OSCE Oscars
Our school has just introduced
new objective structured clinical exams-we are the guinea pigs. It
would be quite exciting were this not our finals. We wait nervously
outside the exam room, bristling with newly sharpened pencils and
polished tendon hammers. The rumour factory has been working overtime
in speculating on the exam's content. Some think there will be lots of
short cases, others imagine interpretation of x rays.
One student interestingly predicts a swimsuit round. But we all know
that such prophecy is slightly less reliable than a British weather
forecast.
Eventually we are herded into a room and placed outside allotted
curtained cubicles. We will move round at the sound of the bell. It is
my contention that the use of these bells leaves an indelible
impression on the fragile medical mind. The sound of a briskly rung
handbell will always cause qualified doctors to stop what they are
doing and try to move on to the next station. Canny spouses may achieve
substantial domestic control by this means.
So, sweating in our white coats, we begin the exam. Each peal of the
bell brings a new world to explore behind the curtains. Many stations
have "resting" actors whom we have to interview. One who looks like
Anthony Hopkins needs to give consent for his hernia operation. I begin
well, but jump the gun somewhat when we get on to recovery prognosis.
"I imagine," I assert, "you'll be wanting to know how long it
will be until you're able to have sex?"
"Well ... no actually," he replies.
At the next station Dustin Hoffman has been suffering from diarrhoea
for the past three days. I take a history. He has recently eaten a
dodgy chicken sandwich, but once again I veer slightly off course.
"How long," I demand, "since you last had sex?"
Poor Meryl Streep is suicidal. Her delicate face is cracked with lines
as she cries her heart out. Amazingly, she seems to be producing real
tears. One lands on my leg as I try to reassure her. "I'm so
lonely," she weeps. "That's terrible," I soothe, "How long
since you last had sex?"
As we move round, a small crowd of itinerant consultants gathers at the
invigilator's desk to watch and cheer. Some have bought popcorn;
others place bets on fancied students. One group expresses their
satisfaction that there will be no essays to mark with an impromptu
Mexican wave. They are moved along by the appropriate authorities.
At last this crazy dance to the rhythm of the bell is at an end.
We file out, pausing only to watch awards being distributed to the
actors, and to listen to the rather tedious acceptance speeches. It has
been stressful, and the situations have been real enough; but we know
it is a safe environment. We exit stage left, to a world where warm
bodies, not dummies, require cardiopulmonary resuscitation, and where
actors are replaced by real people.
Séamus Phillips, fifth year medical student, Southampton University
studentBMJ 2000;08:131-174 May ISSN 0966-6494
