without appearing to suffer 8 from excessive stress. It is unfortunate that. your motivation and drive to do well. Cortisol is 7 part of the body’s response to stress. Copyright © McGraw-Hill Global Education Holdings. whereas others who have routine. 1 2 3 4 Stress and your ability to manage it 5 6 Once you have highlighted what you know and what you don’t know. be under 7 no illusion that stress will kick in to ensure that your body is ready to perform. you need to use the resources discussed in Chapters 2. Cortisol is a corticosteroid hormone produced by the 1 adrenal gland.86] at [07/18/16]. Not to be redistributed or modified in any way without permission. formative assessment. such as accessing practical sessions. Therefore it is essential that you study the assessment criteria 3 and checklist to ensure you are aware of what level of performance and know. It is 2 involved also with the metabolism of glucose. 6 3 and 4.156. PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 97 Once you have worked out what you are required to know and do to ensure 1 you meet the set criteria to pass. 4 ledge the examiners want you to demonstrate in your OSCE. 8 9 10 Make good use of all the help available to assist you in preparing well. uncomplicated lives 9 can feel a great deal of stress. LLC. in our current 9 highly-stressed lives. Excessive stress increases the rate at which your 30 body produces cortisol.62. You will also get stressed at different 20 times depending on your personality. the marking 7 criteria and checklists.

86] at [07/18/16]. Chiangmai University 5. however. such as impaired cognitive 5 performance and blood sugar imbalances such as hyperglycaemia.156. Levels of cortisol in the blood- 3 stream that are higher and prolonged (similar to those linked with chronic 4 stress) have been shown to have adverse effects. excessive stress impairs your ability to learn. you need to ascertain a way of reducing the symptoms. . to retrieve 1 old information and to perform certain skills that you already have. Remember it 8 is not always possible to remove the cause of the stress. at 4 the same time you will need a certain amount of stress to aid your drive and 5 motivation to learn.1). incorrectly managed. 5 6 7 The body needs to return to normal following stress to prevent chronic stress 8 and its side-effects. You will not necessarily display them all. all of which are needed to 3 help you prepare for and perform adequately during your OSCE. too much stress. Your think- 2 ing becomes more automatic and your brain struggles to link new knowledge 3 with the skills you are trying to learn. Hence it is hard to learn anything new as 4 the cortisol is impeding the deployment of your thinking skills. Your 10 brain can lose some of its ability to sort out what is new information. however. you need to distinguish between 40R helpful levels of stress and excessive levels of stress. This can 2 result in a state of chronic stress (Scott 2008). it is how you deal with 9 it that matters. your ability to 2 think. therefore. For 8 example. you need to find your optimal stress level to 6 ensure the efficiency of your learning and effectiveness of your performance. and your memory and problem-solving skills. Downloaded by [ Faculty of Nursing. Excessive 6 levels of cortisol in your body can cause you to feel confused and can reduce 7 your ability to distinguish between what is important and what is not. you may focus on the set of skills you are required to demonstrate in 9 your exam and forget other important areas such as communication skills. LLC.1 demonstrates the relationship between levels of stress and 8 efficiency. You can see that we all need some level of stress to increase 9 our efficiency. Copyright © McGraw-Hill Global Education Holdings. However. Not to be redistributed or modified in any way without permission. if you do recog- 7 nize any. 9 20 1 Consequently. 98 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 the body’s functions don’t always have a chance to return to normal. In order 5 for you to recognize and try and reduce these you need to be aware of them (see 6 Table 5. 7 Diagram 5. Before you act to reduce stress. will cause 30 reduced efficiency levels and eventually burnout.62. 1 2 3 How stress can be displayed 4 Stress can be displayed by both physical and psychological symptoms.

86] at [07/18/16].156. optimal stress. Chiangmai University 5. all 7 of which are needed to help you prepare for and perform adequately in your 8 exam. This worried Jim as he 6 did not want to fail his summative attempt. Not to be redistributed or modified in any way without permission. LLC. 5 stress also helpfully releases the hormones of adrenaline and noradrenaline. not eliminated (as highlighted in Diagram 4 5. He was unable to talk coherently and 5 fumbled when he tried to take his patient’s pulse. So it’s not all bad news from the point of view of the body’s response! 9 30 1 Example 1: managing stress 2 3 Jim had undertaken a formative OSCE in December and had found he 4 was extremely stressed during it. excessive stress 1 and efficiency 2 3 Stress levels need to be fine-tuned.1) in order to ensure efficiency. He had read 40R . motivation and performance. Optimal Excessive Free-fall 6 stress stress stress 7 8 9 Stress 20 Diagram 5.62. As well as producing cortisol in the body.1 The relationship between under-stress. 6 These have the effect of improving perception. Copyright © McGraw-Hill Global Education Holdings. 7 8 Jim decided to try to manage his stress more actively so that he could get 9 the most out of being stressed rather than let it overcome him. PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 99 1 2 3 4 5 6 7 8 Efficiency 9 Mental 10 breakdown 1 2 3 4 5 Under. Downloaded by [ Faculty of Nursing.

raised your expecta- 2 tions and removed some of the sources of excessive stress. You need to think about when you concen- 5 trate best.62. Chiangmai University 5. and these include embarrassment. 7 8 9 10 It is uncomfortable to realize that there are some situations that can push 1 stress beyond helpful levels. creates a vicious circle. This means 8 scheduling study time around the peak times when you know you function 9 most effectively. 1 Even when you have your anxiety at an optimum level. Are you a morning.156. you increase the number of thoughtless decisions. Not to be redistributed or modified in any way without permission. 20 the extra time needed to do the preparation could be gained by taking the deci- 1 sion more quickly. if you do not start to prepare for your exam with 5 enough time to meet the requirements.1 shows both the physical symptoms and the psychological symptoms 8 of stress. Downloaded by [ Faculty of Nursing. LLC. 7 To keep cortisol levels healthy and under control you should activate the 8 body’s relaxation response when undue stress occurs. 4 5 When Jim undertook his summative OSCE he felt more in control and 6 was able to undertake all the parts of the exam at a pass level. it will still require a 3 deliberate amount of effort on your part to improve your ability to concentrate 4 in order to prepare for your exam. it takes longer to make the decisions in the first place and this. 6 you cannot easily change your daily pattern of concentration. Unhelpful levels of stress are more 3 likely when you think there is not enough time to complete a task to the stand- 4 ard required. For example. He felt calmer and more in control. . 100 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 that yoga was a good way to relax so he enrolled for a number of classes. 9 and so any mechanism to manage this will help you to attempt your OSCE 30 more successfully. However. This raises anxiety 6 about the risk of mistakes and further raises the level of stress experienced. If you try to make up for the short- 4 age of time and the slower thinking speed by giving less thought to the deci- 5 sions.86] at [07/18/16]. You can see there are multiple effects on both the body and the mind. As preparation for the 9 OSCE and the exam itself will require you to make a number of decisions. you may display unhelpful levels of 6 stress during the period leading up to the OSCE and during the OSCE. and therefore 7 you need to work around it and make the most of your daily cycle. At this point it may be useful to go back to Chapter 3 and 40R remind yourself of your own learning style analysis. afternoon or night person? Whatever you are. 3 as you can imagine. Copyright © McGraw-Hill Global Education Holdings. 7 Table 5. 2 The yoga taught him several mechanisms which he could use to relieve his 3 stress when it started to build up. perceived loss of 2 status or a belief that a task is impossible. because thinking becomes slower under excessive 2 levels of stress.

finding a quiet area when you 3 are living in student accommodation or in a busy household is difficult. including Feeling inadequate 4 backache 5 Excessive sweating. can you manage with peers or children 2 around. 8 den intermittent noises may be beneficial to your concentration. PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 101 Table 5. Chiangmai University 5. or do you need to be alone? Sometimes. you may think 7 that you study best without music playing. constipation and Difficulty in concentrating 6 diarrhoea 7 Frequent indigestion or heartburn Feeling anxious.62. Therefore. this is only true if it is well matched to the thinking task in hand and 1 to your preference as an individual. 30 however. so 4 remember that sudden intermittent noises are more distracting to your brain 5 than consistent high background noise. 8 and 10 and has to 8 revise for his OSCE. LLC. Downloaded by [ Faculty of Nursing. 6 tive to the background noise level that is the key here. but playing music that mutes sud. 2 3 4 5 Example 2: managing revision time effectively 6 7 Carl is a 35-year-old father of three children aged 5.86] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings. apprehensive or irritable 8 Insomnia and constant tiredness Increasing difficulty in making important 9 decisions 10 Lack of appetite or overeating Poor retrieval of memory 1 2 Sexual impotence 3 Migraine attacks 4 Asthma attacks 5 6 7 How environmental factors will affect you 8 9 Environmental factors are also important. It is the level of intermittent noise rela.156. He is finding the children’s noise very distracting 9 and they are getting fed up with him telling them to be quiet. Background 9 music has been found to reduce mental fatigue and improve concentration. Not to be redistributed or modified in any way without permission.1 The physical and psychological effects of stress 1 2 Physical Psychological 3 General aches and pains. Think about your levels of tolerance 20 to distraction and decide whether you like background noise when you study or 1 whether you need complete silence. 40R .

He 8 then does not feel guilty about not paying the children much attention 9 as he has agreed a concentrated play time with them afterwards. he moves his work into the 4 bedroom and puts on some background music. or just practising clinical skills. glucose. 8 Mental concentration drains glucose from a key part of the brain associated 9 with memory and learning. Downloaded by [ Faculty of Nursing. If your natural light needs to be supplemented with artificial 7 lighting. if you are using resources such as books or computers to increase 4 your knowledge base. ideally. as the primary source of energy 7 in the human brain. LLC. time. prefer- 6 ably natural light. 3 Therefore. Not to be redistributed or modified in any way without permission. One of the authors listened to music by Mozart when studying 8 and now whenever that music is played she can remember the work she 9 was revising! 20 Light affects your mood and therefore your mental energy. but not silent. 102 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 He realizes that asking the children to be silent is not an option. Instead of revising in 3 the room where the children are playing. Having a well-balanced diet is important as dehydration and lack of food 5 make it difficult for the brain to work and can cause poor concentration and 6 increase stress. Chiangmai University 5. and so 2 makes a plan for some quieter. Copyright © McGraw-Hill Global Education Holdings. as for brainwork you need bright light. He negotiates with them 5 that if they play quietly for one hour at a time he will play with them 6 later.62. ‘music while you work’ 5 should be through individual headsets. mental alertness 1 and speed of thinking. can be rapidly used up during mental activity. Think about what type of music you 6 find most relaxing so that you can concentrate on your work and not listen 7 to the music. even exhausting. The background noise is reduced by the music and by having an 7 hour at a time of concentrated work Carl can revise more efficiently. Glucose is the form of sugar that travels in your . 10 1 2 3 Communal background music may impair the thinking ability of some 4 people who need absolute quiet. highlighting how crucial optimum blood sugar is 40R for proper brain function.86] at [07/18/16]. do you dim your lights or 5 use shuttle lighting? Think again. Hence. This is a good thing because melatonin literally sends your brain to sleep. This may help you to concen- 8 trate more efficiently and for a longer period of time.156. Studying is tiring. hydration and change of environment are also important when study- 4 ing. 9 30 1 Nutrition and feeding your brain 2 3 Nutrition. try and use full spectrum ‘blue’ tubes. Light tells your pineal gland to stop producing mela- 2 tonin.

which gradually 7 release glucose into your bloodstream. Soon. depleting its energy supply and compromising 8 your brain’s power to concentrate. Copyright © McGraw-Hill Global Education Holdings.86] at [07/18/16]. 7 She wondered if this was related to her diet and so decided to try eating 8 low glycaemic index food for a week to see if it made a difference. This blood sugar is obtained from 3 carbohydrates: the starches and sugars you eat in the form of grains and leg. 5 stream and store it for later use. She found that she was putting on weight 6 and also experiencing headaches and tiredness more often than normal. white 10 fish.156. it is better to have an oat bar or apple instead. Hence too much sugar or refined carbohydrates at one time can actually 7 deprive your brain of glucose. 4 • had baked beans on brown toast for lunch. Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission. she did feel more alert and less 8 tired. fruits and vegetables. LLC. they depend on the bloodstream to 2 deliver a constant supply of this precious fuel. beans. 9 30 Hannah made sure she: 1 2 • had low glycaemic index cereal for breakfast like porridge. PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 103 bloodstream to fuel the brain and is the only fuel normally used by brain cells. So however tempting it 9 may be to reach for the chocolate. 4 umes. She allowed herself her favourite chocolate bar once she had taken 9 her OSCE. but it’s short-lived. Insulin 4 triggers cells throughout your body to pull the excess glucose out of your blood. Chiangmai University 5. 20 1 2 Example 3: managing diet more effectively 3 4 Hannah liked to eat biscuits and sweets when revising as she felt she 5 needed a boost when working. This gradual release helps minimize 8 blood sugar swings and optimizes brainpower and mental focus. 5 It is therefore essential that you provide your brain with a constant supply of 6 glucose by eating foods with a low glycaemic index number. When you eat 3 something with high sugar content your pancreas starts to secrete insulin.62. 1 Because neurons cannot store glucose. the glucose available to your brain has 6 dropped. 3 • substituted apples and grapes instead of chocolate for a snack. vegetables. 1 A sugary snack or soft drink that quickly raises your blood sugar level gives 2 you a boost (and any caffeine adds to the lift). remember and learn. brown pasta and rice instead of white. 5 • had fish or chicken for supper. chicken and turkey. 40R . 6 7 Although Hannah missed her sweet food. These foods 9 include oats.

10 1 2 3 The importance of exercise 4 5 You may think you don’t have any time for exercise. but try 6 and reduce the amount of tea. It may be hard 7 to find time to exercise. So try to plan your day and fit some exercise around 6 your study time. 2 • Rent or buy an exercise DVD. etc. Chiangmai University 5.156.62. You’ll feel more ener- 2 gized and refreshed and this in turn will help you to perform more effectively 3 in your studies. Not to be redistributed or modified in any way without permission. it also boosts your mental well-being. kick a football around with your friends in the 8 park. ride it to classes or go for a bike ride with friends. Share the cost – and fun – with your 3 housemates. This will need to be supplemented with other liquids. 4 • If you’re going out in the evening. 9 • Clean your flat or house! Housework is a great way to keep fit and should 40R involve stretching. but there is no doubt that 6 it’s a really good way to unwind and feel fresher for your studies. You don’t need to make a special trip to a sports centre to reach 4 your weekly quota of exercise – there are easy ways to introduce some exercise 5 into your daily routine. not only is exercise 9 good for your overall health and fitness. Downloaded by [ Faculty of Nursing. 104 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Hydration: why you need to keep drinking! 2 3 A simple tip to prevent dehydration is to fill a litre water bottle at the beginning 4 of the day. . However. It’s a great way to meet new 5 friends as well as keep in shape. 7 • At lunchtime or weekends. 7 Here are some suggestions. 20 Hence it will reduce stress and improve concentration. dance. so try to drink before you are thirsty. coffee or caffeine-related drinks you consume as 7 caffeine causes the body to lose water (diuresis). particularly during exams when all you seem to do is sit 8 at your desk and work all day (and into the night). Copyright © McGraw-Hill Global Education Holdings. or have a game of volleyball. An important factor to remember is that thirst is a sign of 9 dehydration. or between classes. 1 • If you have a bike. and hence can increase the risk 8 of dehydration. keep it with you and ensure you have drunk it before you go to bed 5 in the evening. LLC. Exercise will have the 1 added effect of helping to keep you calm during exams. 30 • Take the stairs rather than the lift.86] at [07/18/16]. 6 • Go for a jog with friends before going to college. 8 9 • Walk to your lectures instead of getting the bus.

156. 5 so devise a timetable for work and leisure. Try using a pie chart to organize your waking day 8 or your week. Chiangmai University 5. 4 Remember this is your time to succeed. 4 • Try swimming or doing some stretching exercises. 40R . otherwise you may end up failing to start 1 work or enjoy planned leisure time. You need 2 to dedicate time and not be diverted. PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 105 • Try taking small. you actually do some! Set yourself 7 targets so you know what you are going to study – for example. Often people will skip sessions if they are not properly scheduled in. 10 mum levels of well-being while you are preparing for your OSCE. You may find it 3 wakes you up and gives you energy for the day. is today going 8 to be set aside for practising a clinical skill? Or do you plan to revise the 9 anatomy or underpinning knowledge required to practise this skill safely? 30 • Try not to say yes to commitments you can’t keep: don’t feel pressurized into 1 taking time out from work or revision just to please someone else. Downloaded by [ Faculty of Nursing. Here is a range of tools you can use for better time management. Try 1 a walk to the library or around campus. Good time manage. 7 ing to study. Not to be redistributed or modified in any way without permission. Make it a 3 release for you by setting a daily time for work and revision and aim to stick 4 to this. This will allow you to visualize how you can balance studying 9 with having a social life and family time. 8 9 • Getting started: the first thing is to get started on your task. You can be assertive and considerate 3 when you say no. This section 1 looks at how you can prepare by following 10 simple steps. So be decisive and get down to it! 2 • Have a good routine: routine can either be a burden or a release.62. LLC. regular breaks to refresh yourself and clear your mind. 6 ment skills will help you to become more organized and waste less time prepar. Copyright © McGraw-Hill Global Education Holdings. 2 • You could also try to exercise first thing in the morning. 2 3 4 1 Get organized 5 An important key for success in OSCEs is organization. 5 6 7 Ten simple steps to success 8 9 So now you have an understanding of how to look after yourself to ensure opti. The key to this is making sure that 6 at the times you have set aside for work. and in the long run you will be more productive.86] at [07/18/16]. 5 • Make time to plan your work and leisure: items such as daily planners and 6 university calendars will help you to know what you need to do and when 7 you need to have it done. It is a good idea 20 not to procrastinate too long.

It is important to be clear 8 whether you will be expected to answer verbal questions during the exam or at 9 30 1 2 25% 3 Revision 4 Exercise 5 Time with friends 6 60% or family 7 15% 8 9 40R Diagram 5.156. LLC.86] at [07/18/16]. 6 7 8 Diagram 5. Not to be redistributed or modified in any way without permission. 2 3 4 2 Understand the assessment 5 It is important that you are aware of what you are being assessed on and what 6 you are expected to do during the exam.2 gives you an example of how you could manage your daytime 9 activities to make sure you build in enough time for revision. You can see that 20 it builds in exercise time as well as time with friends. Downloaded by [ Faculty of Nursing. Ashanti had a friend’s birthday in the middle 4 of her revision and so built in time to get a present and go out for the 5 evening as well as do her revision. etc. You also need to know what level you 7 will be assessed at and the format of the OSCE.62. Chiangmai University 5. 106 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Example 4: making lists to manage 3 revision effectively 4 5 Ashanti knew that she had to revise a great deal for her medicines man- 6 agement OSCE but couldn’t think where to start. 1 This meant that when she was not revising she was able to feel confident 2 that all of her work could be accomplished in the time available and 3 could enjoy her downtime. Following this 9 she made a plan for a two-week period to make sure she could fit in 10 enough one-hour periods of revision to cover all the areas she needed to. This will make sure 1 you have downtime during your revision. So she decided to make 7 a list of all the areas she wanted to work on. She then broke this down 8 into subsections which could be undertaken in an hour. Copyright © McGraw-Hill Global Education Holdings.2 Managing your day .

