Reflection on the OSPE

A reflection on my semester 1 Objective Structured Practical Examination (OSPE).

In my third month of university, I had to complete an Objective Structured Practical Examination (OSPE), which was essential to pass to move onto the second year. OSPE exams are crucial in assessing and improving clinical competency (Ananthakrishnan, 1993). I had to complete six OSPEs in my undergraduate, so I knew the pressure it would entail. Much like a driving test, the exam was carried out by an examiner who remained silent and marked me for certain points. There were instant fail criteria in line with safety, such as forgetting a hat and gloves when leading the horse, or choosing the wrong sized bridle. This was important to show the examiner I would be a safe and competent clinician, however it has been shown that being assessed under pressure can have a negative effect on performance (Beilock and Carr, 2001).

The equine task involved putting a headcollar and bridle on a horse, leading it up and down, presenting square for examination and picking up it’s left fore hoof before returning it to the stable and untacking. The canine task involved choosing an appropriate collar and lead for the dog, removing it from the cage, leading it up and down, commanding sit, presenting for examination and placing back in the cage. These were simple tasks I did every day with my own animals without second thought, but under examination conditions the pressure of needing to pass, and the small list of things that could cause me to fail instantly made it extremely stressful.

Leading up to the exam I could feel myself becoming stressed and anxious, so I sat quietly and reassured myself. I thought of the exam as a memory test, and reflected on the sequence of events demonstrated in our mock OSPE. Mindfulness is the practice of self-awareness and being present. In day-to-day life, we often become so absorbed with our thoughts and anxieties that we lose touch with our surroundings and how our bodies are feeling. As well as having positive health benefits, mindfulness has been shown to be effective in reducing stress (Grossman et al, 2004; Shapiro et al, 2005; Chiesa and Serretti, 2009). Although I have practiced mindfulness in other scenarios, it was the first time I had used it in an exam setting and it had a positive effect. Throughout the OSPE I remained calm, grounded myself to my environment and took my time with each mini-task. This evaded nerves causing me to rush through and forget elements, a problem which has occurred in my past OSPE’s.

I was extremely pleased to discover I had passed my canine and equine OSPEs, and for me this reinforced the benefits of practicing mindfulness and is something I will use again in my upcoming exams.

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References

Ananthakrishnan N (1993). Objective structured clinical/practical examination (OSCE/OSPE). Journal of Postgraduate Medicine. 39(2), pp. 82-84.

Beilock SL and Carr TH (2001). On the fragility of skilled performance: What governs choking under pressure? Journal of Experimental Psychology. 130(4), pp. 701-725.

Chiesa A and Serretti A (2009). Mindfulness-based stress reduction for stress management in health people: a review and meta-analysis. The Journal of Alternative and Complementary Medicine. 15(5), pp. 595-600.

Grossman P, Niemann L, Schmidt S and Walach H (2004). Mindfulness based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research. 57(1), pp. 35-43.

Shapiro SL, Astin JA, Bishop SR and Cordova M (2005). Mindfulness-based stress reduction for health care professionals: results from a randomized trial. International Journal of Stress Management. 12(2), pp. 164.