Professional Behavior include the interaction with staff and patients, integrity,
sensitivity to diversity, attendance and a commitment to lifelong learning and
independent study.
Communication Skills “as they relate to physician responsibilities, including
communication with patients, families, colleagues, other health professionals and
resolution of conflicts.”
OSCEs
An objective structured clinical examination (OSCE) is designed to test clinical skill
performance and competence in skills such as communication, clinical examination,
medical procedures / prescription, exercise prescription, joint mobilisation / manipulation
techniques, radiographic positioning, radiographic image evaluation and interpretation of
results. It is a hands-on, real-world approach to learning that keeps examinees engaged,
allows them to understand the key factors that drive the medical decision-making process,
and challenges the professional to be innovative and reveals their errors in case-handling
and provides an open space for improved decision-making, based on evidence-based
practice for real-world responsibilities.
An OSCE usually comprises a circuit of short (the usual is 5–10 minutes although some use
up to 15 minute) stations, in which each candidate is examined on a one-to-one basis with
one or two impartial examiner(s) and either real or simulated (actors or electronic patient
simulators) patients. Each station has a different examiner, as opposed to the traditional
method of clinical examinations where a candidate would be assigned to an examiner for
the entire examination. Candidates rotate through the stations, completing all the stations
on their circuit. In this way, all candidates take the same stations. It is considered to be an
improvement over traditional examination methods because the stations can be
standardized enabling fairer peer comparison and complex procedures can be assessed
without endangering patients health.
As the name suggests, an OSCE is designed to be objective – all candidates are assessed
using exactly the same stations (although if real patients are used, their signs may vary
slightly) with the same marking scheme. In an OSCE, candidates get marks for each step
on the mark scheme that they perform correctly, which therefore makes the assessment of
clinical skills more objective, rather than subjective, structured – stations in OSCEs have a
very specific task. Where simulated patients are used, detailed scripts are provided to
ensure that the information that they give is the same to all candidates, including the
emotions that the patient should use during the consultation. Instructions are carefully
written to ensure that the candidate is given a very specific task to complete. The OSCE is
carefully structured to include parts from all elements of the curriculum as well as a wide
range of skills. A clinical examination - the OSCE is designed to apply clinical and theoretical
knowledge. Where theoretical knowledge is required, for example, answering questions
from the examiner at the end of the station, then the questions are standardized and the
candidate is only asked questions that are on the mark sheet and if the candidate is asked
any others then there will be no marks for them. Marking in OSCEs is done by the examiner.
Occasionally written stations, for example, writing a prescription chart, are used and these
are marked like written examinations, again usually using a standardized mark sheet. One
of the ways an OSCE is made objective is by having a detailed mark scheme and standard
set of questions. For example, a station concerning the demonstration to a simulated patient
on how to use a metered dose inhaler [MDI] would award points for specific action, which