3 4 5 5 Review relevant texts 6 Your course textbooks and virtual learning resources are wonderful sources for 7 finding illustrations and diagrams that will help you visualize the concepts you 8 are learning. you 7 may be unsure. 3 attend any lectures/seminars that discuss the OSCEs and review any OSCE 4 checklist and marking criteria. 3 So break the habit of a lifetime and make a plan which helps you to study early 4 and often. You will want to make sure 30 that you understand all the key concepts and topics.86] at [07/18/16].156. discuss them with your tutor. In order 2 to be aware of this you will need to review the module/course documentation. or to complete a written paper (Chapter 4 discusses the type of infor. 1 mation you can expect to receive prior to your OSCE in more detail). 5 6 7 4 Review lecture notes 8 Be sure that you review your lecture notes and other information you have been 9 given to develop the skills. 6 7 8 3 Start studying early 9 It is very important that you start preparing for your OSCEs well in advance. prior to the OSCE.62. You will need to clarify whether there is a 5 simulated patient used in your exam and if so what type (see Chapter 4). 9 tion in your textbooks and virtual learning sites. You should start reviewing your notes on a daily basis. Copyright © McGraw-Hill Global Education Holdings. relearn and then consolidate the information 2 over time and don’t have to cram. Not to be redistributed or modified in any way without permission. You don’t want to go into an OSCE with gaps 9 in your knowledge and revising early and clarifying the areas you are unsure of 40R . It is strongly advised that you seek help and clarification so that 8 you are as prepared as possible. Downloaded by [ Faculty of Nursing. 10 Even if you are a ‘last-minute person’. knowledge and attitude to meet the criteria set for 20 your OSCE. Chiangmai University 5. This will 1 ensure that you gradually learn. this is not the time to use such a tactic! It 1 has been found that students who cram information at the last minute don’t 2 retain the information as well and also get tired and overloaded far more easily. PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 107 the end. Sometimes you may think you fully 6 understand what you need to know but on reflection. 1 2 3 6 Get answers to your questions 4 If you are having difficulty understanding your OSCE or have unanswered 5 questions. LLC. Be sure to reread and review the appropriate chapters and informa.

Why not video each other and 20 then analyse your performances? This way. with one of you acting as the examiner and 7 use the OSCE checklist to mark the other student’s performance. however. Rehearsing answers will give you a good 9 opportunity to see how much you know. Copyright © McGraw-Hill Global Education Holdings.62. They took it in 2 turns to be the student and the patient and they gave each other feed- 3 back as to their performance. 108 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 will give you plenty of time to understand the skills and knowledge you are 2 required to master.156. that any videos are not 2 shared with anyone if all parties do not agree to this. They decided that they would 1 work together to test each other’s knowledge and skill. 6 7 It felt a little weird to test each other at the start but they soon got into 8 the practice and found it to be very valuable. . You can do this by using prepared flash cards or taking a sample 8 test prepared by your course tutors. give 7 yourself a quiz.86] at [07/18/16]. Downloaded by [ Faculty of Nursing. Chiangmai University 5. Ask them 8 questions to assess their knowledge. 2 3 4 8 Find a ‘study buddy’ 5 Get together with a friend or classmate and have a study session. 5 6 7 Example 5: using a ‘study buddy’ 8 9 Kayla and Naomi lived in student accommodation together and were 30 undertaking OSCEs at the same time. It gave them an opportu- 9 nity to realize what they did not know well and what they needed to 40R learn more fully. 3 4 5 7 Quiz yourself 6 To help prepare yourself for the OSCE and find out how much you know. Not to be redistributed or modified in any way without permission. LLC. They weren’t able to take blood pressure in their 5 accommodation but could manage all other parts of the skill. Take turns 6 assessing each other’s performance. You will have had the opportunity to 10 practise your OSCE either in a formal formative attempt or as an informal practice. Ensure. By giving constructive feedback you will 9 learn by being both the student and examiner. 1 You can use the notes from these practices to make up your own quiz questions. It is strongly advised not 3 to put any videos you make on any social networking sites as this may lead to 4 questions about professional behaviour. They were undertaking hand-washing and 4 basic observations. common mistakes can be ironed out 1 and worked upon before the OSCE.

as dis. This is normal and also essential to give you 30 the energy and drive to perform well. as discussed in Chapter 2. 3 What you need to do is ensure that you avoid any unnecessary stress 4 that may tip your stress levels and hence hinder your performance on the day. if your 4 tutors hold a review session. Once you have 7 answered all of them you will be ready to arrive at your OSCE as you have done 8 everything you can to ensure your performance and level of knowledge are 9 adequate. This will help to identify specific 5 topics that will be covered. ensure you attend as this will give 3 you valuable feedback. 1 cussed earlier in the chapter. LLC. Help 6 sessions are also an ideal place to get answers to your questions. Downloaded by [ Faculty of Nursing. it’s time to rest and relax. Aim to relax the evening before but 6 do not be tempted to do so using alcohol as this may impair your performance 7 the following day. you will still feel 9 nervous on the day of the exam.156. Copyright © McGraw-Hill Global Education Holdings. ensure you review this. 5 Being able to answer the questions in Table 5. as by looking at your 8 own performance you will be able to see more clearly where you need to 9 improve. 40R . PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 109 9 Attend any formative or OSCE preparation sessions 1 2 If you are invited to a formative OSCE. 8 9 20 1 You are well prepared so try to think positively! 2 3 4 5 Reducing OSCE nerves 6 7 Even if you have carried out all of the above and therefore feel you have done 8 everything possible to ensure you are successful in your OSCE. Not to be redistributed or modified in any way without permission. Chiangmai University 5. as well as fill in any gaps in knowledge. Nerves are a form of stress and.2 will help ensure you get to the 6 exam on time and prepared. If formative 7 sessions record your performance. be sure to attend. It’s a good idea to make sure you get 5 plenty of sleep the night before your exam. Added to this. avoiding unnecessary stress. a certain amount of stress is important as it will 2 give you the motivation and determination to perform.86] at [07/18/16]. You 4 should be well prepared for your OSCE. 10 1 10 Relax 2 3 Now that you have followed the previous steps.62.

if you are 40R driving to the exam. which may result in you failing a module. Chiangmai University 5. If you rely on 8 public transport. what type of clothes are practical and will aid my performance? 3 F What forms of identification do I need to take? 4 G What equipment/resources do I need to bring to my OSCE and what will 5 be supplied by the HEI? 6 7 8 9 The night before the exam 20 The night before the exam is often the most stressful. allowed texts. book. Here are 2 some tips to help you sleep: 3 4 • gather together what you will need to take into the exam room (pens.2 Are you prepared for your OSCE? 2 3 A Do I know the date and time of my OSCE? 4 B Do I know what time and where I need to report for my OSCE? 5 C How am I planning on travelling to the OSCE? 6 D How long should it take me to get to the OSCE? 7 (Always allow longer in case of hold-ups.). etc.62. Having a good night’s 1 sleep is important in helping you perform well during your OSCE. Not to be redistributed or modified in any way without permission. make sure you have enough petrol and again leave in . have a 1 notebook by the side of the bed and write them down.) 9 E What am I expected to wear to the OSCE? 10 1 Am I expected to wear my clinical uniform? 2 If not. 9 • use a relaxation exercise. as being late 9 due to a cancelled bus will probably not be acceptable.86] at [07/18/16]. 6 • stop revising 90 minutes before preparing for bed. make sure you get an earlier bus than required. student card. music. 7 • relax with friends. LLC. TV. 8 • have a warm bath or shower. Alternatively. Make sure you 7 arrive at the venue a minimum of 10 minutes before the OSCE. 30 • if your head’s still buzzing with thoughts in the middle of the night.156. calculator. Many HEIs will not allow students 8 who are late to sit their exam. etc.. 5 water. 110 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Table 5. Downloaded by [ Faculty of Nursing. 2 3 4 How to perform well in your OSCE 5 6 This section will help ensure you stay calm during the exam. Copyright © McGraw-Hill Global Education Holdings.

30 • remind yourself of the timings for the length of the OSCE and how long 1 you should spend on each section of the exam. before you go into the simulated learning environment. 6 • following the invigilator’s instructions as to where to put your phone and 7 any bags you have with you. PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 111 enough time to avoid traffic jams. follow these simple 6 steps: 7 8 • read the instructions on the front of the paper carefully.86] at [07/18/16].156. During this time. listen to what the examiner 9 in charge tells you to do.g. etc. 2 3 4 During the exam 5 Everyone gets nervous in exams. 1 It is better to arrive early and have time for a calming drink and to get changed 2 into your uniform than to be rushed! 3 You can help to get your mind set for the exam by: 4 5 • turning off your mobile phone.62. Chiangmai University 5. 8 • if you are able to. 20 • read the scenarios slowly. during this time make notes on key aspects as this will 9 help you focus. then read them again – it’s all too easy to misread 1 when you are nervous. Copyright © McGraw-Hill Global Education Holdings. The amount of time you will be given 5 depends on the complexity of the OSCE. 8 • checking your pockets to make sure you don’t take forbidden items into the 9 exam (e. 4 • where there is a choice. mobile phone. notes. 2 • ensure you understand what you have been asked to do rather than what 3 you were expecting to do. ask for clarification. If unsure. LLC. 6 • try not to panic if you are given a station/scenario you were not expecting 7 or one that you feel is not your best. 40R . Take a deep breath before you go in and 6 remember these basic guidelines: 7 8 1 Even though you may be nervous or worried. and to allow you to find a parking space. Not to be redistributed or modified in any way without permission. choose the scenario/station you think you can 5 perform best. 3 This is because you may not know the exact scenario or stations you will be 4 undertaking until the day of the exam. 10 1 It is normal practice for OSCEs to have a period of time before the exam 2 for you to prepare. Downloaded by [ Faculty of Nursing. 9 • make sure you know which scenario/stations you will be examined on.). etc.

86] at [07/18/16]. . Downloaded by [ Faculty of Nursing. 1 9 Read through the paper once and then reread each question. LLC. 9 5 If applicable. Not to be redistributed or modified in any way without permission. ensure you gain consent prior to starting the scenario. and use 10 this opportunity to explain what the procedure will involve. Copyright © McGraw-Hill Global Education Holdings. inform the examiner that 30 you just need to step back and take a few seconds to gather your 1 thoughts. Therefore. remember the examiner is observing your skills 7 and attitude and will also be assessing your level of knowledge. You are better doing this than going on with the exam and 2 making an error. Often when nerves set in we rush and this is 4 when we make mistakes. 5 13 Make sure you do not communicate with. 3 3 Remember to take your time. 8 4 Ensure you carry out every step to the highest quality possible. 4 10 If you are being asked questions during the OSCE or as part of a viva and 5 you do not know the answer instantly. This will give you thinking time and also the opportunity 7 to hear the question again. 7 14 If you finish early. take your time. ensure you relate theory to practice 4 through your narration and if applicable offer differential diagnosis and 5 normal and abnormal pathology. or if something is 4 distracting you. use this 6 time wisely. once you have left the room. however. you cannot 40R return. 1 6 Narrate your way through the exam as this will show the examiner you not 2 only know what to do but you know why you are doing it. 6 You can be disqualified if you break the exam rules in any way. 3 7 To demonstrate your knowledge base. 9 11 If your mind goes blank during the OSCE. ensure you read 7 or listen to the instructions carefully. You might 2 think a topic you’ve revised hasn’t come up. any other candidate. Before looking at the actual 8 questions. read the instructions – are there any compulsory questions? 9 Marks are often lost by nervous or over-confident students who overlook 20 instructions. spend a few seconds going through what you have 8 done – have you missed anything? You can often rectify the situation if you 9 are within the time. 112 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Get into role and remember you are a health care professional as well as a 2 student. Chiangmai University 5. when it is there but the word- 3 ing is unusual. 3 12 If you think that something is wrong.62. this may help you with your performance. if you feel unwell. inform your examiner. you can ask the examiner to repeat 6 the question.156. you may pick up key words that you did not 8 register the first time. or look at. You have been allocated a certain amount of time 5 as this is how much the examiners feel you will need. 6 8 If you have a viva or paper exam as part of your OSCE.

1 8 Plan your route to the OSCE so you arrive in plenty of time.156. Chiangmai University 5. Not to be redistributed or modified in any way without permission. 2 3 9 Make the most of the time allocated to you. 4 10 If your mind goes blank during the exam. 6 7 8 9 30 1 2 3 4 5 6 7 8 9 40R . 2 3 3 Ensure your strategy gives you ample time to revise early and often.62.86] at [07/18/16]. drink and relax to minimize 5 any threat to your brain. 1 2 Plan your revision strategy and use the tools for time management. PREPARING FOR YOUR OSCE: BEFORE AND ON THE DAY 113 It’s all a matter of positive attitude. 5 6 7 8 Chapter summary 9 10 1 Remember the five Ps – ‘prior preparation prevents poor performance’. Copyright © McGraw-Hill Global Education Holdings. this is your chance to 1 perform to the very best of your ability. step back for a few seconds to 5 gather your thoughts. it will be over in a few hours or less. 9 20 7 Read all your instructions well in advance. Downloaded by [ Faculty of Nursing. LLC. 6 7 5 Try revising with fellow students. Remember. 8 6 Recognize excessive stress and reduce any unnecessary stress. It’s worth taking up the challenge to 2 prove what you can do – after all. 3 The next chapter will take you through a range of OSCE examples and tell 4 you what is expected of you in each one. 4 4 Maximize your potential by ensuring you eat.

156. Downloaded by [ Faculty of Nursing. 2 The chapter offers you three examples of possible OSCE stations that you 3 may come across in your course: ‘basic life support’. by breaking down your 30 OSCE stations. 2 Be clear about the terminology of OSCE checklists and marking criteria 3 and how this can help your preparation. you can be well prepared and be 1 more successful in your exam. 4 5 6 OSCE examples 7 8 This chapter offers you additional examples of OSCEs to the one that was pro- 9 vided in Chapter 3. for the greatest 3 fool may ask more than the wisest man can answer. medicines 6 management and aseptic 7 8 non-touch technique 9x 10 1 2 Examinations are formidable even to the best prepared. 4 Charles Caleb Colton (1770–1832) 5 6 7 By the end of this chapter you will: 8 9 Understand the potential components of an OSCE assessment. 8 When assessing OSCEs. Not to be redistributed or modified in any way without permission. Chiangmai University 5. Checklists and marking criteria 5 are included for you to look at when thinking about the OCSE. the examiners will be looking for certain key points. ‘medicines management’ 4 and ‘principles of aseptic non-touch technique’. The purpose is to demonstrate how. 9 The skills and knowledge being assessed will vary but the qualities of an excel- 40R lent performance during an OSCE will be the same whatever the subject.62.86] at [07/18/16]. checklists and marking criteria. 20 Be aware of the minimum standard of competency you will have to 1 demonstrate to pass a range of OSCEs. A brief explana- 6 tion will be given to outline the broad skills and knowledge that the OSCE is 7 assessing and how it might be organized. LLC. 1 2 Sample OSCEs: adult basic 3 4 5 6 life support. Copyright © McGraw-Hill Global Education Holdings. Each .

or it could have 9 greater detail in respect to each grade (see OSCE. This is because at every OSCE station. Copyright © McGraw-Hill Global Education Holdings. LLC. or fail.86] at [07/18/16]. borderline pass. Not to be redistributed or modified in any way without permission. Chiangmai University 5. The reason for this may be the type of OSCE and the stage at which you 30 are in your course. This 4 will be annotated to show what the examiner is looking for in order for you to 5 pass that particular station. but also a global rating 1 from the examiner. 3 lists should have in common is that they should be underpinned. maintenance of dignity and establishing 3 rapport. p. 127–8). For example. 8 You will find that some OSCEs are ‘pass/fail’ while others are given a grade/ 9 score. borderline fail. It is difficult 5 to assess these elements by means of marking criteria – hence the use of a global 6 rating which enables the examiner to comment on the subjective nature of 7 your performance.156. Everything you do 9 correctly is marked against the predetermined criteria. 40R . 6 7 8 OSCE checklists 9 10 There is no standard checklist for an OSCE station as it is up to each university 1 to produce their own. What all OSCE check. It could just give you guidance on your level of performance in 8 respect to good pass. the examiner will 8 evaluate your performance using the standardized checklist. 7 As you perform the required skill(s) during the OSCE. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. 3 The OSCE station/skill will be provided along with the OSCE checklist. the marking criteria 6 were based on the NMC Standards for Medicines Management (NMC 2008b). They will make sure that OSCEs are objective in their 2 nature and that consistency between markers is transparent. and 1 this should be shared with you before you take the exam. MEDICINES MANAGEMENT 115 university will have its own checklist and assessment criteria for the OSCE. consideration should 2 also be given to the patient’s feelings. wherever 4 possible. This is in keeping with good practice guidelines such as those evident 4 in Essence of Care (DoH 2007) and the NMC Code (NMC 2008a). You should use these 2 assessment criteria to support your preparation for your OSCE. by evidence-based guidelines and/or current policy.62. Downloaded by [ Faculty of Nursing. example 2. Usually the final mark 20 encompasses not only the marks from the checklist. the level of your performance or 7 knowledge base.when 5 developing the checklist for administering medication. 1 2 3 Assessment marking criteria 4 5 Assessment marking criteria will be used by the examiner to provide you with 6 feedback on your performance – for example.

5 There are some general grading principles that can be applied to OSCEs. LLC. you need to know the primary causes of common clini- 5 cal signs. to gain an A grade or distinction. You may also have dem- 4 onstrated unsafe practice. Copyright © McGraw-Hill Global Education Holdings. For 6 example. with all the criteria attempted competently. You 9 need to practise performing the skills. your performance would need to be logical in rela- 1 tion to the skill being performed. 1 For a referral/fail grade. you will need to provide an excep- 7 tional performance. Your performance may well be loosely structured with some conse- 9 quent loss of coherence in places. using the criteria to 40R help guide you. go over the stages. you should use it to help you increase your score. There may be significant lapses in presenta- 20 tion but these would not be bad enough to say that you are not competent. 8 More importantly. such as what may cause someone to have a pyrexia. you will also need to use books. Downloaded by [ Faculty of Nursing. standardized checklists and marking criteria will 30 support you in your preparation for your exam. If you are offered a marking grid as well as a 4 checklist. 116 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Marking grids can be useful for you to work out how you can achieve the 2 highest mark possible. The quality of the performance. These will support your learning in respect to performing the skills. you may demonstrate some inaccurate/inadequate 6 parts of the OSCE.62. 3 In addition to this you need to read around the skills you have been asked to 4 perform. until you feel you can perform each step to at least the . you cannot study for your OSCE from reading alone. and supported 8 by an excellent knowledge base. For example. 1 literature and other resources such as DVDs or videos given to you by the 2 university. but not unsafe. You would provide full narration throughout 9 your performance and demonstrate an evaluative approach.86] at [07/18/16]. Related anatomy 6 and pathology are also essential as these are vital for you to demonstrate your 7 underpinning knowledge and decision-making. you are still safe and your knowledge base is very 7 descriptive even though certain aspects of the OSCE did not have supporting 8 narration. you would have demonstrated an insufficient level 2 of knowledge and/or your performance of the skills would have been inade- 3 quate with inaccuracies in style and the technicalities. 10 For a B+/B grade or merit. Your performance may be flawed in a few 2 minor aspects. 5 For a C grade or pass. narration and 3 level of knowledge base at all times would be adequate and at times good or 4 excellent. however. Chiangmai University 5. 5 6 7 Other preparation aids 8 9 Although the OSCE stations. Not to be redistributed or modified in any way without permission. This type of marking criteria is usually divided into the 3 elements you will be assessed on.156.

