Working against the clock – and under live supervision

Objective Clinical Skills Examinations, or OCSEs as they are more commonly known, are held in trepidation by clinical-stage dental students right across the UK.

This type of exam is designed to assess a student’s practical and interpersonal skills in realistic clinical situations, and they are increasingly being used as part of undergraduate dental training.

With OCSEs, no longer is the ability to regurgitate reams of text-book information a useful skill; what’s important is how you apply what you know to your current clinical situation.

An OCSE consists of a number of ‘stations’ set out in a clinic or laboratory with a predefined clinical task to carry out, typically within a five to 10-minute time limit. A bell is sounded at each time interval as a signal for all candidates to move round to the next station.

Generally speaking, there are three types of OCSE station:

1. Unmanned stations consisting of a particular object to be examined (for example a radiograph, a set of study casts or a clinical photograph etc.) with an associated task to be carried out.

2. Stations manned and assessed by an examiner whilst a practical task is observed, for example fitting a rubber dam, placing a matrix band or carrying out basic life support.

3. Stations manned by an examiner to observe a scenario involving a patient (which may or may not be an actor). These tasks can vary widely from taking a medical history or giving oral hygiene advice, to carrying out cranial nerve examinations or measuring blood pressure.

Often a student’s biggest downfall with clinical examinations is anxiety. Any type of examination situation is stressful, but with the added pressure of carrying out a practical task whilst being observed and marked, nerves can really hamper your performance.

Examiners are looking not only at your practical ability, but also at your interpersonal skills; the way you interact with the patient and manage the situation is critical.

Shaking like a leaf is not an ideal way to portray your communication skills to their full potential! Coming across as calm and collected when in reality you’re a nervous wreck is a skill in itself, vital in dental practice.

The best way to tackle a station is to take your time and familiarise yourself with the situation. Often there will be a prompt of a few lines of text outlining the scenario which can provide vital information and clues to your task. Make sure you are clear on the information provided before you start, rather than just jumping straight in.

With manned stations, always start with basic information and talk through exactly what you are doing and any conclusions you make, talking through your reasoning behind it. You may not have the right answer, but this at least demonstrates to the examiner that you’re thinking logically!

Don’t forget that there are easy marks to be picked up, simply by remembering to introduce yourself to patients, explaining what you are going to do, and for following cross-infection control procedures. These can be easily forgotten in the artificial examination environment and can cost you valuable marks.

Stressful as these exams can be, they have been found to be a reliable and informative method of evaluating undergraduate clinical skills, enabling feedback to be given to individuals in order to improve their clinical performance and interpersonal skills.

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