Nursing Times blogger Clare Aubrey on her first objective structured clinical examination
Well, I had my first objective structured clinical examination (OSCE) a few days ago. It was traumatic to say the least.
Twenty minutes of aseptic hell, being savagely overlooked by someone you can normally have a bit of a jape with, but who is in that moment a stony-faced symbol of ultimate power, ruling over your life.
Let’s just say I took it badly. My hands shook so badly that I had to stop several times and apologise as I couldn’t get the packaging open or get my gloves on. I couldn’t think straight and I certainly wasn’t capable of calmly referring back to all the practice sessions we had had, in order to pull off a brilliant performance. In short, I was a mess and I wasn’t alone. Afterwards were stories of upset and anger, and the general mood was grim. That coupled with a three week wait for the results and we were in pretty bad shape.
So my question is why are we put through this unnatural torture for the sake of a technique that we could quite easily have signed off during placement? Of course, OSCEs for skills that are denied students whilst in training make perfect sense. We need to have an opportunity to practise those duties which we will meet once qualified, but an OSCE for aseptic technique? Why?
Naturally, my argument stems from the fact that we were unnecessarily emotional wrecks for a good 20 minutes, meaning that instead of being a test of skill, it was more like a test of endurance and those who could hold their nerve. The idea of being put under such strange and unusual pressure meant that we were not in fact ourselves and so this was not a true representation of us as people or professionals. I can see the flip side, that we should be able to handle immense pressure as nurses, such is the nature of our jobs, however, this really is not the fight or flight kind of pressure, the do-the-right-thing-at-the-right-time pressure. This is the I don’t understand why this is making me so nervous gibbering idiot pressure. It’s the worst kind.
My second argument is the unnatural nature of the situation. As students who study at an off-campus location, our circumstances were compared with the campus students, who had more realistic equipment and environments in which to make their attempts. In fairness, we were given leniency in that it was accepted that we didn’t have the same prompts of the natural environment as them, such as an actual curtain to draw round the bed for privacy. (We didn’t even have a bed!) However, where do you draw that line? The OSCE felt like a staged performance, lines learnt, costume on. There is no way that I would behave in that OSCE how I would behave in real life on the ward. Stupid though it was, I even found myself not really checking the dates on the dressing equipment but just acting it out and saying I was doing it, such was the unnaturalness of the whole event. At no other time is a valid scenario so why be judged by it? Especially when there’s so much placement to be had…
I appreciate that the university have to monitor our progress and understand what kind of levels we are attaining in all things, including our clinical skills, but my question really is whether we should be judged on a moment’s madness which had no relation to life or work whatsoever, due to its fundamental fakery?