6 On station one you would be assessed against predetermined marking cri. 8 • your skills in airway management including using a pocket mask. The OSCE may increase with complexity as you progress in 1 your course – for example. 8 station one would last five minutes. MEDICINES MANAGEMENT 117 minimum level required. 8 an OSCE is a very appropriate way to assess your competence in these skills. 9 Station two consists of a short multiple choice question paper to assess 30 your knowledge and awareness of the key interventions of basic life support. 3 The OSCE consists of two stations that present you with a clinical situation 4 in a community setting and are designed to evaluate your skills and knowledge 5 in basic life support. As this is very difficult to assess in practice. 7 teria on your performance of basic life support on a manikin.uk/pages/standard.156. 9 • CPR. 7 • appropriately calling for help. Copyright © McGraw-Hill Global Education Holdings. 2 strate that you have the skills and knowledge to care for a patient who has had 3 a cardiac arrest and therefore this is a very common OSCE for nursing students. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. In this OSCE. 2 We will now illustrate two OSCEs to help you to understand what is expected 3 of you. The key to success is to practise and practise.86] at [07/18/16]. and one OSCE for you to read through and see if you can work out what 4 is required. which include an evaluation of 7 competency in resuscitation. 1 Station two would last 10 minutes. either 1 alone or with peers. Chiangmai University 5. Not to be redistributed or modified in any way without permission. As part of your mandatory training you will be required to demon. you may have to demonstrate use of an automated 2 defibrillator or work in a resuscitation team in an acute hospital setting.org. 4 The Resuscitation Council Guidelines (www.pdf) 5 state that all health care professionals including undergraduate students should 6 have initial training followed by yearly updates. 40R . 2 You can see below that you will be marked against a range of criteria and 3 these include: 4 5 • safety. Downloaded by [ Faculty of Nursing. LLC. 6 • recognition of the unresponsive patient.resus. 5 6 7 OSCE example 1: adult basic life support 8 9 Explanation 10 The purpose of this OSCE is to assess knowledge and skill in relation to basic 1 life support. 9 This OSCE is assessing your skills at a very basic level and takes place in a 20 community setting.62.

Downloaded by [ Faculty of Nursing. . You are waiting in the sitting room when you hear a loud bang 7 from the kitchen. Copyright © McGraw-Hill Global Education Holdings. 2 N. 4 Station two is the multiple choice paper. She is currently in her car on 5 the phone. or 9 you may have been given this scenario previously along with other information 40R about the OSCE. You need to answer 40 per cent of the questions correctly 7 in order to pass this station. For this OSCE you would have to 1 pass both stations to be successful. Not to be redistributed or modified in any way without permission. It may be that you have just 7 been told that you will be assessed on your basic life support skills and know- 8 ledge and you have not been given the scenario until just prior to your OSCE.86] at [07/18/16]. you go to see what has happened. Please ask if you are unclear about what it is that you have to do. Chiangmai University 5. or if you have to 10 achieve a pass in a set number of stations. 9 30 You are required to assess the patient and act appropriately upon your 1 findings. 118 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Failure of one mandatory criteria will result in you failing this station as it 3 would be deemed that you are not competent. When you enter the 8 kitchen you see that the patient is motionless on the floor. The patient is in the kitchen making you and your mentor a 6 cup of tea.156. 8 When an OSCE has more than one station it is important for you to find out 9 if you need to pass all stations to achieve an overall pass. LLC. The nurse has popped out to the car to collect some equipment 4 and receives a phone call at the same time.B. 2 3 The OSCE 4 5 6 Adult basic life support OSCE station 7 Student information 8 9 IMPORTANT – PLEASE READ CAREFULLY 20 1 You are a first-year nursing student visiting a 45-year-old man with mild 2 learning disabilities at his home with a member of the community nurs- 3 ing team. and here you will be asked a range 5 of questions related to station one to assess that you have the knowledge to 6 underpin your skill.62. 3 4 5 6 The above is the scenario attached to this OSCE.

Therefore. get clarification from the exam. read the scanario very carefully. Chiangmai University 5.62. This may lead you to ask questions 6 such as whether there will be a phone available in the examination room 7 or whether you just have to inform the examiner that you are calling 999 8 and let them know what you would say. 4 iner. 9 40R . SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. 3 ment that would be available in an acute hospital setting. This is very 2 important in this scenario as you will not have any resuscitation equip. 6 Below is the same scenario but we have identified the key points in order to 7 help you understand what you are being asked to do. MEDICINES MANAGEMENT 119 It does not really matter when you are given this information. in order to be successful you will need to 4 perform the skills required in basic life support. The import. You should have been 5 given a skills session in this and also some reading materials and resources 6 such as DVDs or websites. If you are unclear about 3 the scenario or any accompanying instructions. 6 7 You are a first-year nursing student visiting a 45-year-old man with mild 8 learning disabilities at his home with a member of the community nursing 9 team. LLC. 1 ant thing is that you unpick it so that you are clear about what you are being 2 asked to do.86] at [07/18/16]. Do not feel embarrassed or worried about annoying the examiner – it is 5 better to ask than to perform incorrectly at the station. 3 ant information within this section which will not only tell you what you 4 are required to do but will provide you with relevant information to help 5 you succeed in your OSCE. Your preparation prior to the OSCE would have 7 been to revisit these. Not to be redistributed or modified in any way without permission.156. 8 9 10 1 Adult basic life support OSCE station 2 This tells you that you are being assessed on your basic life support skills 3 on an adult patient. 30 1 This informs you of the setting and the age of the patient. Therefore. Copyright © McGraw-Hill Global Education Holdings. 8 9 Student information 20 1 IMPORTANT – PLEASE READ CAREFULLY 2 This is telling you to read what follows as there will be some very import. thus when you 4 call for help you will need to call 999 for an ambulance rather than 2222 5 for the hospital resuscitation team. Downloaded by [ Faculty of Nursing.

you will need to commence CPR. 4 5 This is giving you permission to ask questions! 6 7 8 9 40R . When you enter the kitchen you see that the patient 2 is motionless on the floor. Copyright © McGraw-Hill Global Education Holdings. if you find that your patient is 7 unresponsive and has no signs of life. 3 4 This informs you where the patient is and that you have to respond.156. in which case you will need to ask the exam- 30 iner what your findings are. If 8 you have not already been informed you will need to ascertain whether you 9 will using a basic manikin. Chiangmai University 5. Please ask if you are unclear about what it is that you have to do. 2 3 N. ‘airway’. As you 5 did not witness the event and due to the fact that the patient is in the 6 kitchen. ‘respon- 5 sive’. Therefore you 9 need to assess if it is safe to approach the patient. ‘shout’. 120 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 The nurse has popped out to the car to collect some equipment and receives a 3 phone call at the same time. 20 1 You are required to assess the patient and act appropriately upon your findings.86] at [07/18/16]. you go 1 to see what has happened. the examiner will be expecting you to assess for danger prior to 7 assessing the patient. ‘breathing’ and ‘circulation’. If you remember. the first part of the Resuscitation 8 Council algorithm for basic life support is ‘D’ for danger. 4 5 This is telling you that you are on your own and should not expect the 6 nurse to come back during the OSCE! The rationale for this is that the 7 purpose of this OSCE is to assess your competence in resuscitation. She is currently in her car on the phone.62. Downloaded by [ Faculty of Nursing. 2 3 This is informing you that you need to continue with a systematic assess- 4 ment of the Resuscitation Council algorithm DRSABC: ‘danger’. and act appropriately 6 according to your findings. or whether you be using an advanced manikin 1 where breathing can be assessed directly by you. Not to be redistributed or modified in any way without permission.B. You are 10 waiting in the sitting room when you hear a loud bang from the kitchen. 8 9 The patient is in the kitchen making you and your mentor a cup of tea. For example. LLC.

You will see that it is 3 divided into ‘skill’. Once 10 again we have annotated the criteria in the checklist to help you gain greater 1 understanding of the skills you would be required to demonstrate in this OSCE. 7 The comments box will allow the examiner to provide you with written feed. it will provide you 3 with a better understanding of what skills you need to perform and why.1 is the checklist that could be used at this station. 6 ance you are expected to achieve.156. 9 ciples to different clinical situations and hence practise safely. In this checklist 20 (Table 6. 8 back on your performance. 2 If you annotate your OSCE checklist in a similar way. The ‘criteria’ column splits 5 the skill into sections and therefore helps you understand the level of perform. Downloaded by [ Faculty of Nursing. also that you are not putting yourself at risk. ‘criteria’. It is 4 very important that not only can you perform each element of the skill cor. 4 5 This tells you that you are required to perform every criterion to the required 6 standard in order to pass the OSCE. It is there. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. MEDICINES MANAGEMENT 121 OSCE checklist 1 2 Table 6. 8 You will see that at the end of the checklist it states: 9 30 All criteria have to be attempted using a systematic approach conforming 1 with the Resuscitation Council basic life support algorithm in order to pass 2 the OSCE. If you are 9 unsure of your level of skill you need to seek support from your tutor. attempted but performed incor. 3 rectly or not to an appropriate standard the student will fail the OSCE.62. This could be in the form of congratulating you on 9 your performance or giving you constructive feedback so that you know where 40R . it is important that you revisit these skills. 6 fore important that you find out what the consequences would be should you 7 miss out a component. 8 This level of understanding is very important so that you can apply the prin. If any criteria is not attempted. Chiangmai University 5.86] at [07/18/16]. 6 Therefore we suggest that you write against each criterion why it is important 7 and include the evidence base behind it. This is a very good 3 example of the need to know why you are doing something and not just how to 4 complete the task! 5 You will see that this OSCE checklist does not have bold criteria. 5 rectly but also that you understand why they should be performed in this way.1) you are asked first to ‘assess danger’ and the rationale behind this is 1 that you need to do an initial risk assessment and ensure it is safe to approach 2 the patient. 7 You should have carried out these skills under supervision in a simulated 8 practice session. ‘achieved’ and ‘comments’. The skills that you are 4 being assessed on will be under the ‘skill’ column. LLC. Copyright © McGraw-Hill Global Education Holdings. however. Not to be redistributed or modified in any way without permission.

62. 122 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Table 6. spilt oil. The most effective way to do this 5 is by calling the patient’s name. informing the examiner of what you are 7 doing. Remember 4 the examiner cannot read your mind so you need 5 to narrate your way through your actions in the 6 OSCE. Downloaded by [ Faculty of Nursing. This needs to be 1 related to the location of the incident. Not to be redistributed or modified in any way without permission.86] at [07/18/16]. 8 (R) Check Checks for response by: 9 response • Calling the patient’s name 20 • Tapping the patient on the shoulder and 1 calling his/her name 2 3 In this section you are checking if the patient is 4 responsive and therefore their level of consciousness. 8 9 40R . 5 You are hoping that the nurse who is with 6 you will hear you or perhaps a passer-by or 7 neighbour. Copyright © McGraw-Hill Global Education Holdings. water. If you do not get any response 8 you can deduce that you have a patient who is 9 unconscious and therefore you need to act 30 accordingly.1 Adult basic life support OSCE checklist 2 3 Skill Criteria Achieved Comments 4 Yes No 5 (D) Assess Assesses if it is safe to approach the patient 6 danger 7 You need to make it very explicit that you are 8 assessing the area for danger prior to approaching 9 the patient. in this case 2 the kitchen. Chiangmai University 5. If they do not 6 respond then incorporate touch as a stimulant 7 as well as speech. etc. asking for help 2 help Here you are calling for help as you have 3 found that you have a patient who is 4 unresponsive and will need some sort of help. You could include looking for 3 electrical cables.156. You should inform the examiner that you are assessing for danger and what types of 10 danger you are looking for. 1 (S) Shout for Calls out. LLC.

Downloaded by [ Faculty of Nursing. 5 listen and feel’ mean in this context? You could 6 write notes on your checklist to remind you of 7 what you need to do in order to achieve these 8 three elements. LLC. 4 (B) Checks for breathing and signs of life for not 5 Breathing more than 10 seconds by: 6 and (C) 7 • Looking circulation 8 • Listening and • Feeling 9 20 In this section you need to be able to show that 1 you know how to check for the above. You are also looking for 5 anything that could potentially obstruct the 6 airway further when you open the airway. 4 5 Commence Correct hand position: heel of your hand in 6 compressions the centre of the chest with the other hand 7 on top 8 (Continued) 9 40R .156. Do you know how to check for 4 breathing and signs of life? What does ‘look. chin lift is 1 the manoeuvre used and this section is assessing 2 whether you are able to perform this skill 3 correctly. Try practising this so 3 that it does not feel so awkward when you do it. 7 Opens airway using a head tilt. MEDICINES MANAGEMENT 123 1 (A) Assess Checks if the airway is clear airway 2 Part of assessing the airway is to find out if there 3 is anything obvious blocking the airway that 4 could be easily removed. You need to tell the examiner that you are looking. Copyright © McGraw-Hill Global Education Holdings. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT.86] at [07/18/16]. 9 Ensure help Calls 999 and provides accurate and concise 30 is coming/ information 1 get help 2 Here you will need to accurately state where you are and what the problem is. chin lift 8 manoeuvre 9 You need to open the airway to give the patient 10 every opportunity to breathe. 2 listening and feeling and what you are looking 3 and feeling for. Chiangmai University 5. Head tilt. Not to be redistributed or modified in any way without permission.62.

occasionally you were too fast. the examiner may say. Not to be redistributed or modified in any way without permission. 1 2 Note: All criteria have to be attempted using a systematic approach conforming with the 3 Resuscitation Council basic life support algorithm in order to pass the OSCE. 10 • complete the correct amount of compressions 1 at the correct rate and depth. 5 6 Commence Attempts two breaths by: 7 two breaths • Opening airway using a head tilt.156. LLC. however if it did not you could add this to your notes. 5 6 7 to improve.’ 9 Chapter 7 will provide you with further guidance on how to make best use 40R of the feedback given to you by your examiner. .62. ‘Ensure your compressions are 8 continually at a rate of 100 per minute.86] at [07/18/16]. 6 Continue Continues with chest compressions and 7 with breaths using a ratio of 30:2 until either help 8 effective CPR arrives or asked to stop 9 This tells you need to continue with CPR until 30 you are informed by the examiner to stop. 2 3 This checklist has provided you with this 4 information. Copyright © McGraw-Hill Global Education Holdings. You have to: 9 • know the correct hand position. Downloaded by [ Faculty of Nursing. For example. attempted but performed incorrectly or not to an appropriate standard the student 4 will fail the OSCE. Chiangmai University 5. chin 8 lift technique 9 • Using a pocket mask to blow into the 20 mouth 1 • Watches for chest to rise and fall 2 Once again you are being asked to demonstrate 3 your skills of opening the airway but this time you 4 also need to demonstrate that you can use a pocket 5 mask correctly and give two effective breaths. 124 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Skill Criteria Achieved Comments 2 3 Yes No 4 30 compressions delivered at: 5 • A rate of 100/min 6 • A depth of 4–5cm 7 Here you are being assessed on the accuracy of 8 your compressions. If any criteria is not attempted.

Copyright © McGraw-Hill Global Education Holdings. 7 • the ‘key’ which is the correct response.86] at [07/18/16]. not moving and not breathing normally 8 b) Has no pulse 9 c) Unconscious. The example below assesses your level of knowledge related to the 2 management of basic life support. LLC. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. unresponsive and not moving 40R . unresponsive. 9 20 This type of test is very versatile in that it can measure a variety of levels of 1 functioning. What should you do first? 7 a) Determine responsiveness 8 b) Check for danger 9 c) Call for help 30 d) Commence CPR 1 2 2 Is it advisable to check for signs of circulation in adults by finding the 3 carotid pulse? 4 a) No 5 b) Yes 6 3 ‘No signs of life’ means: 7 a) Unconscious. 3 Try to answer each question to test your own knowledge before looking at 4 the answers. You need to ensure that you find out what are the conse. Not to be redistributed or modified in any way without permission.62. 5 1 There are several things you need to do when you encounter a person in 6 need of assistance. or ‘incorrect’ responses. 4 The multiple choice consists of three elements: 5 6 • the ‘stem’ containing the problem or statement. MEDICINES MANAGEMENT 125 Pass/fail 1 2 Having ‘pass/fail’ informs you that you will either pass or fail the OSCE and will 3 not be given a grade. 4 quences of failing the OSCE: will you be offered another attempt or will you 5 have to take this part of the course again? 6 7 Station two: multiple choice questions 8 9 Station two is a multiple choice paper that assesses the knowledge related to the 10 skill that you performed in station one. If your OSCE is a series of stations. Downloaded by [ Faculty of Nursing. This station is an objective test as the answers are predetermined 3 and selected by you from a number of alternatives. the 1 multiple choice could assess your knowledge related to all the stations rather 2 than just one. Chiangmai University 5.156. and 8 • ‘distractors’.

LLC. Copyright © McGraw-Hill Global Education Holdings.156. then place 8 your other hand next to that 9 b) Find the centre of the chest (lower half of the sternum) 40R . 126 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 4 Which of these means would be appropriate to ‘open the airway’ of a child 2 victim? 3 a) Maintain head in neutral position 4 b) Backward head tilt and chin lift 5 5 Which of these terms means ‘CPR’? 6 a) The technique of rescue breathing combined with chest compressions 7 b) Basic life support 8 9 6 When you commence CPR. Chiangmai University 5. Downloaded by [ Faculty of Nursing.62. how many initial breaths would you give? 10 a) 2 1 b) 3 2 c) 5 3 7 Another way of looking at the rate of compression is: 4 a) The number of compressions given between breathing 5 b) The number of compressions given in a minute 6 7 8 What is the recommended rate of compressions? 8 a) 100 compressions per minute 9 b) 30 compressions per minute 20 9 What is the recommended ratio of compressions to breaths? 1 a) 100 compressions to two breaths 2 b) 30 compressions to two minutes 3 c) 30 compressions to two breaths 4 5 10 The recommended ratio of compressions to breathing (30:2) applies to: 6 a) Adults 7 b) Younger children 8 c) Older children 9 d) Infants 30 e) All of these 1 11 Do you need to count the number of cycles per minute when giving CPR? 2 a) Yes 3 b) No 4 5 12 What is the recommended way to determine the location point for chest 6 compressions? 7 a) Place two fingers at the point where the lower ribs meet. Not to be redistributed or modified in any way without permission.86] at [07/18/16].

6 7 Therefore. 20 • Rationale for decision-making in administration in relation to drug dosages 1 for minimal side-effects. c 10. extremes of life. which consists of the examiner asking the student a 4 maximum of three questions pertinent to the case scenario and medication 5 regime as indicated on the examination sheet.g. LLC. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. 9 30 The examination consists of one station with the following timings: 1 • 10-minute preparation and reading (a BNF will be provided). a 5. Chiangmai University 5. b 8. 2 • 15-minute medication administration. Not to be redistributed or modified in any way without permission. . disease 9 processes). 4 • Ability to reflect upon practice experiences and demonstrate application of 5 theory to practice.156. b 2. Downloaded by [ Faculty of Nursing. a 11. a 9. This OSCE would be suitable for a pre-registration nursing 5 student in their final year of study. The key areas assessed are as follows: 6 7 • The principles of pharmacodynamics and pharmacokinetics. c 4. 7 • Knowledge of the identification of the role of the nurse and other health 8 care professionals in medicines administration and client education. 6 • Effective decision-making in medicines administration. the total time allowed for this OSCE is 30 minutes. 2 • Awareness of the professional accountability of the nurse and legal and 3 ethical implications. a 7 8 9 OSCE example 2: medicines management 10 1 Explanation 2 The purpose of this OSCE is to assess your knowledge and skill in relation to 3 medicines management and assesses the ESCs related to safe medicines 4 management. a 3. Copyright © McGraw-Hill Global Education Holdings. a 7. MEDICINES MANAGEMENT 127 13 What method of compression should you use for infants? 1 a) The two finger technique 2 b) The heel of one hand with the other hand firmly on top of the lower hand 3 4 5 Answers 6 1. 3 • 5-minute questioning. identifying 8 factors that may influence this process (e. 8 The examiner will also act as the staff nurse supervising the student on the 9 ward and will therefore act as the second checker following the administration 40R of any medication.62.86] at [07/18/16]. b 13. a 6. b 12. interactions and hypersensitivity.

