1. Final Assessment OSCE
Candidate Briefing
March 2017
Introduction

2. Objectives Fire & Emergency Evacuation Procedure Skills to be tested
Structure of the OSCE examination
Referrals
Equipment
Camera system
After the examination
The objectives of this short briefing are to:
Make you aware of the Fire & Emergency Evacuation Procedure of the centre
Remind you of the skills areas to be tested drawn from the Stage 2 competencies
Explain the structure of the OSCE examinations including the circuit and station set up
Explain the criteria for referrals to be used in the examination
Make clear what equipment you will require today for the examination and which items are prohibited from the circuit
Describe the camera system we use to monitor the examination
Share the procedure for after the examination and state the College’s policy on keeping the content of the OSCE examinations private

3. Reasonable Adjustments Circuit
Clarify if this is an extra time circuit.

4. Fire & Emergency Evacuation Procedure
Remain with the examiner during the evacuation, do not talk to other candidates
Leave the building via the nearest available exit route closing all doors behind you:
- Do not use lifts
- Do not take risks
- Do not stop to collect personal belongings
- Do not re-enter the building for any reason unless authorised to do so
If the alarm goes off it is real as there is no test expected.
These are the building’s fire regulations. If the alarm goes off while you are in the exam, exit the station you are in – stay with the examiner. If you are in the rest station (1), the examiner in station 2 will guide you.
Follow instructions to leave the building via the nearest exit. Do not use the lifts or stop to collect any personal belongings.
Do not talk to other candidates. Exam quite possibly re-start (re-do station were in when alarm sounded)
The fire assembly point is situated at John Rylands Library.

5. Evacuation Procedure Continued
Confirm your presence to the member of staff conducting a roll call.
Re-enter the building only on the specific instructions of the Evacuation Co-ordinator or the Fire Brigade and at the direction of the venue staff.

6. Skills to be tested History Taking, including diagnosis
Communication Skills
Data Interpretation
Clinical Examination and Practical Skills
The examiners are looking for evidence that you understand the theory behind each of the
stage 2 competencies and can apply it in a clinical setting. They want to see that you can get the right
information from a patient and use it to develop a management plan that suits that patient's needs.
In the examination you will be tested several times on the following skills:
a. History taking, including diagnosis
You should take an accurate and relevant history from the patient or patient’s relative, who will be played by
an actor. You may be required to give a diagnosis and explain your reasoning or suggest further tests that you
would undertake.
b. Communication
You will be observed interacting with the patient or a patient’s relative (who will be played by an actor) or a
fellow health professional. [Note though most important in Communication focused stations, communication
comes into most stations, especially if patient involved – think about how you are communicating as well
as what you’re communicating.]
c. Data interpretation
You will be required to interpret a variety of clinical data (photo/plots/rec card/video..). You may have to
discuss your conclusions diagnoses with a fellow health professional or with the patient or patient’s parent,
(actor). You may also be given a set of data and asked to answer a series of questions on that data (questions
outside room). Finally you could be asked to interpret the data and then complete a referral/notification form.
If a station (not just DI) has a photo it will be on a laptop – you are able to zoom in on the image if you wish.
d. Clinical examination and practical skills
You will be required to demonstrate your ability to undertake a clinical examination or perform a practical
procedure. This may be conducted on an anatomical model if the procedure is invasive or could harm a patient
if undertaken repeatedly. You should still treat the model as you would a patient (within reason – no need
to talk to them!)

7. Objective Structured Clinical Examination (OSCE)
17 five-minute stations including:
2 pilot stations
1 Indirect ophthalmoscopy station
1 rest station
The OSCE (Objective Structured Clinical Examination) is an exam format that is widely used by medical professions. It is a way of testing the practical skills of trainees in an objective way.
The OSCE consists of 17 short tasks, known as stations. Every station lasts for five minutes and you will do each one in turn. Two of the stations are ‘Pilot Stations’. This means that these tasks are being tested for use in future examinations and will not count towards your final mark. You will not be made aware of which two stations are the pilot stations. One of the stations will be dedicated to testing indirect ophthalmoscopy. There is also a five minute rest station in the exam so you have a chance to catch your breath. The rest station can take place at any time during the examination and could be at the very beginning or end of the circuit. You may go straight into the rest station on the circuit as there are no instructions to read. London – area not actual room.
When you first enter the circuit you will be placed outside your starting station. Please
face away from the instructions.
When instructed, you will have one minute to read these instructions. You will be told
when to enter the room .
Inside the room will be an examiner. Please show the examiner your lanyard upon entering.
There will also be another copy of the instructions, additional information if this is required and all the equipment needed to complete the task. If the station requires it, there may also be an actor. You will have a maximum of five minutes to complete the task and provide a diagnosis (if required). When you have thirty seconds remaining, you will be warned. You will also be notified when the time is up. At this point, please leave the station and move to the adjacent station. College staff will guide you to the next station if you are unsure. You may begin reading the next station’s instructions immediately.
Outside each station is also a Hand Hygiene Gel dispenser which you may use before entering
each station (either bottle or dispenser).
The OSCE Circuit
One minute to read the instructions
Five minutes to perform the task
Announcements will guide you throughout
Hygiene Gel

