Med students, just know OSCEs are nonsense

[MedicineZ0Z]

Some med students were talking to me about their step 2 cs prep and other OSCE stuff they've had to do for med school. While it is certainly good *practice* to get a flow of patient encounters before rotations; they are by and large complete nonsense when it comes to actually evaluating someone.
1. Acting skills dominate when it comes to OSCEs. The person infront of you is not a real patient, end of story. You're acting.
2. The pace and expectations of encounters is very unrealistic for real life patients scenarios.
3. People with bad personalities can fake it and get by and people with nicer personalities may not get credit as much in an acting scenario.

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[Splenda88]

Step2 CS is another useless thing that cost med students 2k...


This test should have been only for FMG/IMG

 

[Goro]

Being a doctor is very much like being an actor. Once you put on that white coat, you go into character.

IF your school films the OCSEs, you can get positive feedback, after all.

 

[Hippocrates II]

Being a doctor is very much like being an actor. Once you put on that white coat, you go into character.

IF your school films the OCSEs, you can get positive feedback, after all.

Except when I talk to a real person with a real problem, expressing empathy is not a problem for me. When some actor is telling me about how badly their back hurts and I know they're full of ****, it's hard to put on the 'I'm so sorry' face and come across with fake empathy like I'm supposed to show.

 

[operaman]

Yeh they’re BS but also easily hackable. Even if you’re a terrible actor you just need to drop in a few canned statements to get the empathy checkbox. One open ended question, some “I’m sorry to hear that” and “this sounds like it’s really impacting your life” and bada boom bada bing - honors.

 

[Goro]

Yeh they’re BS but also easily hackable. Even if you’re a terrible actor you just need to drop in a few canned statements to get the empathy checkbox. One open ended question, some “I’m sorry to hear that” and “this sounds like it’s really impacting your life” and bada boom bada bing - honors.

Yes. It's called acting. Again, this is all about going into character.

 

[Goro]

Some med students were talking to me about their step 2 cs prep and other OSCE stuff they've had to do for med school. While it is certainly good *practice* to get a flow of patient encounters before rotations; they are by and large complete nonsense when it comes to actually evaluating someone.
1. Acting skills dominate when it comes to OSCEs. The person infront of you is not a real patient, end of story. You're acting.
2. The pace and expectations of encounters is very unrealistic for real life patients scenarios.
3. People with bad personalities can fake it and get by and people with nicer personalities may not get credit as much in an acting scenario.

Are your OSCEs filmed? This is an important consideration in your education if your school indeed does this. No matter how bad the actor is that you're dealing with, you get to see yourself in action.

At our school the people who failed clinical skills in comlex almost all have defects that you could spot when you retrospectively go back to their oski performances and view them

Also, we have also noticed a pattern in that some students fail their oskies because they treat them simply as another standardized exam question, meaning they try to go directly to the right answer/diagnosis, instead of doing all of the doctor stuff they're supposed to do.

 

[Osteosaur]

I do feel like my scoring on it is somewhat random. After having been through quite a few I've noticed that you need to be of the mindset that the SP has seen like 10+ students that day if not more.

Little stuff like remembering to tie a gown, or offering to help them up, probably sticks out a bit more than winging it with the mindset "I'm an extrovert! We had a good connection I'm sure of it. I'm a people person!"

 

[Oedipa Maas]

I do feel like my scoring on it is somewhat random. After having been through quite a few I've noticed that you need to be of the mindset that the SP has seen like 10+ students that day if not more.

Little stuff like remembering to tie a gown, or offering to help them up, probably sticks out a bit more than winging it with the mindset "I'm an extrovert! We had a good connection I'm sure of it. I'm a people person!"

I also know for a fact that I was confused for another student because the SP wrote something nice about my outfit (an item of jewelry that I do not own). Not comforting.

I just took CS and was shaken by it more than I expected. In the OSCE at my institution, SPs really act and interact to the point where it can *almost* feel real. The SPs for CS were like robots reciting lines without feeling. It was weird.

 

[mehc012]

Even videotaped, they're a waste of time. Not worth studying for, not worth paying attention to, certainly not worth paying for.

 

[operaman]

From reading these comments it sounds like some schools have the SPs doing the grading, is that right?

For ours, we had physician preceptors behind a one way mirror who did the scoring. The SPs would also give feedback and we had to watch our videos and submit feedback on ourselves. Our preceptors would also come review with us and go over anything missed and pointers for moving more efficiently through the encounter.

Personally I found them helpful early on.