You would then be able to use the BNF to support you in 2 being aware of the therapeutic usage and contraindication of the medication 3 you are required to administer. 4 In the explanation section it states that you will be given 10 minutes reading 5 time. It is 0800hrs: 2 please administer her morning medications as outlined on the drug 3 chart: 4 Ramipril 10mg od at 08. 128 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 The OSCE 3 4 5 Medicines management OSCE station 6 Student information 7 8 IMPORTANT – PLEASE READ CAREFULLY 9 10 Sasha Kera has been living in a care home for two years following an 1 ischemic stroke.156. In this time you 20 are able to utilize the BNF to ensure you have the adequate knowledge 1 to administer these medications according to the NMC Standards for 2 Medicines Management (NMC 2008b).00hrs and 20. although you are aware that the skill you will be carrying out 9 will be medicines management. Not to be redistributed or modified in any way without permission. LLC. it is not until you arrive that you are given the 30 scenario.00hrs 7 8 Dipyridamole MR 200 mg bd at 08. Copyright © McGraw-Hill Global Education Holdings.00hrs 9 You have 10 minutes prior to your OSCE commencing. Chiangmai University 5. .86] at [07/18/16]. Downloaded by [ Faculty of Nursing. Sasha is due to receive her medication. 3 4 5 6 7 8 For this OSCE.00hrs 5 6 Aspirin 75mg od at 08.62. 8 Below is the same scenario with the key points identified to help you under- 9 stand what you are being asked to do. and the main points you need to jot 40R down in relation to the drugs you will administer. and you need to use these 10 minutes wisely and review the drugs in the 6 BNF to ensure that you are aware of why the patient is taking the medication 7 and common side-effects and contraindications. Therefore your preparation would be to learn the process for adminis- 1 tration of medication.

however.00hrs 7 8 Therapeutic usage: ramipril is an angiotensin-converting enzyme inhibitor 9 (ACE inhibitor). 6 • precautions. 4 • normal dosage.00hrs: please adminis- 8 ter her morning medications as outlined on the drug chart: 9 10 You may feel that you do not have enough information about the patient’s 1 condition.86] at [07/18/16]. as many drugs have more than one therapeutic usage and 2 dosages are often determined by the usage. Copyright © McGraw-Hill Global Education Holdings. You could confirm this with the patient themselves during the OSCE. 5 6 Ramipril 10mg od at 08. in 7 order to do this safely you need to be aware of polypharmacy (the interaction 8 of drugs) and hence you need to consider what other medication she is on.00 medication. 8 9 You can gain all of this information from the BNF. It is 08. 9 This will be on the chart. therefore the key here is to review the medication 20 chart as a whole and not just the 08. However. 6 You are being asked to administer Sasha’s 08. 5 • common side-effects.62. Downloaded by [ Faculty of Nursing. if the examiners thought you needed more information 2 they would have given it to you! Think about the medication that you have 3 been asked to administer and the respective therapeutic uses: this will 4 help you understand why the patient has been prescribed these medica- 5 tions. Not to be redistributed or modified in any way without permission. 7 • contraindications. LLC. The examiner is looking 30 for your ability to analyse the information and utilize the information rel- 1 evant for Sasha. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. Chiangmai University 5. MEDICINES MANAGEMENT 129 1 Medicines management station 2 3 Student information 4 IMPORTANT – PLEASE READ CAREFULLY 5 6 Sasha Kera has been living in a care home for two years following an ischemic 7 stroke.00 medication. We have completed this for 3 the drug ramipril as an example – try carrying out the same task for the 4 other prescribed medications. You need to ensure you 1 are aware of the following in relation to each of the prescribed medications: 2 3 • therapeutic usage. One of its common uses is to treat mild to moderate 40R .156. Sasha is due to receive her medication.

ACE 20 inhibitors should not be used in pregnancy. Checking if Sasha has any 1 allergies will inform you if she has sensitivity to ACE inhibitors. You need to ensure that the patient is aware of this and 1 what they should do if they are suffering from any of these side-effects. Therefore you could conclude that this is why Sasha has been 5 prescribed ramipril. 1 2 This is giving you permission to utilize the BNF so you are sure that you are 3 aware of the therapeutic usage. Contraindi- 9 cations include patients with hypersensitivity to ACE inhibitors. normal dosages. side-effects. Common side-effects of 9 this drug include profound hypotension. In this time you are able 8 to utilize the BNF to ensure you have the adequate knowledge to administer 9 these medications according to the NMC Standards for Medicines Manage- 30 ment (NMC 2008b). 6 You can see that Sasha is not on diuretics.86] at [07/18/16]. What many practitioners aim to know are the normal dos- . As per the NMC Standards for Medicines Manage- 6 ment you must know the therapeutic uses of the medicine to be adminis- 7 tered. 2 For example.156. Not to be redistributed or modified in any way without permission. renal impairment and a persist- 10 ent dry cough. no one can be expected 9 to know this about every drug. Hypertension could have been one 3 of the contributing factors towards the stroke that Sasha suffered two 4 years ago.00hrs and 20. its normal dosage. and you should be able to 7 ascertain from the notes or the examiner how long she has been on the 8 medication and whether she has peripheral vascular disease. Chiangmai University 5. 2 3 Aspirin 75mg od at 08. ACE 5 inhibitors should also be used with caution in peripheral vascular disease. However.62. with profound hypotension they may get dizzy when standing 3 up too quickly.00hrs 6 7 You have 10 minutes prior to your OSCE commencing. LLC. precautions and contraindications in 8 order to be able to meet the set standards. Copyright © McGraw-Hill Global Education Holdings. Precautions include hypotension with the first doses. Downloaded by [ Faculty of Nursing.00hrs 4 5 Dipyridamole MR 200 mg bd at 08. pre- 4 cautions and contraindications of all of Sasha’s medications (not just the 5 08. As Sasha is prescribed 10mgs od you can conclude 7 that she is taking a correct dose. therefore it is safe practice to use the BNF to 40R support you in this. 130 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 hypertension and prevention of stroke. However. Normal dosage for prophylaxis of stroke is 10mg od 6 (once per 24 hours). 4 which should be initiated with care with patients receiving diuretics. common side-effects. you may wish to check what her 8 blood pressure is to determine its effectiveness.00hrs medications).

MEDICINES MANAGEMENT 131 1 ages.aspx?ArticleID=3958. This is because you will not have been deemed competent. beta blockers and simple analgesics. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT.62. 4 the bold criteria are mandatory to pass the exam. 2 If you demonstrate all of the mandatory criteria to a satisfactory standard.2 is an example of a checklist that could be used for this OSCE.156. 4 Code and ESCs discriminatory 5 behaviour 6 • Demonstrates –2 2 3 4 7 professionalism 8 through approach to 9 practice 40R (Continued) . Copyright © McGraw-Hill Global Education Holdings. 1 2 3 Table 6. Chiangmai University 5. 3 the OSCE mark is calculated by adding the scores you receive in each section to 4 give an overall percentage mark. 6 effects with the patient. Not to be redistributed or modified in any way without permission. anti-hypertensives. 3 A point of caution: ensure that when you verbalize this information to the 4 patient you use lay terms and not medical jargon – you do not want to 5 confuse or frighten them. Here.2 OSCE checklist for medicines management 6 7 Activity Performance expected Refer Satisfactory Good Excellent 8 9 Professional • Adheres to school dress 0 1 2 2 code 30 behaviour This will be • Behaves in a –2 2 3 4 1 assessed throughout professional manner 2 the OSCE and respecting others. Downloaded by [ Faculty of Nursing. 5 Table 6.nmc-uk. you will see that they correlate to the 8 standards set by the NMC for medicines management which can be found at the 9 following link: www. You should only discuss the most common side. steroids.86] at [07/18/16]. 20 you would be strongly advised to view a copy of these standards to help you 1 prepare for this OSCE. and ask also whether there will be a BNF 10 available in the OSCE. precautions and contraindications of drug groups – for 2 example. side-effects. 7 If you look closely at the bold criteria. 8 Ask the examiner if you are able to make notes about the drugs and take 9 these into the OSCE with you. so they can make an informed decision regarding 7 taking or not taking the medication. Consequently.org/aArticle. LLC. 3 relates to the NMC adopting non. Failure of one mandatory 5 aspect will result in you receiving a technical fail. even if your overall mark is 6 above the pass mark.

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132 SUCCEED IN OSCEs AND PRACTICAL EXAMS

1
Activity Performance expected Refer Satisfactory Good Excellent
2
Communication • Introduces self, giving name 0 1 2 3
3
skills • Asks what patient would 0 1 2 3
4
like to be called
5 • Good eye contact, 0 1 2 3
6 appropriate use of touch
7 and clarity of voice
8 • Uses open questions 0 1 2 3
9 • Offers patient opportunity 0 2 4 4
10 to ask questions and gives
1 clear answers
2 • Checks patient identity: –2 1 2 2
verbally, ID bracelet
3
and prescription chart
4
• Gains informed consent –2 2 2 6
5
for administration of
6 medication
7
The first part of this section
8
is assessing the finer
9 communication skills. It is about
20 building a rapport with your
1 patient. Establishing a rapport in
2 the early part of the OSCE sets
3 the scene for the rest of the exam.
4 It is done simply by greeting the
5 patient warmly and giving a clear
6 introduction including your
name, role and purpose: for
7
example, ‘I am Susan, a
8
third-year nursing student and I
9 have been asked to administer
30 your morning medication with
1 the support of my mentor.’ You
2 will then need to inform the
3 patient of what this involves in
4 order for you to gain an informed
5 consent from them.
6 Taking your time carrying out a
7 good introduction will buy you
time to compose yourself and
8
gather your thoughts before you
9
move on with the task. A word of
40R
advice: students that dive straight
in often make silly mistakes!

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SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT, MEDICINES MANAGEMENT 133

1
Procedure • Consults prescription –2 2 4 6
chart to ascertain
2
drugs, dose, timing, 3
route, method of 4
administration and 5
doctor’s signature 6
• Assesses patient as –2 2 4 6 7
necessary (identifying 8
specific observations 9
that need to be carried 10
out prior to 1
administration)
2
• Informs patient of –2 2 4 6
3
medication to be
4
administered
5
• Checks patient’s 0 2 3 4
6
understanding, offers
explanations as needed and 7
answers any questions 8
• Considers benefits of 0 2 3 4 9
written information as 20
support 1
• Checks for allergies, –2 2 3 4 2
verbally and on 3
prescription chart 4
• Selects required –2 2 3 4 5
medication, checks 6
name, strength and 7
expiry date (verbalizes 8
action)
9
• Offers glass of water 0 1 2 2
30
• Ensures patient has –2 1 2 3
1
taken medication
2
(verbalizes action)
3
• Makes a clear, accurate –2 2 3 4
4
and immediate record
of medication 5
administered 6
• Obtains counter- –2 1 2 3 7
signature of examiner 8
• Returns environment to 0 1 2 2 9
previous state 40R

(Continued)

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134 SUCCEED IN OSCEs AND PRACTICAL EXAMS

1
Activity Performance expected Refer Satisfactory Good Excellent
2
3 During the procedure you will
need to carry out each step to an
4
appropriate standard. Therefore it
5
is important to ensure that you
6
can memorize each of these steps
7 so that they are second nature to
8 you when it comes to the OSCE.
9 Remember to talk aloud, stating
10 what you are doing so that the
1 examiner does not miss anything
2 when they are looking down the
3 marking criteria. For example,
4 when you are reviewing the drug
chart read aloud:
5
6 • the name of the medication;
7 • the dose of the medication;
8 • the formulation of the
9 medication;
20 Check that the chart is dated,
1 timed and signed by the
2 prescriber. Verbalize what the
3 drugs are for, whether the
4 dosages are within the
therapeutic range, and so on.
5
The terminology that you use to
6
explain this to the patient will
7
need to be in lay terms. However,
8 explaining them in more detail
9 to the examiner separately will
30 demonstrate a greater depth of
1 knowledge base and hence
2 increase your mark.
3 Knowledge base • Is able to articulate –2 2 4 6
4 legal and ethical
5 duties in relation
6 to medication
7 administration
8 • Verbalizes therapeutic –2 2 4 6
9 uses and normal doses
40R of prescribed
medication

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SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT, MEDICINES MANAGEMENT 135

• Verbalizes side-effects, –2 2 4 6 1
cautions and 2
contraindications of 3
prescribed medication 4
These are the questions the 5
examiner will ask if you do not 6
cover them during the OSCE. It 7
is better to offer this information 8
voluntarily than wait to be 9
questioned. 10
1
2
Assessment criteria
3
Table 6.3 is an example of an assessment marking criteria that will help you 4
determine what your performance would need to be in order to achieve specific 5
grades. You will see that the OSCE marking criteria is divided into four 6
elements. If you are offered assessment criteria as well as a checklist you should 7
use this to help you increase your score/mark. 8
You will see that in order to achieve 90–100 per cent you need to deliver a 9
near perfect performance and have a broad, detailed and accurate knowledge 20
base. Take time to read the criteria and the checklist. 1
2
Table 6.3 Assessment marking criteria 3
Assessment criteria student number: Date: 4
Grade Professional Communication Procedure Knowledge base
5
behaviour skills 6
A: 90–100% Excellent and Gives clear, Safe in all Demonstration 7
Almost no consistent concise and aspects of of a broad, detailed 8
room for professional precise verbal procedure. and accurate 9
improvement behaviour. instructions Confident, knowledge of all 30
at this level Uniform worn and full fluent aspects of relevant 1
according to explanations to technique underpinning theory. 2
Code. patient. Checks with Applies knowledge to 3
understanding rationale. scenario to offer
4
throughout the sound clinical
5
procedure. decision-making and
6
Gives assessment.
reassurance to 7
promote 8
concordance. 9
(Continued)
40R

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136 SUCCEED IN OSCEs AND PRACTICAL EXAMS

1
Grade Professional Communication Procedure Knowledge base
2 behaviour skills
3
A: 80–89% Excellent and Gives clear, Safe in all Demonstration
4
Exceptionally consistent concise and aspects of of a broad, detailed
5
high level of professional precise verbal procedure. and accurate
6 performance. behaviour. instructions Confident, knowledge of all
7 Uniform worn and full fluent aspects of relevant
8 according to explanations to technique underpinning theory.
9 Code. patient and with Considers assessment
10 checks rationale. of scenario to
1 understanding support clinical
2 throughout the decision-making and
3 procedure. assessment.
Gives
4
reassurance to
5
promote
6 concordance.
7
A: 70–79% Excellent and Gives clear, Safe in all Demonstration of a
8
Excellent consistent concise and aspects of detailed and accurate
9 professional precise verbal procedure. knowledge of key
performance
20 behaviour. instructions Confident, aspects of relevant
1 Uniform worn and full fluent underpinning theory.
2 according to explanations to technique Considers assessment
3 Code. patient. Checks with of scenario to
4 understanding. rationale. support clinical
5 Gives decision-making and
6 reassurance to assessment.
promote
7
concordance.
8
9 B+: 60–69% Appropriate Gives clear and Safe in all Demonstration
30 Very good clothing and precise verbal aspects of of an accurate
performance identification, instructions procedure. knowledge of key
1
some aspects of and Could aspects of relevant
2
uniform code explanations extend role underpinning theory.
3 omitted. to patient. to promote Considers assessment
4 Professional Checks concord- of most elements of
5 approach understanding. ance. the scenario but not
6 throughout. Gives fully applied.
7 reassurance and
8 explanation to
9 promote
40R concordance.

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SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT, MEDICINES MANAGEMENT 137

1
B: 50–59% Appropriate Gives clear Safe in all Demonstration of
Good clothing and verbal aspects of knowledge of key 2
performance identification, instructions procedure. aspects of relevant 3
some aspects of and Could underpinning 4
uniform code explanations to extend role theory with minor 5
omitted. patient without to promote inaccuracies. 6
Approaches task prompting. concord- 7
in professional ance. 8
manner. 9
C: 41–49% Acceptable Gives Safe in all Demonstration of 10
Acceptable clothing. satisfactory aspects of knowledge of key 1
performance Demonstrates verbal procedure. aspects of relevant
2
awareness of instructions Could underpinning theory
3
professional and extend role with minor
behaviour. explanations to to promote inaccuracies and
4
patient with concord- needing some 5
minimal ance. May prompting through 6
prompting. lack questioning. 7
organiza- 8
tion. 9
D: 40% Acceptable Gives verbal Safe in all Demonstration of 20
Only just clothing, some instructions to aspects of some knowledge 1
satisfactory awareness of patient; needs procedure; of key aspects 2
behaviour in prompting; demon- of relevant 3
reflection. acceptable strates underpinning
4
summary. limited theory with
5
Some awareness awareness minor inaccuracies
6
of communica- of role in and needing
tion in reflection. prompting through 7
reflection. questioning. 8
Resit: Little awareness Unclear Unsafe in Limited and
9
30–39% or insight. instructions and one or more inaccurate knowledge 30
Weak explanations aspect of of key aspects of 1
performance. given to procedure. relevant 2
Failure of one patient. Lacks Little underpinning theory. 3
or more understanding awareness. Unsafe application of 4
essential of the Inaccurate theory to practice. 5
criteria. significance of and 6
effective ineffective
7
communication. application
8
of the
9
skill.
40R
(Continued)

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138 SUCCEED IN OSCEs AND PRACTICAL EXAMS

1
Grade Professional Communication Procedure Knowledge base
2 behaviour skills
3
Fail: 0–29% Unprofessional Unclear and Unsafe in Insufficient and
4
Generally and careless imprecise one or more inaccurate knowledge
5 weak approach. verbal aspects of of key aspects
6 performance. instructions procedure. of relevant
7 Failure of one and explana- Inadequate underpinning theory.
8 or more tions given to insight on Unsafe application of
9 criteria. patient. reflection. theory to practice.
10 Inaccurate
1 and
2 ineffective
application
3
of the skill.
4
5
6
7 OSCE example 3: aseptic non-touch technique
8
9 Explanation
20 The purpose of this OSCE is to assess your knowledge and skill in relation to
1 aseptic non-touch technique (also known as ANTT). This OSCE would be suit-
2 able for a pre-registration nursing student in any year of their study and
3 assesses the following broad aspects:
4
5 • ability to prepare the patient and the appropriate equipment for ANTT;
6 • ability to demonstrate how ANTT is performed.
7
8 The OSCE
9
30
1 Aseptic non-touch technique OSCE station
2
Student information
3
4 IMPORTANT – PLEASE READ CAREFULLY
5
6 Richard May, aged 72, was admitted to your ward for rehabilitation fol-
7 lowing a myocardial infarction. He had a small non-cancerous lesion
8 removed from his arm three days ago and the dressing requires chan-
9 ging. Under the direct supervision of your mentor, you are going to remove
40R the current dressing and clean and redress the wound using ANTT.

