OSCE feedback, part 2

So this post was a long time coming, but it's been requested, so I'll do it.

At King's we get very... interesting feedback for our OSCEs. You'll have seen my first bout of confusion here, for my first lot of feedback.

The second lot isn't any better...

Standardised mark: 69
Number of stations passed: 16
Centile Rank: 13

And then this wonderful thing:



So yet again, I've passed everything, apparently done pretty well, and then I'm getting really low ranks for certain things, which stands out quite badly. History taking AND communication skills. I had FOUR (out of 16) stations that were pure history taking, that I clearly passed, (and my ranking is still fairly well over the 50% pass limit, so perhaps not even that badly?) yet I'm apparently in the bottom 20% of the year for this stuff.

But I don't know why! Am I somehow passing by pointing at people and saying "YOU, ILL? WHERE?". Is everyone else in the year doing really well at history-taking and I'm just average? Am I missing some incredibly key aspect of the history every time? Did I completely miss that I was talking to the wrong patient, or that they're allergic to every drug known to man, or that they didn't have a face?

The feedback we got in second year gave you the mark you achieved on each station, which they have now done away with because "people were focussing too highly on marks". I can see that you don't want people to just be running a checklist instead of genuinely thinking about the patient and their situation, but at the same time, we're now being left in the dark, with numbers that represent very little.

Personally I don't know whether the numbers would help- either way I'd just find out that I did badly in the same stations. But at least I'd know whether I did genuinely badly, or just badly compared to everyone else. You can be in the bottom 20% if the other 80% simply scored one mark higher.

And then there's that graph. I think it represents the percentage of the year that passed a number of OSCE stations. So along with me, about 50% of the year passed 13-16 stations. However the y axis refers to a "Part A osce", which as far as I'm aware is what the year 4 osce is called. The graph that came with the first set of feedback (in my previous post, although I didn't put it up) also had the wrong numbers on the x-axis- going up to 20-something, when we'd only done 8 stations at that point. This apparently was the amount of stations in the year 2 OSCE. So even though this feedback took MONTHS to get to us, it's clearly recycled from what was produced for other years, and not even checked properly. I mean, come on. I can knock out an incorrect excel graph in 5 minutes flat! Should have let me do it, we'd all have had the same amount of wrong information by the very next day.


...


There have been a lot of (understandable) complaints about the OSCE feedback, and I'm not going to lie, it's completely awful. Especially considering how long it took to get to us, and that some of it isn't even correct. Even more so considering they released a podcast to explain it to us, (and kept directing us to when we asked questions) which explained the 2nd-year OSCE feedback and wasn't really relevant to our data.

But at the same time, we do need to use some common sense. We should generally know if you did well or badly on a station- if you come out with no idea what was wrong with the patient, or unable to perform a procedure, that's probably why you failed. If you weren't slick at an exam, or made a patient cry, you probably failed. If you failed the station once and don't think you'd pass next time, then you know that you need to practise it some more. It's not rocket science.

Personally I do know that my history-taking tends to take a bit too long, and I tend to forget the "Ideas, Concerns, Expectations" questions- such as "what do you think you have?" because I'm fearful of getting the response "you're the bloody doctor, you work it out".
And since doing my A+E rotation, I've realised I can miss out a few key questions which I then only remember when trying to piece my differential together and I realise I'm missing key information. So I guess that's the problem, and I'm going to work on it.

So I think it's a bit of both, really. Talking with other students, we think the "grade and a comment" system might work for the OSCEs, so you have a general idea of how well you did, and a pointer in the right direction. But at the same time, we're getting old now. We should be able to realise when we're wrong- we're not idiots. We're not going to be spoon-fed, ever again, and you've just gotta work out some shit for yourself.