It’s eight in the morning. A shrill whistle echoes through the third floor of the teaching block at the Faculty of Medicine. Hurriedly, and with an impressive degree of synchronization, students open up the task sheets attached to the doors. Their faces a picture of concentration, they attempt to grasp what these say as quickly as possible. Among them are Carlotta Petri and Victor Moldovan, who are both in their sixth program-related semester.
After the whistle sounds, they have one minute to read and understand the tasks that have been hung out for them. They then enter the corresponding room, and their examination begins. Now they have four minutes to demonstrate their skills to the examiners at each station, who are already in the room. After completing every station, they are given some brief feedback before the next whistle goes and they move on. The only station that is different is the conversation with a patient, for which they are given twice as long.
This is the first OSCE that the two medical students and their peers have encountered on their degree program. OSCE stands for “objective structured clinical examination,” an innovative, hands-on format that requires students to complete tasks at a series of themed stations. Today, they are being tested on the basics of clinical medical examinations and handling patients.
Before the exam started, there was a slight degree of tension in the air that even the students’ obligatory FFP2 face masks could not completely hide. “I was nervous before the exam because it was the first time I’ve been assessed on a practical exercise,” says Victor, summing up how he felt. “But as soon as I’d done the first station, I quickly became a lot less nervous. Once the exam was over, I was relieved that I’d managed it,” he adds, even though this feeling of relief in the midst of his written examination period was only short-lived. Carlotta also admits to having been a bit nervous before tackling her first station, although it was “nothing out of the ordinary for an exam situation,” she says. One reason for her heightened nerves was “the fact that it was a whole new concept.”
This special format was introduced at the University of Bonn in 2012 for exams in pediatric medicine. Since then, the concept has not only proven its worth but has also been adopted in more and more departments and curricula. “The biggest difference between a standard exam and the OSCE was that, for the first time, I had the chance to see how much information I was able to take in without being afraid of having to repeat my written examination,” Carlotta says. This is because this first OSCE is ungraded. Even though this will not be the case for the students’ subsequent exams, it is not yet possible to fail them. Victor is also pleased about this: “Usually with an exam, there’s always pressure on you to pass or get a certain grade. This OSCE is different. Rather than it being all about passing, you’re trying to apply what you learned last year from your course on the basics of clinical medical examinations and handling patients.”
Since this exam is not only about simply reproducing knowledge that the students have acquired but also focuses on the practical side, they also have to prepare for it in a different way to their conventional exams. The OSCE simulates scenarios that the students will encounter later on in their careers. For instance, actors are used to simulate discussions with patients, and students are asked to demonstrate the correct way to take blood from a dummy. The exam serves to determine what level students are at. They can see how far their practical skills have come after six semesters and completing their clinical medical examination course.
“Although I also read through the Heidelberger Standarduntersuchung to prepare for the OSCE, I mainly met up with friends and discussed and practiced examining patients,” says Victor, outlining his approach. Carlotta explains that most of her preparation came in a course that she took during the semester break. “My part-time job in a hospital was also a massive help, because I was able to draw on experience that I gained through my work there at many of the stations that formed part of the exam,” she adds.
As far as Carlotta is concerned, the exam is a chance to practice the kind of things that she will encounter later on, when she is a doctor. “It’s a great introduction to clinical work, where you’re confronted with real-life, hands-on situations for the first time,” she says. What Victor likes about the OSCE is the fact that “you’re left on your own and don’t have anyone else alongside you who can help if you get stuck. So you get to see what your strengths and weaknesses really are.” Nevertheless, he would appreciate slightly more detailed feedback. However, there is not much time left for a debrief before the next whistle sounds. The pair hurry off to the next room as there is no time to lose.