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SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT, MEDICINES MANAGEMENT 139

This could be a stand-alone OSCE or a station during an OSCE circuit. From 1
the scenario and the checklist (Table 6.4), you may think at first that you are 2
being assessed on your skills only. However, these are generic principles of 3
wound dressing using ANTT which have been turned into an OSCE checklist. 4
In order to apply these to the scenario you will need a certain level of know- 5
ledge related to preventing cross-infection, aseptic technique and ANTT. 6
Your knowledge related to ANTT and infection control may be assessed fur- 7
ther in an alternative way – for example, an exam paper, short answer questions 8
or an essay. This is a pass/fail OSCE, therefore no mark is awarded. However, if 9
your pass/fail is graded you can tell if you have passed well (good) or only just 10
passed (borderline pass). 1
The examiner will give a global rating on how you perform your skills in 2
relation to: 3
4
• attention to detail; 5
• organization; 6
• articulation when required to give information; 7
• engagement and reception to cues; 8
• professional presentation; 9
• engagement with the patient. 20
1
If you look at the checklist you will see that it is underpinned by evidence- 2
based practice in relation to preventing cross-infection and the principles of 3
ANTT. You therefore need to learn each of the steps of this procedure, ensuring 4
that you understand the underlying principles of ANTT. This is essential for 5
you to be able to adapt the guidelines to the scenario that you have been given. 6
The important principle here is that when ANTT is applied to wound dress- 7
ings the open wound should not come into contact with any item that is not 8
sterile, and any items that have been in contact with the wound must be dis- 9
carded safely or decontaminated. 30
Using the same principles applied to the previous two OSCE examples, try 1
and complete the student information and the checklist and answer the follow- 2
ing questions: 3
4
• What are you being asked to do? 5
• What key information can you gain from the student information that will 6
help you during your OSCE? 7
• What is each criterion asking you to do? 8
• What is the underpinning knowledge? 9
• Do you have the underpinning knowledge? 40R

Downloaded by [ Faculty of Nursing.62. Copyright © McGraw-Hill Global Education Holdings. Chiangmai University 5. LLC. dries hands and 8 wrists effectively without re-contaminating 9 themselves 40R Your response: . how would you grade yourself? 4 5 6 Table 6.86] at [07/18/16]. how and where can you obtain it? 2 • Can you perform the skill correctly? 3 • If so. 140 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 • If not.156.4 OSCE checklist for principles of ANTT 7 Step Criterion Achieved Not achieved 8 9 Preparation Seeks patient’s permission/consent to perform of patient the procedure 10 1 Your response: 2 3 4 Checks patient is comfortable and in good 5 position 6 Your response: 7 8 9 Adjusts patient’s clothing to expose wound 20 area while respecting patient dignity 1 Your response: 2 3 4 Preparation Washes hands using all stages of the National 5 of health Patient Safety Agency (NSPA) hand-cleaning 6 care technique 7 professional Your response: 8 9 30 1 Uses lever-operated taps/infra-red taps 2 correctly 3 Your response: 4 5 6 Using hand towels and working from 7 fingertips towards the wrists. Not to be redistributed or modified in any way without permission.

LLC. Chiangmai University 5. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. MEDICINES MANAGEMENT 141 Disposes of hand towels using foot-operated 1 waste bin 2 3 Puts on plastic apron 4 Your response: 5 6 7 Places yellow clinical waste bag in an 8 accessible position near to the patient 9 Your response: 10 1 2 Preparation Puts on a plastic apron 3 of Your response: 4 equipment 5 6 Cleans dressing trolley/dressing tray 7 Your response: 8 9 20 Assembles all equipment needed for the 1 procedure and checks integrity and expiry 2 dates of all sterile items 3 Your response: 4 5 6 Opens dressing pack using the four corners of 7 the paper and avoiding sterile inner surfaces 8 and content 9 Your response: 30 1 2 Prepares sterile field 3 4 Your response: 5 6 7 Opens sachet of normal saline and opens any 8 additional equipment onto the sterile field 9 Your response: 40R (Continued) .156. Copyright © McGraw-Hill Global Education Holdings.62.86] at [07/18/16]. Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing.

gauze and warmed normal saline solution to clean around edges 9 of wound 30 1 Your response: 2 3 4 Uses a gloved hand and gauze to dry wound edges 5 6 Your response: 7 8 9 Avoids contamination of sterile field and 40R wound site Your response: . 142 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Step Criterion Achieved Not achieved 2 Dressing Puts on a pair of clean vinyl/latex gloves 3 procedure Your response: 4 5 6 Removes old dressing and disposes of this 7 appropriately 8 Your response: 9 10 1 Removes vinyl/latex gloves and disposes of 2 these appropriately 3 Your response: 4 5 6 Decontaminates hands with alcohol hand rub 7 using all stages of the NSPA hand-cleaning 8 technique 9 Your response: 20 1 2 Puts on sterile gloves using appropriate 3 technique in order to maintain asepsis 4 5 Your response: 6 7 8 Uses a gloved hand.86] at [07/18/16]. LLC. Copyright © McGraw-Hill Global Education Holdings. Not to be redistributed or modified in any way without permission.62.156. Downloaded by [ Faculty of Nursing. Chiangmai University 5.

6 ensuring it is secure 7 Your response: 8 9 10 Removes gloves and apron and disposes of 1 them correctly 2 Your response: 3 4 5 Seals disposal bag before leaving patient 6 Your response: 7 8 9 Maintains patient’s privacy and dignity 20 throughout procedure 1 Your response: 2 3 4 Disposes of all clinical waste according to 5 local infection control policy (yellow clinical 6 waste bag) 7 Your response: 8 9 30 Decontaminates hands with alcohol hand rub 1 using all stages of the NSPA hand-cleaning 2 technique 3 Your response: 4 5 6 7 8 Examiner global rating 9 40R Good Pass Borderline pass Borderline fail Fail .156. SAMPLE OSCEs: ADULT BASIC LIFE SUPPORT. Copyright © McGraw-Hill Global Education Holdings.86] at [07/18/16]. LLC. Not to be redistributed or modified in any way without permission. MEDICINES MANAGEMENT 143 Disposes of swabs appropriately 1 2 Your response: 3 4 5 Applies non-adhesive dressing as appropriate. Downloaded by [ Faculty of Nursing. Chiangmai University 5.62.

therefore ensure you ask 3 for clarification from your tutor or examiner. 2 3 4 Ensure you are fully aware of all the possible components of the OSCE 4 assessment that you may be exposed to. 1 7 Identify any areas that seem unclear. LLC. These are the areas that you really 2 need to clarify and understand before the OSCE. Chiangmai University 5. 40R . practice and more practice. 8 9 2 Set yourself a date when you can sit down and work through the documen- 20 tation. You will start to recognize the development of self-assessment through 2 reflection. 4 5 8 The OSCE checklist and marking criteria should be used to help you 6 prepare and succeed in your OSCE. 7 8 6 Examine your OSCE checklists and any marking criteria and make sure 9 you read them thoroughly in order to understand the key components of 30 your OSCE. You could do this on your own or with your peers. It will also detail what good feedback contains and help 10 you to appreciate how this feedback can empower you to improve your prac- 1 tice. Not to be redistributed or modified in any way without permission.156. Copyright © McGraw-Hill Global Education Holdings. 3 4 5 6 Chapter summary 7 1 Fully read any documentation or guidelines given to you before the OSCE.62. 1 3 Ensure you have an understanding of the complexities of your OSCE. 144 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Examiner’s comments 2 3 4 Write in here how you think you did! 5 6 How did you get on? Was it as easy as you expected or do you need to do more 7 preparation to pass this OSCE? 8 Chapter 7 will give you an understanding of what makes a good perform- 9 ance in an OSCE.86] at [07/18/16]. 8 9 10 The key to success is practice. 7 9 Confirm whether the OSCE is pass/fail or has a grade attached to it. 5 5 Ensure you are aware of the minimum standard of competency you will 6 have to demonstrate to pass your OSCE and aim to achieve above this. Downloaded by [ Faculty of Nursing.

To help you to gain insight into your needs and show 8 how you can use feedback most effectively. 8 2 How to develop your skills for reflection. 1 After the OSCE 2 7 has finished 3 4 5 6 7 8 Attitude is a little thing that makes a big difference. Copyright © McGraw-Hill Global Education Holdings.156.62. 9 Sir Winston Churchill (1874–1965) 10 1 2 3 By the end of this chapter you will: 4 Have an understanding of what makes a good performance in an OSCE. They synthesized research literature 1 in the area of self-regulation and formative assessment. The model used is based on princi. 5 Have an understanding of what good feedback contains. and to create a sense of ownership in your own devel. Chiangmai University 5. 20 1 2 3 The importance of feedback cannot be underestimated in helping you to get the 4 most out of your OSCE. Feedback should be a two-way process where you feel that you are 6 working in partnership with your tutor. and are not just a recipient of informa. 7 tion about your progress. 6 Appreciate how this feedback can empower you to improve your practice. 5 opment.86] at [07/18/16]. 30 ples by Nicol and Macfarlane-Dick (2006). Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing. 7 Recognize the development of self-assessment through reflection. and identified seven 2 principles of good feedback practice. These principles have been further adapted 3 below by us to illustrate how you can use feedback to empower yourself and to 4 develop yourself as an independent learner. we have structured this chapter on 9 a model that meets your needs as a learner. 8 Understand the process for the release of results following summative and 9 formative assessments. LLC. 5 This chapter is therefore structured around the following seven key topics: 6 7 1 How to identify a good performance. 40R . 9 3 Understanding the information you are given in feedback.

1 2 3 Rust et al. and 3 • assess your own progress against that goal. Yet it remains important for you to clarify verbally. 2 • take on ownership. that it is a difficult task 4 to make assessment criteria and standards clear in written or even verbal 5 descriptions. 3 6 How to reduce the gap between your actual and ideal performance. Downloaded by [ Faculty of Nursing. it is vital that you are both aiming for the same 3 goal. 8 along with detailed explanations about what is actually being looked for in 9 each part of the OSCE. This approach is recommended by Orsmond et al. Copyright © McGraw-Hill Global Education Holdings. through research. Naturally.156. Norton (1990) has shown 9 that students have different ideas about goals and criteria for essays. in writing and by . We 20 are concentrating on OSCEs in this book.86] at [07/18/16]. 4 7 How you can contribute to evaluation. In this book we have aimed to explain the criteria you may be 6 assessed on as clearly as possible. but it is still important to be 1 aware that your view of what you should be aiming for and your tutor’s 2 view may differ. Not to be redistributed or modified in any way without permission. 5 6 7 How to identify a good performance 8 9 The most effective way to achieve your goal is to: 10 1 • understand what your goal is. however. In addition. but your interpretation may still not be the 7 same as ours! To help with this. Chiangmai University 5. 40R (2002). research has shown that there is sometimes quite a 7 gap between what your tutors are expecting of you and what you think 8 you need to achieve (Hounsell 1997). 146 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 4 How to get the most from dialogue with your tutors. 2 5 Your motivational beliefs and self-esteem. LLC. we have given you examples in many chapters. This will ensure that there are no discrepancies between what you 4 think you are being assessed against and the criteria on which you are actually 5 being assessed. 4 5 It probably seems obvious that it is best that your goals are also those of 6 your tutors.62. (2003) have shown. 6 7 8 9 Sometimes there is a gap between what your tutors are expecting of you and 30 what you think you need to achieve.

analysed. Downloaded by [ Faculty of Nursing. Chiangmai University 5. The main principle 6 when thinking about reflection. 5 tion and have used it to inform and improve your practice.156. expected goals and 9 standards clear include: 10 1 • using well-designed criteria sheets and clear definitions of performance. is to use a model to 7 guide you in the process. in writing and by example from your tutors. identified by Johns (2000). 4 • using peer assessment so that students are used to giving feedback to others 5 and identifying how they may perform themselves. LLC. 6 • giving students the opportunity to develop their own assessment criteria to 7 experience the process of using such a marking tool (Nicol and Macfarlane.62. 4 lenging yourself and engaging instead in self-affirmation. You may already be familiar with the concept of reflec. exactly what is 5 being looked for and assessed in your OSCE. We will talk about this skill later in the chapter. exactly what is being looked for and assessed in 1 your OSCE. Copyright © McGraw-Hill Global Education Holdings. 2 • making time in class for discussion and reflection about criteria and levels 3 of performance expected. To make it meaningful you need to open up 2 your practice to critiquing and examination by others as well as yourself. Along with this you 40R . but you may fall into the trap of not chal. It is 3 very tempting to reflect by yourself. 8 Bulman writes that ‘I see reflection as reviewing experience from practice so 9 that it may be described. This will help you 8 to develop the lifelong skill of accepting constructive criticism without feeling 9 defensive. rather than trying to fit your reflection into a model. 8 Dick 2006). evaluated and consequently used to inform 30 and change future practice’ (Bulman and Schutz 2008: 2). 9 20 1 How to develop your skills for reflection 2 3 One of the aims of feedback is to prompt you to reflect on your performance 4 following your OSCE. This may result in you 6 not learning as much as you could have done from your reflection. 6 7 8 Other strategies that have helped to make the criteria. Try to reflect 7 with your peers so that you can challenge yourself and them. AFTER THE OSCE HAS FINISHED 147 example from your tutors. 2 3 4 Clarify verbally.86] at [07/18/16]. 1 Reflection also takes courage. which is just seeing 5 the OSCE from your angle and not thinking objectively. Not to be redistributed or modified in any way without permission.

by undertaking learning with the OSCE 5 activity. 148 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 need a willingness to act on what you discover and an ability to change your 2 practice.156. We have both found reflection to be a key component of our nursing 3 careers and have used it constantly to inform and improve our work. To make it meaningful you need to open up your 7 practice to critiquing and examination by others as well as yourself. It is a useful 4 tool to use as it enables you to see how. We have used the work of Gibbs et al. 7 If you use this triangle to reflect on an experience in an OSCE. Not to be redistributed or modified in any way without permission. adapted from Jasper (2003). 4 5 OSCE practice 6 7 8 9 Reflection on the 30 Reflection on the new knowledge 1 OSCE and skills gained 2 3 4 5 6 7 Increased knowledge Identification of learning 8 from the OSCE from the OSCE Learning process 9 40R Diagram 7. Downloaded by [ Faculty of Nursing. LLC. 8 9 10 1 Professional development triangle 2 The professional development triangle. Copyright © McGraw-Hill Global Education Holdings. you can see below how it can aid your performance (see Diagram 7.1). 9 There are a range of reflective models you could adopt to help you improve 20 your practice. Chiangmai University 5.86] at [07/18/16]. you can increase your knowledge and improve your practice (see 6 Diagram 7.62. Below you will find 2 an explanation of both models and examples of how they can be used to reflect 3 on a hand-washing OSCE. (1988) and Borton (1970) 1 and have found their style of reflection particularly helpful. such as hand- 8 washing.2). 4 5 6 Reflection also takes courage. illustrates 3 the role that reflection can have in informing professional practice.1 Professional development triangle (adapted from Jasper 2003) .

Downloaded by [ Faculty of Nursing. It helps you to see how you can think about reflection during the 1 OSCE process itself. to undertake your How did it go? What did you 6 hand-washing OSCE do correctly? 7 What do you need to improve on? 8 9 10 1 2 Increased knowledge What evidence can you 3 How has your knowledge use to increase your increased? knowledge of infection 4 What do you know now control procedures? 5 that you did not before? 6 7 Diagram 7.2 OSCE hand-washing development triangle 8 9 20 The Gibbs cycle 1 Gibbs et al. 7 We have also developed an OSCE reflective cycle using adaptations from 8 Gibbs et al. By this we mean using 3 your skills notes and any literature you have been recommended to review your 4 own knowledge base.1 takes you through 5 the stages of the cycle and is adapted from the Bulman and Schutz (2008) inter. One key aspect of this work was 3 to value highly the need to analyse both feelings and events together as part of 4 the reflective process when thinking about practice. (1988) developed a cycle for structured debriefing and it is now used 2 by many people as a basis for their reflection.62. 2 sis of the literature to help you make sense of the OSCE.156. The cycle then encourages you to think about what you 5 have learned that is new and how you can change your practice to improve in 6 the OSCE next time.86] at [07/18/16]. You can then introduce analysis of your feelings and analy. This is shown 9 in Diagram 7. 7 8 9 40R . Chiangmai University 5. Jasper (2003) and Bulman and Schutz (2008). Not to be redistributed or modified in any way without permission. AFTER THE OSCE HAS FINISHED 149 Hand-washing OSCE 1 2 3 4 5 Think again about how Reflect on the formative attempt. Copyright © McGraw-Hill Global Education Holdings. (1988).3 and gives you an illustration of how you can use reflection in 30 your OSCE. Table 7. 6 pretation of it. LLC.

I was 4 starting to think I was better than I had been 5 marked but they were able to really challenge 6 me to think about the OSCE performance and not link the performance to me personally. Looking back on it. Although I had 4 undertaking it? Just practised this OSCE it was very different doing 5 record these during it in exam conditions. 6 this phase and 7 don’t think too 8 deeply about them. This 7 really helped me to think more objectively. how did and asked in my own time to undertake 8 you do it? hand-washing. I was 4 very fazed by how nervous I felt and how the 5 nerves made me forget a lot of the basic 6 information I thought I knew. 8 Having looked at the seminar notes from this 9 skills teaching session I now realize that I need 40R . Copyright © McGraw-Hill Global Education Holdings. so I 1 apparent to you? must learn from this. I was shown into the room 7 did you do. This was 9 outside? Are there helpful and the colleagues who had done well 30 any themes that are were the ones who were very well prepared. I undertook this in a skills lab in our 6 your OSCE. I was also unsure and bad? about whether I had dried my hands correctly. 7 Analysis of What evidence can I chatted to colleagues afterwards and many of 8 the OSCE you bring in from them had the same experiences.1 Stages of the Gibbs cycle (adapted from Bulman and Schutz 2008) 2 Cycle Interpretation of Actual example of Jane undertaking a hand- 3 OSCE performance washing OSCE 4 5 Description Describe what I had to undertake a formative hand-washing of the OSCE happened during OSCE. 9 Evaluation How did the I think I did most parts of the hand-washing 20 of the OSCE experience make OK. I was then asked a few 9 questions by the tutor. 10 Feelings How did you react I was very nervous when I went into the room. Not to be redistributed or modified in any way without permission. at one point I was not 1 you feel and react? sure if I had washed my thumbs correctly and 2 What was good so I went back over these. What health care faculty. I explained to my friends 2 what I had done in the OSCE and asked them 3 also how they thought I had done. Downloaded by [ Faculty of Nursing.62. Chiangmai University 5. 150 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Table 7.156. 1 during the OSCE? It took me a while to get my bearings and I had 2 What feelings did to concentrate hard to understand what the 3 you have while tutor was saying to me. LLC.86] at [07/18/16]. 3 so I made sure I redid this section too.

This 30 revolves around three questions: ‘What?’. 40R . 9 mines what you do in your next OSCE and how you can improve. However. 5 Conclusions What specifics have I know that I react badly to nerves and so this 6 specific for you learned that has taught me to try and get on top of these so 7 this OSCE can help you in that I can be more productive and professional. Next to each question are trigger questions. 6 • The ‘So what?’ question is the opportunity to review the OSCE more deeply 7 and to analyse your feelings and knowledge base. particular? This will also help me when I am out in a 8 practice setting if I get nervous about doing 9 something. such as revision and being well 5 prepared.86] at [07/18/16]. Not to be redistributed or modified in any way without permission. AFTER THE OSCE HAS FINISHED 151 to learn more about the reasons for correct 1 hand-washing. 4 The nerves were a part of my problem and so I 5 think I need to make sure I am confident with 6 my practice so that if I am nervous it will not 7 affect me so much. I need to 2 OSCEs will you do increase my knowledge base infection control 3 differently in and also develop strategies for managing my 4 future? nerves. This will help me to understand 2 why I am doing things in a certain order and 3 then hopefully make them easier to remember. LLC.2) so you can see how easily it can be 2 used. 20 1 Action plan What will you do I know that there were many aspects of the for future the same and what hand-washing I did OK in. 1 Conclusions What have you I think I have now learned the value of being 2 for future learned in general prepared and having a good knowledge base 3 practice from this to understand why I am doing this in a 4 experience? particular way. Copyright © McGraw-Hill Global Education Holdings. ‘So what?’ and ‘Now what?’ We have 1 put this into an example for you (Table 7. although if you only remem. 6 7 8 The Borton framework 9 A different type of technique to try is the Borton framework (1970). Downloaded by [ Faculty of Nursing. 8 • The ‘Now what?’ question builds on the two previous questions and deter.156. 3 ber the three main questions you will be doing very well. Chiangmai University 5. 4 5 • The ‘What?’ question is where you describe what happened in your OSCE. It was really good to have 8 gone through the formative attempt so that I 9 now know what it will be like in the summative 10 attempt and it won’t be so daunting.62.

