ISCE Handbook 2019-20 PDF

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Summary

Updated ISCE handbook...

Description

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2019-20" " Year"4"ISCE""

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Information"for"students" Contact!Emails! [email protected]" Undergraduate"Assessment"Administration"Team Year"4"Director"Dr"Rachel"Brooks" " " " " [email protected]"" Director"of"Clinical"Skills"and"Simulation"Dr"Paul"Frost" " [email protected]"" Director"of"Assessment"&"Clinical"Assessment"Lead"Dr"Liz"Metcalf" [email protected]""

Contents! " ISCE-!definition………………………………………………………………………………………………..…………!! 3! Standard!setting……………………………………………………………………………………………..…………! 3! Formative!mini!ISCE………………………………………………………………………………..…………………! 4! Summative!ISCE……………………………………………………………………………………………..………!

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When!and!where,!timings…………………………………………………………………………………..………! 6! Patients……………….…………………………………………………………………………………………………..…! 7! Examiners……………………………………………………………………………………………………………………! 8! Student!conduct……………………………………..…………………………………………………………………..! 8! Extenuating!circumstances!and!specific!provisions……………………………………………………….!9! Domains!of!competence.!…………………………………………………………………………………………!

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Example!generic!formative!ISCE!marksheet!back! …………………………………………………..! 14! Feedback……………………………………………………………………………………………………….……..……! 15! Safety!alerts………………………………………………………………………………………………………………..! 15! Types!of!station………………………………………………………………………………………………………..! 17! Clinical!examination!stations!! ! ! ! ! ! ! Clinical!examination!station:!symptom!presentation! ! ! ! Acute!assessment!stations! ! ! ! ! ! ! ! Psychological!medicine!stations! ! ! ! ! ! ! ! Women,!child!and!family!stations! ! ! ! ! ! ! SBAR!stations!! ! ! ! ! ! ! ! ! ! e-Learning!resources!and!Self-Directed!Learning…………………………………………….…!! "

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ISCE!(Integrated!Structured!Clinical!Examination)! " In"order"to"progress"to"Phase"3"of"the"undergraduate"C21"curriculum," you"must"pass"the"year"4" ISCE,"designed"to"ensure"that"you"have"acquired"the"necessary"clinical"skills"for"phase"3."" " This" booklet" outlines" the" format" of" the" Year" 4" ISCE," including" detail" regarding" the" domains" of" competence"against"which"you"will"be"assessed."This"booklet"should"be"read"in"conjunction"with" the"Year"4"schedule"of"assessment." " The" ISCE" is" an" examination" which" assesses" your" clinical" competence" and" professional" ability-" testing" your" ability" to" communicate" and" perform" a" range" of" clinical" examinations" and" related" practical" clinical" skills" in" an" integrated" fashion." The" examination" is" aligned" with" learning" outcomes" up" to" and" including" phase" 2" and" is" based" upon" the" common" clinical" systems." The" summative" ISCE" is" undertaken" to" ensure" that" you" have" acquired" the" necessary" clinical" skills" to" progress"to"Phase"3"of"the"undergraduate"C21"curriculum."" " The" examination" must" be" passed" in" order" to" progress" to" Phase" 3." Should" you" fail" to" meet" the" required" standard" during" your" summative" assessment" you" will" be" offered" remediation" and" will" have"the"opportunity"to"re-sit"the"exam"at"the"next"exam"period."The"re-sit"examination"will"be" equivalent"in"format"and"difficulty"to"the"original"practical"examination"failed."" ! ! !

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Standard"setting" The"examination"is"standard"set"by"the"borderline"regression"method."In"order"to"pass"the"Year"4" ISCE," you" must" pass" 10" out" of" the" 12" stations" and" IN" ADDITION" achieve" ≥50%" standard" set" adjusted" mark" overall" for" the" examination." For" further" information" regarding" the" standard" setting" process" please" refer" to" the" Combined" Assessment" and" Progression" Guide" on" Learning" Central." " Candidates" have" to" meet" both" criteria" to" ensure" that" they" have" demonstrated" an" acceptable" level" of" performance" across" a" range" of" stations." This" is" a" standard" method" for" examinations" of" clinical"performance."" " Should"you" have"to" re-sit" the"ISCE" you" will"again" require"a" ≥50%"standard"set" adjusted"mark" to" pass,"and" you"must"pass" 10"out"of" 12"stations."However," your"mark"will"be"capped"at"50%"for"a" re-sit"(second)"attempt."

Standard!setting! ! Form! ! !

