About OSCE

The OSCE will normally consist of 18 examined stations each of 9 minutes’ duration.

“Applied Knowledge” (8 stations = 160 marks) comprising of:

• Anatomy and surgical pathology (5 stations)
• Applied surgical science and critical care (3 stations) 

 “Applied Skills” (10 stations = 200 marks) comprising of:

• Clinical and Procedural Skills (6 stations)
• Communication skills (4 stations)

There may, in addition, be one or more preparation station and one station that is being pre-tested. Any such pre-testing station will not contribute towards the final mark of the examination. Candidates will not be informed which station is being pretested.

Each of the 18 examined stations is ‘manned’. Some of the stations will have two examiners and some one. In stations with two examiners, each examiner will be examining different aspects of a candidate’s performance. 

Each station will be of 9 minutes’ duration. There may, in addition, be one or more rest or preparation stations and one station that is being pre-tested. The total duration of the OSCE will be approximately 3 hours 30 minutes; this may vary slightly depending on the time allowed between stations, on the rest break(s) provided during the examination and on whether a pre-test station is included. 

Domains
In addition to the four broad content areas examined in the OSCE, four domains have been identified which encompass the knowledge, skills, competencies and professional characteristics of the competent surgeon. These domains map to GMC’s Good Medical Practice (GMP) and are assessed in the OSCE. They are as follows:

1. Clinical knowledge and its application: the clinical knowledge specified in the syllabus; the ability to understand, synthesise and apply knowledge in a clinical context.
2. Clinical and technical skill: the capacity to apply sound clinical knowledge, skill and awareness to a full investigation of problems to reach a provisional diagnosis, the ability to perform manual tasks related to surgery which demands manual dexterity, hand/eye coordination and visual/spatial awareness.
3. Communication: the ability to assimilate information, identify what is important and convey it to others clearly using a variety of methods; the capacity to adjust behaviour and language (written/spoken) as appropriate to the needs of differing situations; the ability actively and clearly to engage patient/carer/colleague(s) in open dialogue.
4. Professionalism: the demonstration of effective judgement and decision making skills; the consideration of all appropriate facts before reaching a decision; the capacity to make the best use of information and think beyond the obvious; being alert to symptoms and signs suggesting conditions that might progress or destabilise; being aware of own strengths/limitations and knowing when to ask for help; the ability to accommodate new or changing information and use it to manage a clinical problem, to anticipate and plan in advance, to prioritise conflicting demands and build contingencies, to demonstrate effective time management; being aware of the need to put patient safety first.

he four domains are assessed via the 18 stations of the OSCE. Candidate performance on domains will not be pass/fail criteria. Domains will be used primarily for structuring the scenarios and mark sheets. 

Candidate instructions

• Each of the stations will have detailed instructions on the outside about the task to be performed.
• One minute is allocated for reading the instructions which will also be available within the bay for reference if required.
  
• In stations that involve a task followed by interaction with an examiner there will be an indication of the time allocated for each part.
• This will normally be six minutes for the task and three minutes for the examiner interaction.
• A sound indication will be given at this point and the examiner will commence their questioning.
• In each station the examiner will check the candidate’s number; candidates are to ensure that their badges are visible at all times.
• In bays involving the examination of patients the examiner will usually watch the candidate conduct the required examination. Candidates will not be prompted and will not be required to give a running commentary.
• If the examiner judges that a candidate is not performing the task requested, the candidate will be prompted to reread the instructions for the station.
• ​If a candidate has had contact with patients/cadaveric material or been performing a practical task he/she must use the hand gel provided.
  
• A candidate completing the task within the 9 minutes available for each station must remain within the station until the signal to move on.
  
• A candidate not managing to complete the task must move on promptly even if in the middle of a question. 

Marking and standard setting

Each station is marked out of a total of 20 marks. It is important to note that to score the highest marks it will be necessary for a candidate to demonstrate the knowledge, skills, competencies and professional characteristics described by the domains across the stations of the OSCE. In addition to being given a maximum mark of 20 for each examined station, candidates will be awarded a separate, overall global rating for the station as follows:

• Fail
• Borderline
• Pass

In order to pass the examination candidates must obtain a pass mark in the two aggregated Broad Content Areas - Knowledge and Skills. Using information from the structured mark sheets for each station out of 20, and the global rating for each station, a mark will be calculated out of 160 for Knowledge and 200 for Skills, that is judged to be the mark required to pass each BCA. To be awarded a pass in the OSCE a candidate must pass EACH of the two grouped areas at the same sitting. Candidates will note, therefore, that from February 2013, there will be no overall pass mark. Knowledge (8 stations) incorporating the broad content areas of anatomy and surgical pathology and applied science and critical care. Skills (10 stations) incorporating communication skills in giving and receiving information and history-taking.