86] at [07/18/16].156.62. Chiangmai University 5.Downloaded by [ Faculty of Nursing.3 The reflective cycle (adapted from Gibbs et al. Jasper 2003 and Bulman and Schutz 2008) . 1988. Not to be redistributed or modified in any way without permission. Diagram 7. Copyright © McGraw-Hill Global Education Holdings. LLC.

Downloaded by [ Faculty of Nursing.2 Reflection based on Borton’s (1970) framework 1 2 What? So what? Now what? 3 What are you reflecting I am going to reflect on my experience of the 4 on? hand-washing OSCE that I have just completed. 3 So what. However. AFTER THE OSCE HAS FINISHED 153 Table 7. I had 5 previous experiences? no idea. 7 I also had no idea about the risk to patients of not 8 doing this properly. does Before I started my nursing course I had obviously 4 this situation connect with washed my hands throughout my whole life. 10 that way? 1 What was I feeling and I was feeling very nervous because of the examiner 2 what made me feel watching me.86] at [07/18/16]. Chiangmai University 5. 30 So to what extent did I act I went into the OSCE as well prepared as possible as 1 for the best? I felt I knew all the stages of hand-washing and 2 drying. 6 effectively? 7 What were the The consequences relate only to me in this instance 8 consequences of my actions as it was an examination. how important it was to do this properly. LLC.156. before undertaking practical sessions in the 6 skills lab. 5 What particular issues Did I complete all six stages of hand-washing 6 seem significant enough correctly? Did I dry my hands without 7 to demand attention? recontaminating them? 8 What were others feeling I sensed that there were others undertaking their 9 and what made them feel OSCE at the same time who were also very nervous. and how. 9 40R (Continued) .62. Not to be redistributed or modified in any way without permission. Copyright © McGraw-Hill Global Education Holdings. correctly so that I am a safe practitioner. 1 So what factors influenced I was really wanting to make sure I undertook this 2 the way I was feeling. 3 that way? 4 What was I trying to I was trying to achieve safe hand-washing and pass 5 achieve and did I respond the OSCE. others and in an actual practice setting the consequences of 20 myself? poor hand-washing will affect patients adversely. 8 I need to review all of this knowledge base before 9 my next OSCE. 4 So what knowledge I had based my knowledge on the ESC related to 5 informed or might have infection prevention and control and the 6 informed me? supporting literature that I was given as part 7 of my skills practical session related to this area. Not 3 thinking and responding? wanting to fail was making me nervous. I recognize that 9 on the patient.

86] at [07/18/16]. (2001). 5 Now what would the If I fail this hand-washing OSCE and continue to 6 consequences of alternative fail I will not pass the course and will be a danger to 7 actions for the patient. 154 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 What? So what? Now what? 2 Now what might I do to Although I felt fully prepared for this by ensuring 3 respond more effectively that I could perform the skills. Chiangmai University 5. Copyright © McGraw-Hill Global Education Holdings. 3 4 5 Understanding the information you are given in feedback 6 7 You will receive feedback from peers and examiners following completion 8 of your OSCE. Not to be redistributed or modified in any way without permission. I am 10 this experience? anxiously waiting my results and hope that I have 1 shown safe practice. LLC. very close to your 3 OSCE. 8 others and myself be? 9 Now what do I feel about I feel relieved that it is over. 6 7 8 Feedback needs to be timely and occur soon after your OSCE to be most 9 valuable. however.156.62. Your tutors will be well versed in being able to identify any errors 9 you have made. as well as 4 explaining how you have made an error. Jasper (2003) and of course Bulman and Schutz 1 (2008): they all show you exemplars. among other authors. 2 3 4 You can reflect on your OSCE practice on the day of your assessment and 5 then again once feedback is given to you (if you don’t get your feedback imme- 6 diately). it needs to ensure you understand how 5 to rectify this. Your peers will be valuable in this area as well. Have a 20 look at Rolfe et al. It also needs to offer constructive criticism – for example. I had not recognized 4 given this situation again? how my nerves could affect my performance. my patients. as well as taking you through a wider 2 variety of models than we have been able to illustrate here. In this way you can gain control of your reflection by undertaking it 7 when you wish to. 1 Freeman and Lewis (1998). therefore 9 do try different models before opting for the one that suits you best. have identified that for feed- 2 back to be most effective it needs to be timely – for example. and gain from it what you need to. The important learning to 8 take from the examples above is that reflection needs to work for you. Downloaded by [ Faculty of Nursing. 40R . and together 30 they can help you to fully appreciate your strengths and areas for development.

there needs to be a good 4 dialogue between student and tutor. feedback also needs to offer you praise for all the areas you managed 4 well in your OSCE. Downloaded by [ Faculty of Nursing. To be able to do this. 8 9 How to get the most from dialogue with your tutors 20 1 One of the comments made by students when they receive essays back is that 2 the comments written on them do not make sense (Channock 2000.’ He recognizes the importance of feedback being given near to 2 the event while the goals of the assessment are still fresh in the student’s mind. 9 Pose some ‘how’ questions to yourself with your tutor and use these to try 30 and guide your improvement: 1 2 • How do you think you did? 3 • How did you actually do? 4 • How can you improve? 5 • How can you do this? 6 7 A clear dialogue between student and tutor has been identified by Laurillard 8 (2002) as essential if feedback is to be effective. 5 6 7 Ask for feedback regularly to improve your practice most effectively. In addi. as well as 40R . This should help you to progress 2 more effectively and you should feel more in control of your progress. Hyland 3 2000). LLC. AFTER THE OSCE HAS FINISHED 155 As Wiggins (1998: 64) states. 9 Gibbs and Simpson (2004) have found that receiving regular feedback helps 10 students to self-regulate more effectively. ask for feedback often rather than just once.62. either by use of a grading grid or clear goal standards. So if you are undertaking OSCE prac.156. Your relationship with 7 your tutor will be more effective if you view getting feedback on your OSCE as 8 an opportunity to gain support but also to be challenged. 3 Finally. approval 1 or disapproval.86] at [07/18/16]. In this way you can focus on improvement where it is most needed. Chiangmai University 5. 5 One of the key areas you can develop from your feedback is the ability to 6 begin to self-correct and solve your problems proactively. 1 tice. If you feel as though you are only being 5 ‘told’ when getting the feedback from your OSCE. 3 tion. you may wish to prioritize your revision depending on the feedback from 4 your OSCE. So aim to have a discussion as 9 mentioned above with your tutor about your OSCE performance. Copyright © McGraw-Hill Global Education Holdings. Not to be redistributed or modified in any way without permission. you may not play such an 6 active role in understanding the messages being given. 7 your feedback must be given to you in relation to the standards that are expected 8 of you. To make feedback effective and understandable. ‘Feedback is not about praise or blame.

ensure you have a piece of paper 20 and pen handy to write down key points mentioned by the examiner – this 1 will ensure you have a paper copy to refer to at a later date. In this case you will be able to get 9 verbal feedback from your tutor as well as from your peers. 156 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 reading the written feedback. 4 5 Having a good dialogue with your tutor will help you to feel more of a partner 6 in your feedback. 4 you will be really encouraged by your peers to improve even more as you are in the 5 same boat as them! You could try using the ‘How?’ questions mentioned above 6 with your peers and see what perspective they have on your OSCE. be prepared to ask the person 6 who gave you the feedback for further advice. 2 • at the end of the feedback. LLC. to ensure you have understood the examiner correctly. Not to be redistributed or modified in any way without permission.156. ask to summarize your understanding of the 3 feedback given. 4 • if you do not understand your feedback or want further clarification or sup- 5 port in how to implement the suggestions. or support. Copyright © McGraw-Hill Global Education Holdings. Hopefully. 7 8 Listen to your fellow students and gain good feedback and encouragement to 9 improve in your OSCE. Downloaded by [ Faculty of Nursing. Boyle and Nicol (2003) have identified the importance of 1 peer feedback in terms of giving you more self-control over your learning. 7 • feedback is a dialogue. which may be more difficult with your tutors. 4 5 Verbal feedback 6 7 Verbal feedback can also take place in a group setting. 40R . Having a discussion will help you to get an imme- 2 diate response to your queries as well as clearing up any misunderstandings you 3 may have as to what has been written. Often. for example. who can also give a 30 valuable perspective. 9 • if you are receiving your feedback verbally.86] at [07/18/16]. watching 8 a video-recording of an OSCE with your peers. 7 8 9 Think about how your feedback relates to the assessment criteria: 10 1 • you should always have the assessment criteria near when you are review- 2 ing/receiving feedback as this is what the examiner would have assessed 3 you against. so you should not be concerned about contacting 8 the person and asking to meet up for further discussion. Chiangmai University 5.62. 2 discussing practice with fellow students will allow you to admit that you didn’t 3 know something either.

make sure you read them fully. Chiangmai University 5. how would you like to change? 40R . try not to compare the grades that you receive with the ones of your 8 fellow students. Although it is very 7 tempting. 2 awareness. Not to be redistributed or modified in any way without permission. 9 self. It should be constructive.156. So try not to fall into this trap and if you have a grade.62. Try to think of 9 your feedback as a commentary on the task you undertook and not you as a 30 person. in the arena of self-esteem. Downloaded by [ Faculty of Nursing. Copyright © McGraw-Hill Global Education Holdings. 2 ine your own responses to feedback in different situations. Introspection is not sufficient for developing self-awareness: we also 3 need pointers from other people such as peers and tutors. Being able to receive 4 constructive feedback is an important interpersonal skill and a skill for life. Comparing yourself to everyone else can make you less likely to think 10 about your improvement and instead concentrate more on your performance 1 in relation to others. aim to be objective and do not take your feedback too personally. There will always be those who do better or less well than your. Try doing this with 3 a buddy: think of situations where you have both received feedback and then 4 think about how you felt: 5 6 • Did you want to accept it? 7 • Did you feel ‘hard done by?’ 8 • Would you like to have reacted differently to the feedback? 9 • If so. LLC. 1 It is easy to be defensive when you receive feedback and it is useful to exam.86] at [07/18/16]. If 5 you receive negative feedback regarding an aspect of your behaviour or 6 performance during the exam. 7 8 9 20 Responding to feedback 1 To be able to respond to feedback you need to have a certain level of self. as well as written 6 comments for your OSCE. without devaluing you as a person. 2 3 4 5 Try not to compare your marks with others – concentrate instead on making 6 your own performance better. This 8 leads us to another area to work on. It has been found that some 4 students are less likely to read written comments if a grade is also given (Butler 5 1988). it should be focused feedback on your specific 7 performance. AFTER THE OSCE HAS FINISHED 157 Your motivational beliefs and self-esteem 1 2 Your self-esteem and motivation will play a key role in your learning and what 3 you can gain from an assessment such as an OSCE.

Chiangmai University 5. LLC. This means that they think there is a limit to what they 3 can achieve. 158 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 You may wish to reflect on Dweck’s (1999) observation that some students will 2 have an ‘entity view’. 3 4 5 How to reduce the gap between your actual and 6 7 ideal performance 8 9 It is crucial that you feel: 20 • supported while you are undertaking the OSCE. 3 • generic comments made during class feedback following the exam. Downloaded by [ Faculty of Nursing. as opposed to students who have an ‘incremental view’.62. 4 5 6 Support while you are undertaking the OSCE 7 Feedback comes in many formats. Copyright © McGraw-Hill Global Education Holdings. 8 • seminar tutors. If you are the ‘entity view’ person at the moment. So why not try to 7 become an ‘incremental view’ person and think of OSCEs as a challenge? Then 8 put real effort into making improvements. Not to be redistributed or modified in any way without permission. for example: 8 9 • written. 30 • verbal. 1 • supported through repeated practices at the OSCE. These 4 students believe that their ability can be flexible and will improve with effort 5 and practice. 9 10 1 Work on being a person who sees themselves as someone who can always 2 change and improve and does not have a fixed ability level. 9 • fellow students.156. 2 • able to understand how to improve for your next OSCE as well as in clinical 3 practice. 4 5 Feedback can come from: 6 7 • the examiners. 1 • comments made during the exam or while reviewing a recording of 2 the exam. .86] at [07/18/16]. 40R • the simulated patients themselves. you may feel 6 that any failure is just an illustration of your low ability.

3 you 2 can see an example of feedback that could be given following a hand-washing 3 OSCE. Downloaded by [ Faculty of Nursing. 6 It appeared that at one point the water had become too hot for 7 you. 40R . Not to be redistributed or modified in any way without permission. Too hot will burn 9 you and too cold will be ineffective. not just following the exam itself.156. seek further guidance. the following areas would improve your 7 practice: 8 • You need to perform the hand-washing in a timely manner. LLC. 4 Once you have received your feedback.86] at [07/18/16].62. However. Chiangmai University 5. If you do not know the answer to any of them. 7 8 1 Does the feedback identify what I have done well and what I need to 9 improve on? 10 2 Can I see how this feedback will help me to plan future assessments? 1 3 Can I see how I can use this feedback to inform my practice? 2 4 Does this feedback help me to identify where I need to further develop my 3 knowledge/understanding of the process being examined? 4 5 6 Table 7. as it 9 took you four minutes to complete the washing and drying. 6 in order to gain maximum benefit from the feedback. AFTER THE OSCE HAS FINISHED 159 You may receive feedback in more than one format and at several points 1 within the learning process. works from fingertips towards the 2 wrists. you have demonstrated safe hand-washing and drying 6 technique. 30 Although this was safe in practice you will need to speed up. Copyright © McGraw-Hill Global Education Holdings. The 1 literature recommends that safe hand-washing and drying should 2 take a minimum of 45 seconds and a maximum of 90 seconds.3 Example of feedback from a hand-washing OSCE 7 8 Hand-washing √ Completes all stages of the National Patient Safety 9 Agency (NSPA) hand-cleaning technique 20 √ Uses lever-operated taps correctly 1 √ Using hand towels. 3 • Effective hand-drying is an important element. ask yourself the following simple 5 questions. In Table 7. However. dries hands and wrists effectively without 3 re-contaminating themselves 4 √ Disposes of hand towels using foot-operated waste bin 5 Well done. when 4 drying your hands you need to think of resources and not use 5 as many hand towels. Aim to make sure you have the water temperature correct for 8 comfort before you start to wash your hands.

failed to meet the criteria or if the exam was formative or summative – you 40R should still act upon the feedback. as with a summative assessment. and at the same time you can refine the skills that were 9 identified as needing development. It is tempting to only think about the comments or mark if you 8 have not met the set criteria. 4 Your next step is to think about whether you are happy with the mark and 5 the feedback.62. 4 Often the university will put on extra support sessions where you can either 5 go and undertake practice in the simulated learning environment independ- 6 ently. you need to be fully aware of what the consequences 4 of this are. your final attempt). If this is offered.e. However. It is essential that you find this information out prior to the OSCE. . the purpose was to inform both you 5 and your tutors of your current progress). or if you have to retake any component of 10 the course. The important outcome is that you can 7 identify for yourself what you did well and where you need to improve. 1 2 Aim to attend any extra support sessions to gain the maximum amount of 3 practice time for your OSCE. Find out what sort of feedback you can expect. then ask one of your tutors. when 2 you can expect to receive it and who will be providing it. if it is summative. If this information is not 3 explicit within the course/module documentation. Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission. However. you may have to wait until 30 the results have been ratified by an examination board. as well as receiving immediate feedback 20 from the facilitator.e. 8 If your OSCE was summative (i. It is important that you 1 get ready for your feedback. then the result is important but not a 6 final. you need to ensure you seek tutorial advice and respond to 3 the feedback that the examiner has given you. Copyright © McGraw-Hill Global Education Holdings. If the exam was formative (i. the feedback will often be instant or very 9 shortly after the OSCE. it is paramount 7 that you attend. it should not matter if you met the cri- 9 teria. LLC. 160 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 Support through repeated practices at the OSCE 2 3 If you failed your OSCE.86] at [07/18/16].156. Chiangmai University 5. 4 5 6 7 Understanding how to improve for your next OSCE 8 If the OSCE is a formative attempt. or it is facilitated by one of the tutors. During these sessions you can clarify any feedback that you did 8 not fully understand. Are they what you were expecting? Were there any surprises? You 6 then need to put an action plan into place to decide how you plan to respond 7 to the feedback. 1 If you are unfortunate enough to fail the summative OSCE but you are offered 2 another attempt. you need to find out 9 if you will be given another chance.

you would need to be able to landmark the radial 10 artery correctly. In order to assess a patient’s radial pulse safely. The point is that you should be able to see where you have lost a lot of 3 marks or even what caused you to fail to meet the essential criteria. 6 • consider how you are going to deal with each item on your list. Copyright © McGraw-Hill Global Education Holdings. but your voice was very quiet. as well as verbally. not only for OSCEs but also 6 feedback on your practice competencies: 7 8 • Are there any similarities? 9 • Can you see where you have improved? 20 • Can you see where you are not improving? 1 • If so. Chiangmai University 5. if during your 6 OSCE you were asked to carry out an assessment of a patient’s radial pulse and 7 the examiner commented that your landmark for the radial pulse was incorrect. AFTER THE OSCE HAS FINISHED 161 1 Put an action plan into place and highlight comments for future OSCEs. what do you need to do to improve? 2 3 Once you have completed your list: 4 5 • number the items in order of priority to help you plan your time effectively. This may be from your 8 tutor or from your peers. 2 3 4 A good place to start with your action plan is to highlight any comments 5 that you feel would be useful in future OSCEs. Not to be redistributed or modified in any way without permission. You may be asked to give feedback via 8 online questionnaires or as hard copy.62. For example. LLC. However. 8 this would be a major error. 5 Compare your list with previous feedback. and 9 hence meet essential criteria.156. 9 30 You will also find it useful to think how you can improve your technique in 1 your practice setting. 2 3 4 How you can contribute to evaluation 5 6 It is important to remember that your tutors need feedback on the OSCE 7 process and your experience of it.86] at [07/18/16]. in order to: 40R . Downloaded by [ Faculty of Nursing. if one of the comments was that during your assess. this would be a minor 2 error. 1 ment you were very polite. as well 4 as which minor errors could be worked on to improve future performances. 7 • consider how you are going to get further feedback. Tutors always aim to 9 act on feedback given to them.

Copyright © McGraw-Hill Global Education Holdings. 162 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 • improve the session for subsequent students. 2 3 Engage in your feedback. 6 7 6 Aim to reflect with your peers to prevent you self-engaging in self- 8 affirmation. 3 • monitor quality for regulatory bodies. 3 4 4 Highlight any comments that you feel would be useful in future OSCEs. LLC.156. Not to be redistributed or modified in any way without permission. 2 9 If you fail your exam. 10 1 2 Find out in what format(s) you will receive your feedback. even if you passed. 4 5 6 7 Chapter summary 8 1 Find out when you can expect to receive feedback on your performance in 9 the OSCE. 5 5 Reflect on your performance and feedback given. 6 7 8 9 30 1 2 3 4 5 6 7 8 9 40R . ensure you seek support and take up any extra 3 support that is offered. 9 7 Act upon your reflection. reports and visits. 4 5 10 Engage in evaluation of your OSCE process to help improve it for others.62. 2 • review their own performance. Chiangmai University 5.86] at [07/18/16]. 20 1 8 If you do not understand any of the feedback. ask for clarification. Downloaded by [ Faculty of Nursing.