 

[Oedipa Maas]

From reading these comments it sounds like some schools have the SPs doing the grading, is that right?

For ours, we had physician preceptors behind a one way mirror who did the scoring. The SPs would also give feedback and we had to watch our videos and submit feedback on ourselves. Our preceptors would also come review with us and go over anything missed and pointers for moving more efficiently through the encounter.

Personally I found them helpful early on.

We had SP and physician scorers.

 

[ScreamingInternally]

We had SP and physician scorers.

Same^ Most of our small ones, especially early on, were primarily scored by SP, then it shifted more toward clinicians evaluating your clinical stuff/notes and SP evaluating the interaction/emotion part of it, esp leading up to CS.

Regardless, every single second of it was a miserable waste of time. I learned nothing from it and spent a bunch of time/money in order to do so.

 

[Fidelio17]

At this point in M1 it's just the SPs scoring us. My last graded SP assessment was done in a room without cameras because the sim center didn't have enough space for everyone. 🙄 Not a lot of useful feedback there. & certainly no physician feedback.

My school also has us learning the physical exam skills from watching Bates videos & then practicing in small groups on a SP.
Problem being that the standardized patients aren't very standardized, & some of them have a bad habit of trying to lecture us about the physical exam instead of letting us try it on them (which is what they're being paid for). Between that & the SP who tried to tell me not to ask my patients for consent before touching them... let's just say it's been less than a stellar learning opportunity.

 

[studentdocftw]

I also know for a fact that I was confused for another student because the SP wrote something nice about my outfit (an item of jewelry that I do not own). Not comforting.

I just took CS and was shaken by it more than I expected. In the OSCE at my institution, SPs really act and interact to the point where it can *almost* feel real. The SPs for CS were like robots reciting lines without feeling. It was weird.

Yeah, the whole day was just weird. I'm actually a little concerned I may have failed..because I didnt act enough. Sigh....chance is on my side, but it pains to think all of this work could go down the drain because I didnt ask enough scripted questions for the SPs checkboxes.

 

[bananafish94]

Of all the hoops I’ve had to jump through in my medical education, CS is easily the greatest sham of them all. I can’t believe the NBME has been getting away with that joke of a “test” for 15 years. And this is from someone who handily passed each subcategory so I’m not some kind of bitter malcontent (except for when I think of everything else I could have done with $1300).

 

[Splenda88]

Of all the hoops I’ve had to jump through in my medical education, CS is easily the greatest sham of them all. I can’t believe the NBME has been getting away with that joke of a “test” for 15 years. And this is from someone who handily passed each subcategory so I’m not some kind of bitter malcontent (except for when I think of everything else I could have done with $1300).

Medical students are spineless...

Maybe you did not have to travel to take CS. People who have to travel to take it waste ~2k for that joke...

 

[Matthew9Thirtyfive]

SPs score us too, but their grade is almost pointless because the preceptor score is what determines if you pass or not. They watch from a screen from cameras in the room and then grade us. The SP score is more just general feedback.

 

[MedicineZ0Z]

Are your OSCEs filmed? This is an important consideration in your education if your school indeed does this. No matter how bad the actor is that you're dealing with, you get to see yourself in action.

At our school the people who failed clinical skills in comlex almost all have defects that you could spot when you retrospectively go back to their oski performances and view them

Also, we have also noticed a pattern in that some students fail their oskies because they treat them simply as another standardized exam question, meaning they try to go directly to the right answer/diagnosis, instead of doing all of the doctor stuff they're supposed to do.

5 years into practice, how you faked an OSCE vs showed your real personality will make 0 difference.

We had SP and physician scorers.

Physicians who are out of touch with reality and barely practice now or do 30 minute appointments? Or just ever did outpatient clinic?

At this point in M1 it's just the SPs scoring us. My last graded SP assessment was done in a room without cameras because the sim center didn't have enough space for everyone. 🙄 Not a lot of useful feedback there. & certainly no physician feedback.

My school also has us learning the physical exam skills from watching Bates videos & then practicing in small groups on a SP.
Problem being that the standardized patients aren't very standardized, & some of them have a bad habit of trying to lecture us about the physical exam instead of letting us try it on them (which is what they're being paid for). Between that & the SP who tried to tell me not to ask my patients for consent before touching them... let's just say it's been less than a stellar learning opportunity.

Your typical patient in real life is morbidly obese and your physical exam has a sensitivity of 0% on them. And not asking for consent is probably the one real life screw up you can actually do that's even worse than being rude.