8. The OSCE Circuit Sample Instructions
Outside each of the 16 stations (but not the rest station) are instructions briefly explaining the scenario and background of the task to be performed. Here is a sample.
Clip board – can touch

9. The OSCE Circuit Floor Plan 13 14 15 16 17 12 11 3 2 1 10 9 8 4 5 6 7 12 11 10 9 8
College Staff
GMC circuit
Candidate Entrance

10. In the OSCE Station Be natural – treat the actor as your patient
Explain what and why
Notes
Speak clearly
Silence is golden
Diagnosis
Leave on time
Although the clinical scenario is simulated, you should act as you would in the same situation in real life.
The actors who portray the patients are highly trained and experienced at playing the patient in a standardised way while at the same time responding to the words and actions of the candidate. You should ensure that you watch and listen to the patient and respond appropriately.
When explaining something, address the actor directly and make sure your explanation is comprehensive. The examiner will not ask for any clarification, the only instances in which they may interact would be to ask you to repeat something is if they didn’t hear you or to guide you or to guide you back to the instructions if necessary (e.g. examining wrong eye).
You may take notes during the examination if you wish. These notes should be left in the stations. They will not be marked and will be destroyed immediately after the examination.
Speak clearly and not too quickly; the tasks have been designed so that you should not have to rush. Please be aware that the maximum time for each station is 5 minutes. If you feel you have completed the station fully, just sit in silence until you hear the beep. Although this may seem strange and awkward, examiners and actors are used to it.
If a diagnosis is required, read the candidate instructions carefully to see if you are to give your diagnosis to the simulated patient or the examiner. If you have not given your diagnosis by the 30 second remaining mark, you will be prompted to do so by the examiner. The examiner will not interact with you otherwise – but if you do start the task incorrectly (e.g. examine wrong eye) they will guide you back to the instructions.
The OSCE relies on prompt timing so please leave on time.
NOTE: In the unlikely event that something goes wrong with any equipment in a station, you will
repeat the whole station at the end of the circuit.

11. Referral Criteria Emergency = Same or next day
Urgent = Within one week
Routine = In due course
Because the criteria for referral are different in different parts of the country we will be
using the following definitions for the purposes of the examination. These definitions will be
placed on the wall in each station. You should use these terms during the exam as the
examiner may not be familiar with referral criteria in your area.
Emergency = Same or next day
Urgent = Within one week
Routine = In due course
Final note re stations: If you think you have done badly in a station, pause and put it to the
back of your mind. It is important that you move to the next station with confidence in your
ability. Do not let a poor performance in one station affect you in the next station.
Remember that you do not need to pass every station in order to pass the exam. (usually 10).

12. Equipment Required: Retinoscope Ophthalmoscope ID card
Starting station number
Personal belongings
Stationery
Mention whether the candidates need one or both retinoscope / ophthalmoscope. IF SO LEAVE OUTSIDE OF ROOM IF NOT NEEDED.
Please do not bring any other equipment in with you as you will not be permitted to use it. We will provide any equipment necessary to complete the station.
Please also ensure you are wearing your ID card at all times. As mentioned, the examiner will check this in every station.
Please do not forget your starting station so that you can be guided to the correct station at the beginning of the examination.
Please make sure that all other personal belongings, including mobile telephones/electronic devices/watches, are removed and placed in your allocated lockers before entering the circuit.
We will provide pencils and paper in every station. You will not be permitted to use your own stationery.
Can take bottle of water but again keep with you (note that water is provided in rest area).

13. Quality assurance of the OSCE
Camera system
Additional examiner
A camera system will allow observers to watch the examination remotely. Please do not be put off by this. It will allow us to see how the examination is progressing without disrupting it, as it will reduce the need to sit in on stations. The camera does not record the examination so cannot be viewed retrospectively.
There may also be an additional examiner present in any of the stations – they are looking at the examiner not you.
All part of the quality assurance of the exam.

14. At the end of the OSCE Leave the centre quickly and quietly.
Remember that there may be other candidates waiting to do their exam.
Don’t be tempted to share any information about the stations with others via any means
After the exam, please leave the centre quickly and quietly. Other candidates will be
waiting to take the examination. We will collect your lanyards and you collect your
personal belongings from the envelopes. You will then be led down to get your coats
and leave the building.
It is imperative that you do not share any details about the exam or the stations with
other trainees. This includes, but is not limited to, posting details of the exam to social
media sites like Facebook or Twitter, web forums or lists. Trainees caught sharing
exam information will be considered to have cheated and may face disciplinary action.

15. ABOUT THE COLLEGE OF OPTOMETRISTS
The College is the professional body for optometry. It qualifies the profession and delivers the guidance and training to ensure optometrists provide the best possible care. We promote excellence through the College’s affixes, by building the evidence base for optometry, and raising awareness of the profession with the public, commissioners, and health care professionals.
Hopefully you are now aware of all these aspects of the day and you are clear of how the examination will run.
Please remember that the exam is designed to help you demonstrate your skills. These are all skills you have practised many times.
Any questions?