8 • Self-assessment is a useful tool to master as it will enable you to develop the 9 ability to examine and think critically about your practice.86] at [07/18/16]. 4 ronment have increased. 1 2 3 1 Introducing OSCEs 4 5 Summary 6 7 • OSCE means Objective Structured Clinical Examination. Chiangmai University 5. 20 understand how reflection can give you greater understanding of your 1 practice.62. Not to be redistributed or modified in any way without permission. key points and useful subject sum. 9 40R . 7 • Try to undertake a self-assessment of your current knowledge and skills. 8 • This book will help you to: 9 understand your own learning style. 3 • The teaching and assessment of clinical skills in a simulated learning envi. 7 • As with many new techniques. 1 Summary 2 8 3 4 5 6 7 8 In this chapter you will find all the tips. 6 • There is a wide variety of simulated settings.156. Downloaded by [ Faculty of Nursing. the easier the process will become. knowledge and attitude. 5 • There is a wide variety of simulated patients. 2 understand how you can be empowered to improve your practice. 9 maries from throughout the book. 30 1 2 3 Tips and key points 4 5 • OSCEs and practical examinations are a form of assessment which allows 6 you to demonstrate your skills. it is worth taking the time to practise and 8 the more times you evaluate your practice. We hope the chapter will prove a useful 10 revision tool and quick reference guide for you. LLC. Copyright © McGraw-Hill Global Education Holdings.

8 • Ensure you know how many attempts you are able to undertake. 8 • Will help you to be a more competent professional. 8 • Will enable you to demonstrate your knowledge. Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission. skills and attitude in 9 real-life health care situations. 2 • Will enable you to work through scenarios. computer-generated 1 program or classroom.86] at [07/18/16]. Chiangmai University 5. 40R • Identify which areas from your learning style analysis you can develop further. Copyright © McGraw-Hill Global Education Holdings. 7 • Be sure about whether you are taking a formative or summative attempt. 10 • Can be undertaken in a clinical skills laboratory. 164 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Understanding OSCEs 2 3 4 Summary 5 Skills teaching. 9 • Aim to work out your own learning style. 3 • Make use of any additional information the lecturers provide to help you 4 succeed in your exam. learning in and from 9 practice. 1 • Ensure you have the adequate level of knowledge and skills to undertake 2 the OSCE by making use of lecture notes and other resources. ensure that your module or course leader is aware as 6 soon as possible so that any reasonable adjustments can be made. 20 1 2 3 Preparing for your OSCE 3 4 Summary 5 6 • Ensure you take every opportunity possible to undergo supervised 7 simulated practice so that you get used to the environment and equipment 8 that will be used in your exam. 9 • Attend formative OSCEs and act upon the feedback that the examiners 30 give you.156. 7 • Have quality assurance mechanisms built in. simulated learning and OSCEs: 6 7 • Are a rigorous way to identify your strengths and limitations. 3 • Can give you instant feedback.62. 5 • Allow you to practise and be examined in a safe environment. LLC. 6 • Are time-limited. 4 • Are well researched as a validated method of assessment. 5 • If you have a disability. .

2 3 4 5 Tips and key points 6 7 • Ensure you are familiar with any equipment that you will be required to use 8 in your OSCE. Copyright © McGraw-Hill Global Education Holdings. 7 • You may be videoed during the examination for quality assurance and also 8 for feedback for you to learn from. skills and attitude: you will 9 need to demonstrate competency in all of these areas. 5 • Talk to your tutors about how you manage your disability. 6 • There is lots of help available to support you if you have dyslexia or another 7 specific learning disability. 30 • If you feel you have not been treated fairly. SUMMARY 165 1 Tips and key points 2 3 • Knowing your learning style will make your learning more efficient.156. 20 • You should understand the set guidelines and protocols for your OSCE.62. 5 • The examination process is governed by strict quality assurance mechan. 8 • Remember your OSCE is about knowledge. 10 1 2 3 4 What to expect from your OSCE 4 5 Summary 6 • You should have an idea of the room and station layout before you start 7 the OSCE. Not to be redistributed or modified in any way without permission. 9 • Try not to use jargon that the patient may not understand. 8 • You should be aware of and familiar with any equipment or documentation 9 you will be required to use. 6 isms to ensure objectivity. Downloaded by [ Faculty of Nursing. 2 • Your models may be members of the general public. staff. 1 • You need to behave in a professional manner at all times during your OSCE. 4 • Declare your disability as early as possible to gain maximum support and help. LLC.86] at [07/18/16]. manikins or task 3 trainers. 9 40R . you may be able to access a 1 video recording of the event and review how you performed. 4 • All patient models will be working to the same ground rules to ensure parity. Chiangmai University 5.

Not to be redistributed or modified in any way without permission. 30 • Ensure your strategy gives you ample time to revise early and 1 often. will an examiner be 2 there as well? 3 • If you are required to sit a multiple choice or short answer paper as part of 4 your OSCE. and reduce any unnecessary stress. however. LLC. ensure you access and complete some practice papers prior to 5 your OSCE. they have to 7 act professionally during the OSCE and ensure that they treat each student 8 the same.86] at [07/18/16]. 4 • Try revising with fellow students. 166 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 • Ensure you find out prior to the OSCE what type of simulated patient 3 you will have to perform your OSCE on. Will it be a live model or a 4 manikin? 5 • If you are required to perform any aspect of your OSCE using a 6 manikin or task trainer. Downloaded by [ Faculty of Nursing. 9 • Although you are being watched closely. 5 • Recognize excessive stress. being well prepared helps you to 10 overcome any nerves this causes. 6 • The examiner is not trying to be intimidating. Chiangmai University 5. ensure you ascertain which one you will be 7 using and that you are familiar with it and practise performing the skills 8 using it. 8 • Make the most of the time allocated to you. drink and relax to minimize 3 any threat to your brain. Copyright © McGraw-Hill Global Education Holdings. 9 20 1 2 3 4 5 Preparing for your OSCE 5 6 7 Summary 8 • Remember the five Ps: prior preparation prevents poor performance.62. if so. 1 • Find out if your OSCE will be video-recorded and.156. 7 • Plan your route to the OSCE so you arrive in plenty of time. 9 • Plan your revision strategy and use the tools for time management. step back for a few seconds to 40R gather your thoughts. 6 • Read all your instructions well in advance. . 9 • If your mind goes blank during the exam. 2 • Maximize your potential by ensuring you eat.

8 attend any formative or OSCE preparation sessions. 5 get answers to your questions.86] at [07/18/16]. 4 review relevant texts.. LLC. 6 quiz yourself. music. Copyright © McGraw-Hill Global Education Holdings. 20 1 Top tips to help you sleep: 2 • gather together what you will need to take into the exam room (pens. 8 • Get into role and remember you are a health care professional as well as a 9 student. 3 allowed texts. water. 7 • use a relaxation exercise. book. this may help you with your performance. 9 relax. have a 9 notebook by the side of the bed and write them down. 40R . TV. 2 start studying early.62. 7 • The body needs to return to normal following stress to prevent chronic 8 stress and its side-effects. SUMMARY 167 1 Tips and key points 2 3 • Prior preparation prevents poor performance.). 4 • stop revising 90 minutes before preparing for bed. 8 • if your head’s still buzzing with thoughts in the middle of the night. Chiangmai University 5. 3 review lecture notes. 1 understand the assessment. listen to what the examiner 7 in charge tells you to do. student card etc. 5 • relax with friends. If unsure. 30 1 2 3 4 5 On the day 6 • Even though you may be nervous or worried. 6 • have a warm bath or shower. ask for clarification. calculator.156. Downloaded by [ Faculty of Nursing. 7 find a study buddy. but try to be both 5 intrinsically and extrinsically motivated! 6 • Make good use of all the help available to help you prepare well. 4 • Your motivation to learn may be just to pass the OSCE. 9 • Utilize the following 10 simple steps: 10 get organized. Not to be redistributed or modified in any way without permission. etc.

7 • Ensure you carry out a performance and perform every step to the highest 8 quality possible. Use this 10 opportunity to explain what the procedure will involve. 168 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 • Remember to take your time. and 2 this is when we make mistakes. take your time.86] at [07/18/16]. 4 • Make sure you do not communicate with. 5 You can be disqualified if you break the exam rules in any way. This will give you thinking time and also the opportunity to 7 hear the question again. 3 • To demonstrate your knowledge base. 9 • If your mind goes blank during the OSCE. You 1 are better off doing this than going on with the exam and making an error. 6 • If you have a viva or paper exam as part of your OSCE.156. remember the examiner is 5 observing your skills and attitude and will also be assessing your level of 6 knowledge. just spend a few seconds going through what you have 7 done – have you missed anything? You can often rectify the situation if you 8 are within the time. or look at. 4 • If you are being asked questions during the OSCE or as part of a viva and 5 you do not know the answer instantly. Copyright © McGraw-Hill Global Education Holdings. 1 • Read through the paper once and then reread each question. 2 • If you think that something is wrong. You have been allocated a certain 3 amount of time as this is how much the examiners feel you will need. 4 Therefore. 1 • Narrate your way through the exam as this will show the examiner you not 2 only know what to do but you know why you are doing it. use this time wisely. you cannot 9 return. or if something is 3 distracting you. ensure you gain consent prior to starting the scenario. Chiangmai University 5. once you have left the room. and if applicable offer differential diagnosis and 5 normal and abnormal pathology. LLC. if you feel unwell. you can ask the examiner to repeat 6 the question. ensure you relate theory to practice 4 through your narration. Before looking at the actual 8 questions. Downloaded by [ Faculty of Nursing. ensure you 7 read or listen to the instructions carefully. however. You may pick up key words that you did not regis- 8 ter the first time. inform the examiner that you 30 just need to step back and take a few seconds to gather your thoughts. 6 • If you finish early.62. Not to be redistributed or modified in any way without permission. inform your examiner. 40R . You might 2 think a topic you’ve revised hasn’t come up. Often when nerves set in we rush. 9 • If applicable. read the instructions: are there any compulsory questions? 9 Marks are often lost by nervous or over-confident students who overlook 20 instructions. any other candidate. when it is there but the word- 3 ing is unusual.

You could do this on your own or with your peers. 3 • Reflect on your performance and the feedback given. 7 • If you fail your exam. 5 • Set yourself a date when you can sit down and work through the documen. 1 • Engage in your feedback. Chiangmai University 5. ensuring you understand the key com. 10 • Ensure you are aware of the minimum standard of competency you will 1 have to demonstrate to pass your OSCE and aim to achieve above this.86] at [07/18/16]. 2 3 4 7 After the OSCE 5 6 Summary 7 8 • Find out when you can expect to receive feedback on your performance in 9 the OSCE. Not to be redistributed or modified in any way without permission. LLC. 6 • If you do not understand any of the feedback.62. even if you passed. 5 • Identify any areas that seem unclear. therefore ensure you ask 7 for clarification from your tutor or examiner. 2 • Highlight any comments that you feel would be useful in future OSCEs. 9 • Engage in evaluation of your OSCE process to help to improve the experi. 4 • Aim to reflect with your peers to prevent you engaging in self-affirmation. 8 • The OSCE checklist and marking criteria should be used to help you 9 prepare and succeed in your exam. practice and more practice. 40R ence for others. 20 • Confirm whether the OSCE is pass/fail or has a grade attached to it. 30 • Find out in what format(s) you will receive your feedback. 5 • Act upon your reflection. .156. and make sure 3 that you read them thoroughly. 6 tation. 1 • The key to success is practice. Downloaded by [ Faculty of Nursing. 4 ponents of your OSCE. 2 • Examine your OSCE checklists and any marking criteria. These are the areas that you really 6 need to clarify and understand before the OSCE. ask for clarification. Copyright © McGraw-Hill Global Education Holdings. 8 • Ensure you are fully aware of all the possible components of the OSCE 9 assessment to which you may be exposed. ensure you seek support and take up any extra support 8 that is offered. SUMMARY 169 6 Sample OSCEs 1 2 3 Summary 4 • Fully read any documentation or guidelines given to you before the OSCE. 7 • Ensure you have an understanding of the complexities of your OSCE.

2 • Ask for feedback regularly to improve your practice most effectively. Copyright © McGraw-Hill Global Education Holdings. 170 SUCCEED IN OSCEs AND PRACTICAL EXAMS 1 2 Tips and key points 3 4 • There is sometimes quite a gap between what your tutors are expecting of 5 you and what you think you need to achieve. To make it meaningful you need to open up your 9 practice to critiquing and examination by others as well as yourself. 6 • Clarify verbally. exactly what is 7 being looked for and assessed in your OSCE. Not to be redistributed or modified in any way without permission. 10 • Feedback needs to be timely and occur soon after your OSCE to be most 1 valuable. and by example from your tutors. in writing.62. 4 5 6 Good luck from the authors for all of your future OSCEs! 7 8 9 30 1 2 3 4 5 6 7 8 9 40R . LLC. 3 • Put an action plan into place and highlight comments for future OSCEs. 8 • Reflection takes courage. 1 • Aim to attend any extra support sessions to gain the maximum amount of 2 practice time for your OSCE. 5 • Listen to your fellow students and gain good feedback and encouragement 6 to improve in your OSCE. 3 • Having a good dialogue with your tutor will help you to feel more of a 4 partner in your feedback. 7 • Don’t compare your marks with others – concentrate instead on making 8 your own performance better.156. Downloaded by [ Faculty of Nursing. Chiangmai University 5. 9 • Work on being a person who sees themselves as someone who can always 20 change and improve and does not have a fixed ability level.86] at [07/18/16].

Oxford: 8 Blackwell..86] at [07/18/16]. 9 Bramble. Nurse Education 4 Today.J. 4 Boyle. 1 Brookes.. (1994) Nurse practitioners’ education: enhancing performance 30 through the use of the OSCE. (2003) Nursing students’ and lecturers’ perspectives of objective 3 structured clinical examination incorporating simulation.156. J. 10(6): 184–7. Association for 6 Learning Technology Journal. 1 Borton. (2004) A dynamic theory of organizational knowledge creation. 5 Baume. and Merriman. 3 Journal of Neonatal Nursing. A. 6 Organization Science. (1956) Taxonomy of Educational Objectives. Touch and Teach. 9 Bloom. Copyright © McGraw-Hill Global Education Holdings. (1970) Reach. 22(2): 59–65. 7 Bulman. G. and Brew. Downloaded by [ Faculty of Nursing. (2008) Reflective Practice in Nursing.S. LLC. 23: 419–26. A. (1984) From Novice to Expert: Excellence and Power in Clinical Nursing 8 Practice. C.T. 11: 248–55. and Schutz. G. 2 Boud. C. M. New York: David McKay. CA: Addison-Wesley. S. Journal of Nursing Education. 9 40R . Not to be redistributed or modified in any way without permission. 11(3): 43–57. 5: 14–37. Chiangmai University 5. and Nicol. Research and Development in Higher Education. D. 17(10): 1263–9. 4th edn. McMillan. D. (2008) Nursing competence 10 years on: fit for 8 practice or purpose yet? Journal of Clinical Nursing. Handbook I: The Cognitive 20 Domain. 1 2 3 4 5 6 References 7 8 9 10 1 2 Alinier. D. 18: 130–5. (1995) Developing a typology for learner self assessment 3 practices. (1991) Assessing compre. T. and Hazelton. (2003) Using classroom communication systems to 5 support interaction and discussion in large class settings. J. P. Menlo Park. part 2.62. report of the evaluation 6 project. (2004) Assessment of student advanced neonatal nurse practitioners 2 in resuscitation and stabilization of the newborn: the use of the OSCE. M. L. 7 Benner. 4 Bujack. Nurse Education Today. B. K. 5 hensive nursing performance: the OSCE. London: McGraw-Hill. 7 Bradshaw. Dwyer.

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(2005) Assessment of low fidel. (chair) (1999) Dyslexia in Higher Education: Policy. Nurse 9 Education Today. A. M. F. Nicol. R.. 3 and Linton.. S. B. About. (1998) Comparing the 4 psychometric properties of checklists and global rating scales for assessing 5 performance on an OSCE format examination. 1 Waugh. Chiangmai University 5. H.H. A. 3 Regehr. (2002) Assessing 1 competence to practise: a review of the literature. 14: 177–85. J.. 20 Shanley. G. 40R . Yee. (1988) Using the OSCE to measure clinical skills performance 4 in nursing. and Dauphinee.. Carroll. (1994) Teaching and learning clinical 7 skills. D. 9 updated February 2008. C.. 2 Singleton. Freshwater. Not to be redistributed or modified in any way without permission. 5 Wiggins. Calman.. Kelly. 2: 224–9. 28(2): 147–64. D. G. 3 While.. E. (2001) Misplaced confidence in a profession’s ability to safeguard 1 the public? Nurse Education Today. G. 10th edn.. A. 7 Reznick. 73: 97–9. Watson. and Szalay. Hull: University of Hull on behalf of the Higher Education 5 Funding Councils of England and Scotland.. Norman. Academic Medicine. 5 Rust. E. and Fox-Hilary. Nurse Education in Practice. 7 Assessment and Evaluation in Higher Education. D. (1994) Competence versus performance: which is more important?. Report of the National Working Party on Dyslexia in Higher 4 Education. and Pitzner. Journal of Advanced Nursing. 6 Studdy. R. Blackmore..156. I. LLC. Research Papers in Education. S. J. MacRae. G. A. G. M. J. 21: 136–42. 2 Ross. Reznick. (1998) Educative Assessment: Designing Assessments to Inform and 6 Improve Student Performance. Shepherd. REFERENCES 175 Redfern. Forthergill-Bourbonnais. Nurse Education 8 Today. C. 13: 45–56. J. M. 7 Wilson. 10 Rolfe. Price.. Basingstoke: Palgrave Macmillan. Copyright © McGraw-Hill Global Education Holdings.. Part 1: development of a multidisciplinary skills centre.com Guide. L.. D. Chamberlain. Knight. Academic Medicine. 8 ity human patient simulator for the acquisition of nursing skills. 9 Walters. 25: 56–67.. G. 4 Journal of Advanced Nursing. and O’Donovan. and Adams. (2001) Critical Reflection for Nursing and 1 the Helping Professions. and Grant. Philadelphia. (2008) Cortisol and stress: how to stay healthy. (2002) A child health nursing objective structured 30 clinical examination (OSCE). 6 (73): 993–7.62. M.. Regehr.. 2 17(1): 51–77. (2003) Improving students’ learning by 6 developing their understanding of assessment criteria and processes. Downloaded by [ Faculty of Nursing. R. San Francisco: Jossey-Bass. C. and Murrell. Provision and 3 Practice. M. 8 (1998) Process rating forms versus task-specific checklists in an OSCE for 9 medical insurance. J.. and Jasper.. 20: 525–31. A. I. PA: Elsevier. 8 Scott.86] at [07/18/16]. (2006) Ross and Wilson: Anatomy and Physiology in 2 Health and Illness. A. M. Rothman.

