The student experience in Objective Structured Clinical Examinations (OSCEs): phenomenological analysis

Background and purpose
The dominant psychometric discourse of OSCEs may lead to unexpected problems, such as a checklist-based student performance1 which under emphasises the clinical relationship with student and standardised patient (SP). Such encounters can be dehumanising for SPs2 and have implications for what students learn about relational skills through the assessment process. In this study we explore medical students’ experiences of undertaking OSCEs using a phenomenological frame.
Methodology
Interpretative phenomenological analysis is a form of qualitative methodology which has strong resonance with existentialism and focuses on the lived experience without significant reference to external political or discursive
forces.
Six 4th year undergraduate medical students from Queen’s University Belfast were recruited in December 2013. Maximum variation sampling was used. Students were interviewed by a researcher in the week prior to the
OSCE and then again in the week following the OSCE in Jan 2014. Interviews were minimally structured in order to be open to respondents, rather than adhering to a fixed topic guide, but focussed on participants’ experiences, thoughts and feelings about taking part in OSCEs. Interviews were audio-recorded and
transcribed. Students were also asked to complete a short diary entry in the days prior to the OSCEs and another immediately following. Diary entries were written, emailed or audio-recorded at student’s preference.
Results
Transcripts are currently being analysed by interpretative phenomenological analysis. Preliminary analysis has demonstrated the significance of students’ relationships within the OSCE triad (student, SP and examiner); the effect of the immediate examination environment; realism versus roleplay; students’ perceptions of the purpose of assessment; and coping mechanisms.
Full results will be available by the time of the conference.
Conclusion and Discussion
Understanding the student experience in OSCEs is a crucial step in understanding the complex construction of relationships within the OSCE triad. The focus in OSCEs is typically on standardisation and reliability, but in exploring social interactions we may refocus attention on their inherent potential for learning and effects on both students and patients.
References
1. Hodges B. Medical education and the maintenance of incompetence. Med Teach 2006;28(8):690-6
2. Johnston JL, Lundy G, McCullough M, Gormley GJ. The view from over there: reframing the OSCE through the experience of standardised patient
raters. Med Educ 2013;47(9):899-909

Parenthood and Open Adoption: an Interpretative Phenomenological Analysis

This book explores what it is like to be involved in contemporary open adoption, characterised by varying forms of contact with birth relatives, from an adoptive parent point of view.

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Spirituality and Basketball Fanship: An Interpretative Phenomenological Analysis and Synthesis

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Men’s strategies for preserving emotional well-being in advanced prostate cancer: an interpretative phenomenological analysis

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Sinister creativity: a phenomenological exploration of some of the experiences and perceptions of six lefthanded visual artists

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Acknowledging mother's lived experience of raising a child with Autism : a phenomenological inquiry

Autism is one of those human ambiguities that forces vigilant open-mindednesssometimes this open-mindedness comes without choice, for example when you become the mother of a child with autism. Recent reports indicate that Pervasive Developmental Disorders affect 1 in 150 children (Centre for Disease Control and Prevention, 2007). This also means that there are many families caring for children with autism. The purpose of this research was to explore the day to day lived experiences of mothers caring for a child with autism. With a drastic increase in children diagnosed with autism, and very little research on mothers themselves, assisting in articulating lived experiences from mothers themselves seemed like an acceptable first step. Mothers were asked to journal for a period of one month, once a week, as well as participate in a focus group. Findings from both of these techniques were analyzed using underpinnings from Amelio Giorgi and Max van Manen. General findings indicate that mothers present poignant narratives about living with their child. It becomes clear that mothers are stressed, and live a complicated and often contradictory existence. Many days are fraught with struggle, anticipation, watchful eyes, judgment and guilt. There is a constant battle waging; the one within themselves, and the one with an uninformed and uncooperative public. Given that this research contributes to an extremely small body of qualitative research on mothers, future research should continue to gain insight from mothers, without classifying or categorizing their words. Their words speak volumes. Professionals may know autism, but mothers know their children.

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