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An introduction to Clinical Assessments (OSCEs)

The School of Medicine uses Objective Structured Clinical Examinations (OSCEs) to assess the clinical performance of Student Doctors across Years 3-5 of the MBChB Programme.

Our OSCE assessments use a sequential testing format. This a modern approach to assessment that is fairer to all students and allows an accurate determination of pass/fail standards in complex clinical assessments.

Each OSCE station has been designed at an appropriate level based on the learning outcomes for their year (and previous years) and the standard expected from a prepared and practised candidate.

Whether you are new to OSCEs or wish to refresh your knowledge as an experience examiner, the information within the Examiner Portal will guide you through the process.

If you have any questions that are not answered within these pages, please get in touch: osce@liverpool.ac.uk.

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What is expected from an examiner?

It is the role of every examiner to objectively assess the competence of student doctors in a safe environment, where their performance and actions can be critically evaluated and analysed.

The skills required to be an examiner are not limited to the formal process of examining, they include a knowledge of patient care, communication and professionalism.

This role of the examiner is critical to ensure the graduating student doctors are of a standard appropriate to care for patients at FY1 level.

As you play a vital role in the student assessment process you should:

  • Complete training for your role as an examiner
  • Be aware of the examination process
  • Contribute to the overall good conduct of the examination
  • Be attentive to candidates as soon as they enter the station
  • Carefully observe the candidate’s performance
  • Score according to the marking schedule provided
  • Only prompt the student if indicated on their marking schedule / instructions
  • Maintain a passive demeanour
  • Prevent students encroaching on other students’ ‘time’
  • Refrain from commenting about a candidate’s performance to the simulated patient
  • Uphold the confidentiality of the OSCE station content and individual student performance.

Types of station

OSCE stations are written and reviewed by clinical staff from within the School of Medicine and our NHS partners and include current clinical best practice.

Selecting stations from a blueprinting matrix ensures an assessment which tests a broad spectrum of the curriculum’s content in a variety of ways.

The process is not only applied to a single academic year, but also longitudinally across the years.

There are three main types of station

Consultation

  • Consultation stations are designed to assess the candidate’s history taking, communication skills, professionalism and ability to adopt a patient centric approach to history taking.
  • An actor will play a simulated patient in consultations stations. They will have received a copy of the ‘script’ and training regarding the standardised manner in which the patient is to be portrayed.
  • As an examiner in a communication station, you will generally take on a passive role and not interact with the candidate, unless there is a specific requirement to do so.
  • If interaction is required then this will be detailed within the examiner marking criteria.

Examination

  • Examination stations are designed to also assess the candidate’s communication skills, professionalism and ability to adopt a patient centric approach to the examination.
  • The examination may be performed on a simulated patient portrayed by an actor (standardised), lay person or a manikin will be used.
  • As an examiner in this type of station, you will generally adopt a passive role and not interact with the candidate, unless there is a specific requirement to do so.
  • If interaction is required then this will be detailed within the examiner marking criteria..

Procedural skill

  • These stations are designed to assess the candidate’s procedural skills, communication skills, professionalism and ability to adopt a patient centric approach.
  • An actor, lay person or manikin may simulate a patient in procedure stations. If appropriate they will have received a copy of the ‘script’ and advice regarding the standardised manner in which the patient is to be portrayed.

Communication

  • Communication for Clinical Practice is incorporated into all stations.  The balance of communication against other assessed skills will be different in each station depending on the type of station, e.g. history and breaking bad news as a station will have a larger proportion of communication marks than say urinalysis and presenting findings to the examiner.

What is Sequential testing?

Sequential testing is a method of using a screening assessment (Sequence 1), which all candidates attempt.

Candidates who have not achieved a clear pass at sequence 1 are required to sit a second assessment containing different stations (sequence 2). These results are combined with sequence 1 and this gives a larger number of stations to assess the candidates on.

The candidates are required to achieve the pass mark (sum of all the individual station cut scores) plus 1 SEm to pass the summative OSCE.

Sequential testing was introduced in Liverpool in the academic year 2015/16. The OSCE reliability for both sequences was 0.78 with only a small number of students failing both sequences which was less than previous years when sitting the traditional resit assessment.

Why the move to Sequential testing?

The traditional method of assessment has candidates who fail the OSCE receiving short term remediation and shows improved performance for the resit attempt. However these candidates do not appear to retain this level of remediation and continue to be around or below the borderline performance levels required to pass.

A typical OSCE day

An example of an OSCE day for an Examiner

08.00 Register in the examiner hub and be allocated to a station. Log into your ipad and listen/read through all station material. You will then have the opportunity, if you wish, to chat to the other examiners marking the same station

08.00-08.45 Meet with your allocated member OSCE team for any questions

09.00-10.20 Session 1 exam

10.20-10.50 Refreshment break

10.50-12.10 Session 2 exam

If you are examining all day lunch is provided.

12.10-13.30 Register / lunch and re-register on the and be allocated to a station

13.00-13.30 Meet with your allocated member OSCE team for any questions

13.45-15.05 Session 3 exam

15.05-15.20 Refreshment break

15.00-16.40 Session 4 exam

Venue and parking

Aintree Racecourse

Exams are held at our usual venue; Aintree Racecourse. Please register in the Examiner Hub, Lower Saddle Bar, Earl of Derby Stand.

View on Google Maps

Venue address

Aintree Racecourse, 
Ormskirk Road, Liverpool, 
L9 5AS

Directions

Enter the racecourse via Grand National Avenue (off Ormskirk Road).

The barrier will raise upon approach, please drive to the back of the stands (course side) to park.

Free parking is available in any of the marked bays on site.

There is a train station opposite the racecourse with trains every 15 mins to and from the city centre.