1. Yes, we can improve performance in 60 minutes!
Sport Psychology principles and its application to performance in the OCSE
Dr. Kirsty Forrest
Ian Maynard, Ph.D
Joanne Butt, Ph.D
Dr. Brian Nicholson
Slide 1: Cover Page

2. Overview of the Research Project
Project initiation
Getting started ….
Aims of the project
Funding
For medical students KF

3. Objectives of the Session
Sport psychology
Performing under pressure
Elite sport and preparing for OSCE
Overview of the 6-week intervention
Cognitive and somatic anxiety intervention
Activity 1
Develop awareness of our own responses to stress
Activity 2
(a) Cognitive restructuring
(b) Cue controlled relaxation JB

4. Performing Under Pressure
Mentally and physically prepared
Manage emotions
Do not let uncontrollable factors affect their performance
Able to focus and refocus
Have high levels of self belief JB

5. Psychological Skills Training for OSCE
Intervention Overview
Completing the CSAI-2
Cognitive and somatic anxiety, and self confidence
Develop awareness
Responses to stress IM

6. Psychological Skills Training for OSCE
Cognitive anxiety & self confidence
Controlling the controllable factors
Cognitive restructuring
Building confidence
Planning and focusing
Somatic anxiety
6-stage process of applied relaxation
Systematic desensitisation
Coping responses IM

7. IM Session Progressive Relaxation 2 15 – 20 mins 3
Release-Only Relaxation
5 – 7 mins
Cue-Controlled Relaxation
2 – 3 mins
Differential Relaxation
60 – 90 secs
Rapid Relaxation
20 – 30 secs
APPLICATION TRAINING 2 3 4 5 7 8 9 10
Figure 1. The different components of applied relaxation with approximate time to get relaxed at various stages IM

8. Intervention Examples
Activity 1: Developing awareness of our own responses to stress
Activity 2:
(a) Cognitive restructuring
(b) Cue controlled relaxation IM

9. What characteristics do elite sport and OSCE/your world share?
Developing Awareness
What characteristics do elite sport and OSCE/your world share? JB

10. The mirror of sport and preparing for the OSCE
What characteristics do elite sport and OSCE/your world share?
High pressure situations
Demand for results
Performance is critically evaluated
Continuous need for improvement
Performance edges are critical
Personal accountability for performance
Good communication JB

11. Recognising when you are under stress
Common Early Warning Signs
Mental (e.g., inability to concentrate, difficulty in making rational judgements)
Emotional (e.g., state of anxiety, increased moodiness, angry outbursts)
Physical (e.g., tense muscles, erratic breathing, cough/colds)
Behavioural (e.g., increased or decreased sleep, social withdrawal)
Activity 1: see Booklet p. 7 JB

12. Activity 2a: Cognitive Restructuring
Countering
Identifying negative thoughts
Thought stopping cue
Reframing
Activity 2: see Booklet p IM

13. Identifying Negative Thoughts and Expectations
Examples: OSCE Negative Self-Talk
I don't know what to expect
Its so difficult getting through so many stations
I hope I say the correct things
I shouldn't have asked that question IM

14. Thought Stopping
Involves briefly focusing on the undesired thought and then using a cue or trigger to stop the thought and clear it from your mind.
Cues or triggers can be mental or physical (e.g., saying the word 'stop' to yourself, clenching your fist) IM

15. COUNTERING – OSCE Specific Reframing Negative Self-Talk to Positive Self-Talk
I don't know what to expect
I'm well prepared, I've been through this before.
I have the skills to perform at each station.
Its so difficult getting through so many stations
Just take one station at a time, and stick to my routine
I hope I say the correct things
I'll perform well because I have the knowledge
I shouldn't have asked that question
Its Ok, its just one question, I will accrue points from asking questions at each station IM

16. Activity 2b: Progressive Relaxation
Stage 3: Cue Controlled Relaxation
Focus on breathing
Use of 'cue' words e.g., 'relax', 'loose' etc IM

17. Changes in CSAI-2 Scores: Pre and Post Intervention
Pre-OSCE CSAI-2 (M)
Post-OSCE CSAI-2 (M)
T-Test Results
Cognitive Intensity (decreased)
25.39
20.83
t=3.57;df=17; p<.01
Cognitive Direction (less debilitating)
-10.06
-2.89
t=-3.66;df=17; p<.01
Somatic Intensity (decreased)
22.78
17.94
t=3.09;df=17; p<.01
Somatic Direction (facilitative)
-10.11
1.44
t=-4.49;df=17; p<.001
Self-confidence Intensity (increased)
14.22
21.50
t=-5.19;df=17;p<.001
Self-confidence Direction (facilitative)
-5.06
9.59
t=-5.18;df=16; p<.001
Intensity Range : 9-36
Direction Range: -27 to +27
- Understanding your own scores JB

18. Summary
Psychological skills intervention: Successful transition from sport to medicine [OSCE]
Multi-modal Stress Management Training Programme (6 weeks)
Focus on managing cognitive and somatic anxiety, and improving self confidence
Provided examples of cognitive restructuring and cue-controlled relaxation JB

19. Thank You for Listening
Final Comments
Summary of the project
Benefits for the medical students
Future work
Thank You for Listening KF