Not to be redistributed or modified in any way without permission. LLC.62.156. Chiangmai University 5. Copyright © McGraw-Hill Global Education Holdings. .Downloaded by [ Faculty of Nursing.86] at [07/18/16].

student 1 strategies for reducing on day.. 32. 30 anxiety. Chiangmai University 5. Downloaded by [ Faculty of Nursing. 7 see also information. student 8–19 8 see also specific eg books. 7 Adams. LLC.62. 31 40R . OSCE 87–90. 89. Benner. P. A. B. Ben (case study) 6 138–43. assurance. assessment form.86] at [07/18/16]. 88. 41 106–7 8 adults see also specific eg Objective 9 case study of basic life Structured Clinical 20 support OSCE for. 90 attitudes. Copyright © McGraw-Hill Global Education Holdings. OSCE assessment.. 1 117–27. 33. self 5 availability of for preparation. 140–43 examiners role in undertaking 7 Ashanti (case study) OSCEs. 35 9 106 Bloom.. reflection. 35. 34. 2 strategies for reducing prior to. 1 2 3 4 5 6 Index 7 8 9 10 1 2 Locators shown in italics refer to diagrams. 88 8 managing OSCE revision time. 119–20. importance and documentation 6 48 for OSCE preparation. 110 4 aseptic non-touch techniques (ANTT) B 5 case study of application of. 8–19 3 109–10. 138. computers. 21–2 communication 4 aids and resources. 117–18. 76 for OSCE success. DVDs role of examiners in ensuring. 110–13 as element of OSCE self. 7–19. Not to be redistributed or modified in any way without permission. figures and tables. critical 2 122–4 see also subjects assessed eg 3 affective learning. 38–9 5 use as simulated learning importance of understanding 6 models.156. quality 9 checklists. 3 A assessment 4 actors characteristics of types. Examinations.

Chiangmai University 5. assessment of as element of 20 138–43. J. environment. 114 8 122–4 communication 9 aseptic non-touch techniques. 8 characteristics of OSCE. 37 measurements. 101–2. 23 6 127–8. G. LLC. 140–43 OSCE. 89 consent 3 staff member experience as OSCE nature and requirement in 4 ‘patient’. 138. 75–6 7 117–27. 151. OSCE. 67 7 buddies (study buddies) patient physiological 8 importance of for OSCE success. 91–3. 74. 122–4 3 examinations.86] at [07/18/16].. 145 Bulman. 77. 152 clusters. 31–5. 149. 75–6 testing of using simulated 5 medicines management. 24–7. 101–2. 2 use as aid to passing 121–4. Downloaded by [ Faculty of Nursing. Not to be redistributed or modified in any way without permission. 116–17 for medicines management 4 Borton.. Colton. 77 simulated learning. 117–18. OSCE 7 checklists methods of identifying required. 119–20. 150–51. 58–66 9 108. 156 patient observation 6 Brookes.. W. 115 146–7 9 for aseptic non-touch technique see also specific eg reflection.. 92–3 1 effective diet management. cognitive learning. C. 88 part of OSCE. 127–38. Copyright © McGraw-Hill Global Education Holdings. 81 1 99–100 conscious competence model recipient of OSCE video (skill acquisition). 140–43 critical . 45–6 3 managing OSCE revision time. 101–2 colleagues 5 case studies use as simulated learning models. use for OSCE training. 178 INDEX 1 books for basic life support OSCE. 3 experience as OSCE ‘patient’.. 92–3 4 75–6. 131–8 computer-assisted learning 7 OSCE revision time use and characteristics as type of 8 management.156.62. 6 adult basic life support OSCE. 129–31. 5 use of study buddy experience. 35 2 feedback. 75–6. 131–5 5 Boyle. essential skills (ESCs). C. 24–7 6 108 criteria. 153–4 OSCE. T. 108 Churchill. 21 4 101–2. 2–3 10 Code of Practice for the Assurance 1 C of Academic Quality and 2 Carl (case study) Standards (1999). 40R OSCE. measurements. 83 9 106 computers 30 personal stress management.. 103 method of assessment of as 2 examiners role in OSCEs.

129–31. 103 equipment. 70. tutor–student environments. 116–17 7 David (case study) Dweck. 2 debriefing 46 3 Gibbs reflective cycle of. 8 learning and teaching support role in ensuring successful 9 for students with. on ethos of. Downloaded by [ Faculty of Nursing. Copyright © McGraw-Hill Global Education Holdings. 88 learning and teaching support 10 ‘day dreamer’. oral 6 OSCE preparatory information. medicinal 1 Daniel (case study) case study of management of. 87–90. 45–6 1 characteristic as learner style. 151.156. 27–8 2 102–3. the for students with. 158 8 examiners role in undertaking dyslexia 9 OSCEs. OSCE 1 with.62. consent assurance. 89.86] at [07/18/16]. 157–8 30 OSCE information for students evaluation. LLC. 161–2 2 discrimination. 2–3 7 disabilities esteem. 47 role of student. 101–2 7 dialogue. 86 7 48–58. 3 ‘patient’. INDEX 179 D drugs. 4 150–51. 103 influence of experiential learning 1 impact of on OSCE preparation. 71 4 digital video discs see also types eg models. 8–19 examiners 8 see also specific eg checklists. 77 131–8 4 Darren (case study) DVDs 5 examiners role in undertaking use as aid to passing 6 OSCEs. 2 experience as staff member OSCE 127–38. 44–6 feedback. Chiangmai University 5. 149–51. Not to be redistributed or modified in any way without permission. 9 diet 21–3 20 case study of effective. role in ensuring quality 9 forms. 70–72. 153–4 impact on OSCE preparation. 127–8. 49–58 OSCE self-assessment. 43 Dyslexia in Higher Education (1999). 46–8. 116–17 Essential Skills Clusters (ESCs). 152 E environments 5 Borton’s framework of. 90 40R . characteristics as type of OSCE. OSCE examinations see Objective 3 procedures required to address Structured Clinical 4 93 Examinations 5 documentation examinations. 77. 6 see also feedback 101–2. 86. 88 examinations. student self. simulated 5 use as aid to passing Essence of Care (2007). simulated learning 8 strategies for beneficial. OSCE 3 see also elements eg hydration nature and use of. 88. 155–6 characteristics and advantages. 150 6 examinations. C..

103 1 Harden. R. student. F. 20 understanding of information 47 1 given. 27–8 OSCE 6 explanations. 81 2 forms.86] at [07/18/16]. 7 importance of obtaining for critical 8 OSCE success. 46–8. E. 7 158–61. 88 . 5 experiential learning.. 129–31 7 self-esteem. 36 OSCEs. OSCE see success hydration 4 and failure.. 154 recipient of OSCE video 7 feedback. the H characteristic as learner style.62. information. 31 3 failure and success. 180 INDEX 1 exercise goals. 9 reflection. Not to be redistributed or modified in any way without permission. OSCE. W. 89 8 G Jill (case study) 9 Gibbs.. Hannah (case study) 10 44 managing diet effectively. 2 use of videos in presenting. 36 2 F Howell. OSCE 2 importance in OSCE methods of identifying required. 154–5 for adult basic life support OSCE.. M. 107–8 8 see also process of gaining eg sample OSCE information sheet. 155 examiners role in undertaking 40R Gleeson. 95 Jerome (case study) 6 Freeman.. 103 6 salience in gaining OSCE success. 3 preparedness.. 150–51 152. 148–9. 24–6 Jasper. 24–7. 49–58 30 Fleishman. OSCE importance in OSCE preparation. 5 feedback 102–3. student 9 155–6 as aid for disabled students. 149. student OSCE course content. 104–5 146–7 4 see also relaxation see also success and failure. 159 I 8 strategies for gaining value from. 118. 107–8 9 ‘explorer’. LLC. Copyright © McGraw-Hill Global Education Holdings.. Downloaded by [ Faculty of Nursing. 149. 128. 148. 90 for aseptic non-touch technique 4 see also debriefing OSCE. 89. Chiangmai University 5. 138 5 see also drivers ensuring successful for medicines management 6 eg motivation. R. B. 119–20 3 89–90.. 152 5 Franklin. G. critical 48–58. course content see also specific eg reflection. 38–9 feedback forms see documentation internet use for OSCE training. consent 3 requirement in simulated J 4 learning. 31 see also specific eg checklists. 1 formative OSCE assessment.156.

29 feedback. 9 using a ‘study buddy.’ 108 8 use as simulated learning models. R. LLC. Chiangmai University 5.156. 75–6. 77 6 simulation student peers as. 79. 116–17 motivation. 35 2 assessment form.. 80. 43 127–38. Laurillard. examination room. 5 experiential learning. 72–81. 79. 115–16 2 99–100 example of scheme of. 155–6 149 5 layout. 78. the case study of management of. INDEX 181 Jim (case study) marks. 75–6. 8–19 reflective cycle of debriefing. National Review of Nurse Education 9 77–81.. 1 as element of OSCE self. 76 7 characteristics of types and manikins as. 135–8 3 Johns. Not to be redistributed or modified in any way without permission. 3 see also specific types eg 77.86] at [07/18/16]. 21–2. student 1 importance in OSCE preparation. 7. 81 Australia (2002). D. 73–4. 154 Mollie (case study) 8 literature experience as volunteer OSCE 9 use as aid to passing ‘patient’. teaching and members of the public as. 2 M 96–7 3 Macfarlane-Dick. 80. nature. 80. N 107 Naomi (case study) 7 manikins using a ‘study buddy. 129–31. 147 medicines 4 ‘jumper’. student professional skills acquisition. 69–70 models. 79. strengths and 2 OSCE weaknesses. 148–9. OSCE 1 managing personal stress.. 43–4 81 9 see also support. 77–81. 145 role in ensuring successful 4 Making a Difference (1999). Copyright © McGraw-Hill Global Education Holdings. 78. 8 styles. 5 characteristic as learner style. 153–4 10 knowledge. criteria for schemes of. 148. 127–8. 74 30 examinations. D.. 75–6 7 Lewis. 150–51. Downloaded by [ Faculty of Nursing. 152 4 L triangle of reflection. professional health staff hands. 36 40R . 41–4.62. time 6 importance of for OSCE success. 81 4 computer-assisted learning. 3 149–51.’ 108 151. 20 learning 74 1 see also outcomes eg assessment. 157–8 5 management. 6 131–8 7 K models 8 Kayla (case study) Borton’s framework of debriefing. 77. C. 78. 30–5. 74. simulated learning 6 learners and learning actors as.

85. Copyright © McGraw-Hill Global Education Holdings. 74–7. characteristics and performance. OSCE Powell. OSCE. 107–8 75–6. 30 49–58. 46–58. 101–2. skills. 2 recording of process of. 117–43. 82. 159 7 assessment. LLC.. checklist of measurements for. 86 strategies to acquire ideal OSCE.. 156 professional and 7 Norton. nursing use and characteristics as type of 1 Nursing and Midwifery Council OSCE. Chiangmai University 5. 88. 158–61. 145. see also methods and purpose 5 109–10.86] at [07/18/16]. L. use as simulated learning models. patient 3 learning. 36–7 strategies for enhancing on day. student 9 information for. 89. 84. 140–43 77 8 course and preparatory peers. 9 OSCE. 110–13 3 89. 4 89. 6 Nicol. 89–90. nursing quality of. 90 observation 10 see also students. 21 . 109–10. short answer 3 case studies. patient 8 OSCE content. characteristics as type of OSCE. 77. 105–6. 29–30 checklist of measurements 4 nutrition for. 129–31. Downloaded by [ Faculty of Nursing. 103 106 8 see also elements eg hydration OSCEs see Objective Structured 9 Clinical Examinations 20 O 1 Objective Structured Clinical P 2 Examinations (OSCEs) papers. 4. 182 INDEX 1 nervousness. 82–3 2 role in encouraging simulated observations. 6 see also aids and resources. physiology. D. OSCE 6 119–20. case study of experience as.156. OSCE. 108. 101–2. 146 communication 8 nurses and nursing see also players eg examiners.. 75–6. 88. OSCE see also elements examined 2 strategies for reducing on day. 75–6 1 definition. preparation. 99–100. 90 strategies for enhancing prior to. personal 6 impact of on OSCE preparation. 47. 67 5 case study of effective. 9 role of examiners in ensuring students. 117–18. 37–8. 110 eg simulation. 86–7 5 106. 103 organisation. explanations. C. 3 110–13 professionalism 4 strategies for reducing prior to. 110 5 81–7. 58–66 40R success and failure. 30. eg communication.62. performance. 7. 7 102–3. 4 types and purpose of use. Not to be redistributed or modified in any way without permission. 7 131–8. 127–8. patients. 77. salience in OSCE success. OSCE advantages. 87–90.

characteristic as learner style. time. 7 preparation. multiple choice 1 professional development characteristics as type of OSCE. 148–9. 21 effective time management of. OSCE 152. 86–7 3 149 characteristics and use in basic 4 salience as element of feedback. 74 case study of effective. see also aids and resources. S. INDEX 183 practice. document 9 OSCE. 150–51. 109 43 3 importance of exercise and reading. nursing practice aseptic non-touch technique role of examiners in ensuring. R 10 101–2 ‘rationalist’. Redfern. reflective questions. examination 9 learning style. Copyright © McGraw-Hill Global Education Holdings. 148. 150–51. 149 9 organisation. Downloaded by [ Faculty of Nursing. the 107 1 use as simulated learning models. 91–3. 4 101–2 5 Q Richard (case study) 6 quality..62. 104–5 salience and resources available. 2 triangle of. 42–4. 138. 148. OSCE. 148. 90 140–43 8 questionnaires rooms.156. triangle of. 43–4 nature of layout of. OSCE 107 8 impact of personal 9 environment on. 138–43. quizzes 6 152. 101–2. LLC. 2 95–7. OSCE 2 73–4. personal. 149. 4 see also targets to address eg 109 5 exercise. see also exercise 6 nutrition. 125–7 5 147–54. OSCE importance of for OSCE success. documentation. 69–70 40R . 48. salience as element of feedback. 1 revision. 20 reading. 88.86] at [07/18/16]. 147–54. preparatory 4 relaxation. 37 6 information. 153–4 2 see also outcomes eg success and relaxation 3 failure. the 1 importance and purpose. 148–9. critical 7 see also influences eg professional development 8 management. 7 87–90. stress resources and aids. 30 public. 153–4 importance of for OSCE success. revision. Not to be redistributed or modified in any way without permission. Chiangmai University 5. 89. preparatory. life support OSCE. 149. 148. student reflection. 92–3 importance of for OSCE success. hydration. 106 3 psychomotor learning. OSCE see aids and 7 professionalism resources. OSCE 8 assessment of as element of reviews and reviewing. 48 5 OSCE.

M.. 9 medicines management OSCE. 97–101. stages of clinical competence model 4 106 (skill acquisition). 3 Special Educational Needs and 107 4 Disability Act (2001). 149. Copyright © McGraw-Hill Global Education Holdings.86] at [07/18/16]. 157–8 for. Chiangmai University 5. simulated see also qualities required 5 learning. 146–7 2 35 importance of time management. C. professional health 108 9 use as simulated learning models. 6 examiners role in undertaking 105–6. . disabled 6 self-esteem. 7–19. 47 9 simulation students. S. critical 127–38. student role in ensuring learning and teaching support 7 successful feedback. 24–7.156. C. 46 ‘study buddies’ 8 skills. 101 5 8–19 students. 44–6 8 Simpson. OSCE 1 part of OSCE. student.. personal nursing 3 salience in OSCE success. effects and 3 importance and documentation management of. 155 OSCE information for.. models of acquisition of. 44 procedure in OSCEs. 129–31. 3 use in nursing courses. 23–4 case study of experience as OSCE 1 consent form for. 75–6 2 role in nurse training. 146 standards. 9 communication 108. 24–7 ‘patient’. 6 learning motivation. 30–35. 128 1 Schutz. student 7 Singleton. Not to be redistributed or modified in any way without permission. 150–51. 92–3 goal identification as element of. student. LLC. 32 5 Rust. Downloaded by [ Faculty of Nursing. C. 8 staff. 88 salience of study buddies in.. simulated eg attitudes. tutor-student.62. student 4 see also environments. 152 stress 2 self-assessment manifestation. 75–6. nursing 20 characteristics. see also tools in ensuring success 40R 77. models. 99–100. 106 7 OSCEs. 91–3. 105–6. 127–8. 4 for OSCE preparation. 3 peers. 108. 28–30 see also dialogue. professional and importance of for OSCE success. OSCE 6 methods of identifying required.. 108 30 method of assessment of as success and failure. 115. 46–8. 184 INDEX 1 Ross. 36 see also specific eg nurses and 2 routine. Standards for Medicines Management 10 131–8 (2008). 7 S 146–7 8 Sasha (case study) see also specific eg reflection. 77 eg information. 125 5 Stacey (case study) salience of personal organisation.

Twain. A. M.. management of 86. G. teaching and learning unfairness. 75–6. 39 beneficial student 3 support. 9 44–6 93 10 OSCE information for disabled 1 students. Wiggins.. 138. Copyright © McGraw-Hill Global Education Holdings. information vivas 9 use for OSCE training. 84. procedures required to address. OSCE 8 for students with disabilities.86] at [07/18/16]. reviews and tutors 1 reviewing. 119–20. 148–9. Chiangmai University 5. 117–18. document strategies for securing 2 summative OSCE assessment. 81 30 (Jasper). student characteristics and use as type of 4 OSCE. 89–90. 47 V 2 see also elements of eg videos 3 information. Not to be redistributed or modified in any way without permission. LLC. 83–5. 85 T role in recording process of 5 techniques. volunteers 2 101–2 case studies of experience as 3 importance of for OSCE success.156. 90 6 case study of application of. 116–17 8 technology. 149 1 2 3 4 5 6 7 8 9 40R . 155 8 75–6 worldwide web 9 triangle. 6 122–4 U 7 support.’ 74 4 107 5 Tom (case study) W 6 experience as student While. 20 time. 155–6 4 case study of adult basic. INDEX 185 quizzes. 86 1 importance in OSCE revision. 89. 140–43 examinations.62. use as aid to passing 7 138–43. aseptic OSCE. 148. 46–8. Downloaded by [ Faculty of Nursing. 81 characteristics as type of OSCE. 1 5 117–27. OSCE ‘patient. professional development use for OSCE training.. life feedback. 37 7 OSCE ‘patient’.

Not to be redistributed or modified in any way without permission. HATFIELD. UK NEED HELP TO PREPARE AND SUCCEED IN YOUR OSCE OR PRACTICAL EXAM? OSCEs or practical exams are intended to challenge you both personally and professionally. Clair Merriman is the Head of Professional Practice Skills in the School of Health and Social Care at Oxford Brookes University. This book is designed to be the ultimate companion to help you fly through OSCEs with ease. UK. Copyright © McGraw-Hill Global Education Holdings.156. LLC. Downloaded by [ Faculty of Nursing. degrees and short CPD courses. Chiangmai University 5. it is an essential guide for students.com www.co. This book provides a fresh view on OSCEs and will be of OSCEs and great assistance to tutors about to embark on their use as an assessment strategy in nursing education. SCHOOL OF POSTGRADUATE MEDICINE.hybertdesign. SFHEA.86] at [07/18/16]. PRACTICAL EXAMS UNIVERSITY OF HERTFORDSHIRE. SUCCEED in OSCEs and SUCCEED in SUCCEED in OSCEs and PRACTICAL EXAMS PRACTICAL EXAMS An Essential Guide for Nurses “This is a good companion to students who may be overwhelmed by the idea of having to take part in an OSCE.” GUILLAUME ALINIER.uk CLAIR MERRIMAN & LIZ WESTCOTT .62. but more importantly. NTF. inspiring quotes and plenty of top tips to help you tackle your OSCEs with confidence! Succeed in OSCEs and Practical Exams is indispensable reading for nursing students taking all courses that involve OSCEs or practical exams – including diplomas.openup. whilst testing your competence with the key clinical skills that nurses need to demonstrate to be effective in practice. UK. Cover design Hybert Design • www. It covers: An Essential Guide for Nurses • What OSCEs involve and how to prepare for them • The most common types of OSCE scenarios • What examiners are looking for • How to develop your own clinical simulation learning style • How to learn from your OSCEs • How reflection can help give you greater understanding of your clinical simulation practice MERRIMAN & WESTCOTT The book includes examples of OSCEs for you to work through. Liz Westcott is Director of Pre Qualifying Learning and Development in the School of Health and Social Care at Oxford Brookes University.