Leads: Dr Charles Twort; Dr Tushar Vince
The GMC requires that we ensure all medical graduates demonstrate the qualities of a good safe doctor, namely as a scholar, scientist, practitioner and professional. The Medical School has a strong ethos of assessing medical knowledge and technique in conjunction with interpersonal skills.
In each year medical knowledge is assessed by computer-marked written papers consisting of 100-150 Single Best Response Questions. In successive years the questions progress from assessing pure knowledge to assessing the integration of knowledge required for diagnosis and patient management.
Alongside written papers, we also have a well organised, extensive clinical assessment programme through Objective Structured Clinical Examinations (OSCEs) which run for each of years 2 to 5. Each OSCE consists of several short (5-7.5 minute) stations, examined on a one-to-one basis using either real or simulated patients (actors).
In the early years, clinical skills are learnt and examined as discrete tasks. As skills develop throughout the degree course, the OSCE assessment becomes more sophisticated, with each OSCE station assessing more than 1 skill. By the final year, the OSCE is an integrated assessment of 18 typical tasks faced by a Foundation Year 1 doctor: a mix of practical skills, history taking, communication, management and examination tasks.
In each year, the OSCEs are under continuous review and scrutiny to ensure assessments are of the highest quality. This is a dynamic process as OSCEs are devised to reflect clinical practice and the increasing focus on patient safety and clinical reasoning. This includes innovative stations, such as assessment of information retrieval, anatomy and applied clinical ethics.
The Department of Clinical Assessment
The Department of Clinical Assessment (DCA) is responsible for managing OSCE examinations. It monitors the quality of examination questions and assists examiners in question writing. It is also responsible for providing data analysis and results to each exam board and maintains an overview of clinical assessment across the years to enable a streamlined and standard approach to clinical assessment. Current work focuses on providing examiner & patient guidance on global scores and developing robust examiner feedback.
The Clinical Assessment team are also responsible for providing feedback from examinations to students. Personalised feedback is provided by each examiner in a booklet that students may collect as soon as results are published. This provides specific feedback on the stations performed. Students also receive feedback analysed at a cohort level to enable shared learning and a third mode of feedback analyses results according to the skills assessed, so that students can focus on skills development for future practice.
More recently, the DCA has been developing a Clinical Assessment website for students and staff to gain a greater understanding of the OSCE process. The website provides information on how assessments are devised and benchmarked, with pages dedicated to each year group. Further work continues on the website to act as a training resource for examiners and to help students understand the levels of expectations for each year group.
The Clinical Assessment team are also now developing formative assessments for each year group to allow students to gauge their progress.