Inter-school variations in the standard of examiners' graduation-level OSCE judgements.

Introduction: Ensuring equivalence in high-stakes performance exams is important for patient safety and candidate fairness. We compared inter-school examiner differences within a shared OSCE and resulting impact on students' pass/fail categorisation.

Methods: The same 6 station formative OSCE ran asynchronously in 4 medical schools, with 2 parallel circuits/school.

A realist evaluation of how, why and when objective structured clinical exams (OSCEs) are experienced as an authentic assessment of clinical preparedness.

Introduction: Whilst rarely researched, the authenticity with which Objective Structured Clinical Exams (OSCEs) simulate practice is arguably critical to making valid judgements about candidates' preparedness to progress in their training. We studied how and why an OSCE gave rise to different experiences of authenticity for different participants under different circumstances.

Methods: We used Realist evaluation, collecting data through interviews/focus groups from participants across four UK medical schools who participated in an OSCE which aimed to enhance authenticity.

How do medical schools influence their students' career choices? A realist evaluation.

Introduction: The career choices of medical graduates vary widely between medical schools in the UK and elsewhere and are generally not well matched with societal needs. Research has found that experiences in medical school including formal, informal and hidden curricula are important influences. We conducted a realist evaluation of how and why these various social conditions in medical school influence career thinking.

How well do UK assistantships equip medical students for graduate practice? Think EPAs.

The goal of better medical student preparation for clinical practice drives curricular initiatives worldwide. Learning theory underpins Entrustable Professional Activities (EPAs) as a means of safe transition to independent practice. Regulators mandate senior assistantships to improve practice readiness.

Enhancing authenticity, diagnosticity and quivalence (AD-Equiv) in multicentre OSCE exams in health professionals education: protocol for a complex intervention study.

Introduction: Objective structured clinical exams (OSCEs) are a cornerstone of assessing the competence of trainee healthcare professionals, but have been criticised for (1) lacking authenticity, (2) variability in examiners' judgements which can challenge assessment equivalence and (3) for limited diagnosticity of trainees' focal strengths and weaknesses. In response, this study aims to investigate whether (1) sharing integrated-task OSCE stations across institutions can increase perceived authenticity, while (2) enhancing assessment equivalence by enabling comparison of the standard of examiners' judgements between institutions using a novel methodology (video-based score comparison and adjustment (VESCA)) and (3) exploring the potential to develop more diagnostic signals from data on students' performances.

Methods And Analysis: The study will use a complex intervention design, developing, implementing and sharing an integrated-task (research) OSCE across four UK medical schools.

'What do we do, doctor?' Transitions of identity and responsibility: a narrative analysis.

Transitioning from student to doctor is notoriously challenging. Newly qualified doctors feel required to make decisions before owning their new identity. It is essential to understand how responsibility relates to identity formation to improve transitions for doctors and patients.

The role of purple pens in learning to prescribe.

Background: Medical doctors are required to prescribe drugs safely and effectively upon qualification, a skill that many feel poorly prepared to undertake. To better prepare doctors, a whole-task approach that develops knowledge and skills, but that also considers the effect of the complex clinical workplace on prescribing, is optimal. We describe an evaluation of an experiential learning programme that allows senior medical students to gain experience with inpatient prescribing during their hospital assistantship.

What's in a name? A discussion of what medical students and junior doctors call their senior colleagues, and why it matters.

This article was migrated. The article was marked as recommended. How should a medical student address their clinical tutor? Sociolinguistic ideas such as politeness theory tell us that the choice of formal or informal terms of address is determined by the positions of those communicating on two axes; relative status and degree of intimacy.

Qualitative research using realist evaluation to explain preparedness for doctors' memorable 'firsts'.

Context: Doctors must be competent from their first day of practice if patients are to be safe. Medical students and new doctors are acutely aware of this, but describe being variably prepared.

Objectives: This study aimed to identify causal chains of the contextual factors and mechanisms that lead to a trainee being capable (or not) of completing tasks for the first time.

Taking on the doctor role in whole-task simulation.

Background: Untimed simulated primary care consultations focusing on safe and effective clinical outcomes were first introduced into undergraduate medical education in Otago, New Zealand, in 2004. We extended this concept and included a secondary care version for final-year students. We offer students opportunities to manage entire consultations, which include making and implementing clinical decisions with simulated patients (SPs).

Development and face validation of strategies for improving consultation skills.

While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of written feedback. To systematically develop, validate and maximise the utility of a comprehensive list of strategies for improvement of consultation skills through a process involving both medical students and their clinical primary and secondary care tutors.

Real-time situation awareness assessment in critical illness management: adapting the situation present assessment method to clinical simulation.

Background: Situation awareness (SA) is a human factor of critical importance to patient safety. Simulation training aims to examine and debrief human factors; however, SA cannot be directly observed. This has led to the development of SA measurement tools.