Jane Davidson RVN career zone, veterinary-nurses
Of all exams, it seems that OSCEs cause the most stress. It’s understandable. They are often the final exams for vet nurses to qualify. For many students, they need to go to an external exam centre which can add to the stress. I’ve also found that the many myths surrounding OSCEs can add to the stress. There are tales of evil examiners, students weeping, and unusual equipment. Well, I’m here to burst a few bubbles and try and explain the background to these exams and make sure you focus on the truth and can prepare for the exams based on the facts.
What are OSCEs?
OSCEs are Objective structured clinical exams. They are used in many fields and are very common in the medical field. You are not alone in sitting these exams. There is a lot of research to support their use. They were developed in the 1970s by a doctor and are used across the world. They are an accurate and objective way to examine clinical skills
All the examiners you meet are vets or RVNs. They are all experienced clinical coaches and have been trained to be examiners. They don’t just arrive and pick up a clipboard. They are there to help you pass. However I know some students feel they are a little cold or stand offish. This is because it’s very limited what you can say to students. Each student, pass or fail, first student of the day or last, must have the same experience from the examiner.
This means examiners can’t give any feedback during the exam process, and they can’t give information that would advantage any one student over the others. This really limited what they can say. You will often find their response is ‘thank you’.
Contrary to popular belief you can ask questions of an examiner. However to get the best response you need to ask direct questions. An open question such as ‘Is this ok?’ isn’t going to get a response that helps you. However a direct question ‘where is the on switch for the microscope please?’ can be answered. This is not information that will advantage you over another student and the exam is not ‘On switches of microscopes 1984-1992’. The examiner does not want you to waste time finding a switch when this isn’t a demonstration of your clinical skills.
Examiners want to see you pass. There is nothing worse than watching a student complete a task but knowing they haven’t passed. You want them all to pass!
If you need to leave your college to attend your OSCEs it can feel really stressful. OSCE centres aren’t chosen to add to the stress. Exam providers know they are limited across the country. There are several reasons for this.
Venues need to have a large enough space to take 12 stations. That’s a lot of space. They also need to be free for regular periods across the year. They also need to have some of the large equipment available or very close by. OSCE exams are expensive to set up and run and if the cost of moving large equipment was added to the cost it would make the exams even more expensive.
While there are different centres for all OSCEs, from university courses to diploma the equipment used is standardised. It is not set to challenge you. It is equipment you would find in practice.
As I mentioned earlier it is not a quiz on your knowledge of different brands on refractometer or X-ray tube heads. You can ask where things are that you need. On switches, emergency flush, fresh gas flow outlet. All things that will then allow you to move on and demonstrate your clinical skills.
An exam where you get the answers! Yay! That’s amazing! Remember the mark sheets are written for several reasons. Yes, they can help your case and see what the standard is for the task. They are also written for examiners to use and allow for structured feedback.
That means there are sometimes more steps written than you need as a student. If the task needs you to draw up medication then you are going to put together a needle and syringe in a sterile fashion. You don’t need the 5-6 steps there are in the mark sheet to know that.
Some people focus on memorising each step. With around 40 tasks with at least 15 steps each then you are looking at remembering almost 1000 steps, many of which you will do automatically.
There are steps you need to achieve to be safe – that’s all these steps are. Safety marks to ensure you are competent and safe. These are areas to focus on, not every single step.
You can use key steps, or areas that you are worried you might forget to focus your planning for the exam – but don’t get stuck trying to recall every step.
There are myths that there is a lot of crying and hysteria in the exam room. In all the time I have examined I have seen people looking like they are controlling tears and nerves. That’s normal, it’s a stressful day. It is incredibly rare that people cry/are sick/have breakdowns. If anyone does feel unwell, sick, or too upset to do a task then there are spare examiners to step in and help. They will help the person feeling unwell and make sure there is minimal disruption to everyone else. If you feel unwell during the exam please alert an examiner. Get some water to drink. Take a deep breath. Nerves can affect anyone, the examiners will help you.
Your own nerves
Nerves affect us all. Some people can turn it into positive energy and some of us aren’t that lucky. Be prepared to feel nervous. It means you will cope much better when you are nervous.
It’s a myth that some people sail through their exams, they just have a plan in place to cope. It’s a good idea to have a plan. This means you focus on yourself. The huge majority of students are so focused on their task they don’t notice anything else in the room. Examiners need to note any noise or activities that may distract students and I’ve always found that while I note these events, the student doesn’t lose focus!
It’s also worth noting that what we remember about the exams is not always reliable. Our brains are not a video camera. Our memories are a compilation of what we have done on the day and previous experiences of the task. This can mean your memory of what you did in the exam is not exactly what happened. This can lead to its own stress after the exam as you can focus on certain areas and become convinced you’ve failed – but that’s for another blog!
Should OSCE’s be videoed?
I’ve heard people saying there would be no issues with OSCE exams if they were recorded by video. This has been debated in other sectors that use them. The research suggest that somewhere in the region of 27 cameras would be needed to accurately film all aspects of a practical task, and this would still not be 100% fool proof.
It’s a shameless plug, but please see my videos on YouTube to see what it’s like filming OSCE tasks. It’s hard enough completing a task in front of an examiner let alone considering cameras. I’m doing the tasks for the camera and there are tasks like bandaging that are hard to do when facing a camera.
I hope many of these myths can now be put to bed and let students and clinical coaches together focus on working towards passing these exams with the minimum of stress – it’s all that everyone wants!