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Formative!mini!ISCE! " In"order"to"give"you"the"opportunity"to"practise"a"range"of"ISCE"stations"in"the"run"up"to"your"Year" 4"ISCE"in"May" 2020,"you"will"be"given"the"opportunity"to"attend"a"formative"mini"ISCE,"normally" held" during" the" Catch" up" Week" in" February" 2020." The" formative" mini" ISCE" will" give" you" the" opportunity"to"learn"more"about"the"exam"process"and"domain"marking"by"completing"modified" domain" mark" sheets" for" your" peers." Above" all," the" formative" mini" ISCE," and" other" formative" clinical"assessments"that"you"undertake"whilst"on"clinical"placement,"are"a"learning"experience-"a" great" opportunity" for" you" to" learn" more" about" what" is" expected" of" you" in" the" clinical" assessments,"to"test"your"existing"knowledge"and"focus"your"future"learning"to"achieve"your"best" potential"in"future"clinical"assessments." " You"will"rotate"in"pairs"around" six"15"minute"ISCE"stations.""You"will"each"undertake"three"of"the" stations" in" full," under" exam" conditions," working" individually" and" each" of" you" will" observe" your" peer"undertaking"three"stations."After"completing"each"of"the"stations,"you"will"then"be"provided" immediate"verbal"feedback"from"your"examiner"and"written"feedback"via"MyProgress."" " Building"upon"your" experiences"of"peer"marking"in"the"year"2"formative"ISCEs," you"are"asked"to" complete"a"formative"feedback"mark"sheet"for" your"colleague."This"provides"another"dimension" to"the"feedback"that"you"receive"and"has"the"added"advantage"of"giving"you"good"insight"into"the" expectations"of"examiners,"the"exam"process"and"domain"marking,"in"the"summative"ISCE."At"the" end" of" the" rotation," you" will"also" be" given" the" completed"‘peer" marksheets’" to" take" away" with" you." " This"is"just"one"opportunity"for"formative"feedback"on"your"clinical"skills"and"you"should"be"using" every"opportunity"on"clinical"placement"to"obtain"feedback"from"consultants"and"other"clinicians," many" of" whom" are" examiners." The" formative" mini" ISCE" is" designed" to" give" you" an" idea" of" the" types"of"station,"timings"etc." Simulated"patients"are" experienced"and"specifically"trained"to"give" appropriate"feedback"and"this"model"has"been"shown"to"be"highly"beneficial"in"previous"years." " All" SLEs" performed" during" year" 3" and" 4" should" be" thought" of" as" a" formative" attempt" getting" feedback"from" a" range"of" assessors"including"consultants." The" marking"forms" for"the" SLEs" have" been"devised"specifically"with"this"in"mind"as"they"mirror"the"domains."Senior"faculty"from"both" year" 3" and" 4" continuously" emphasize" that" students" should" be" doing" many" more" than" the" minimum"detailed"in"the"handbooks."The"more"SLEs"you"do,"the"more"feedback"you"get." " There"is"no"‘global"rating’"on"formative"feedback"mark"sheets,"and"no"numerical"score,"however" feedback"from"your"peers"will"support"you"in"your"final"few"months"of"preparation"ahead"of"your" summative"ISCE."Your"completed"peer"marksheets"may"be"taken"away"on"the"day,"but"you"MUST" NOT" remove" any" other" paperwork" from" the" sessions" (scenarios," clinical" resources" etc.)" Please" note" the" formative" ISCEs" are" not" standard" set" and" therefore" you" will" not" be" told" whether" you" have"‘passed’" or" ‘failed’-"instead" the" feedback"they" will"receive" will" be"aimed" at"helping" you" to" identify" your" strengths"and" weaknesses" in" your" clinical" and"examination" technique." You" will" be" allocated"a"specific"time"and"pairing"prior"to"the" session"and"will"be"notified"in"advance"when"&" where"to"attend." ! ! ! ! " " 4"

! Giving"feedback"to"your"peers:" DO! •" •" •"

say"what"they"did"well" say"what"could"be"done"better"and"how"(be"specific)" say"HOW"to"improve"(e.g."practise"with"patients,"clinical"skills"lab,"books,"e-learning" resources,"etc.)"

" DON’T! •" Be"so"negative"they"feel"they"cannot"improve"" •" " Overstate"the"quality"of"the"performance"(or"lack"of"it)"-"the"feedback"should"be"candid" " "

Summative!ISCE! " In" the" summative" year" 4" ISCE," you" are" required" to" undertake" twelve! 15! minute! ISCE! stations," enabling"appropriate,"coverage"of"the" key"areas"of" the"C21" practice"domain"learning"outcomes." There" will" be" a" 3" minute" gap" between" each" station" to" allow" you" adequate" time" to" prepare" for" your"next"station"and"to"allow"examiners"and"simulated"patients"time"to"give"written"feedback."" " Stations"will"involve"a"variety"of"tasks,"for"example"you"may"be"required"to:" " • Communicate"with" a"patient" or" their"relative"or" a"colleague-"for" example""take" a"history" +/-""give"an"explanation"or"discuss"a"patient"with"a"colleague" • Perform"a"clinical""examination"" • Perform"a"clinical"procedure"relating"to"the"patient"you"have"examined"or"taken"a"history" from"" • Interpret"clinical"data"e.g."X-rays,"ECGs"and"biochemistry" • Answer" questions" relating" to" diagnostic" synthesis," clinical" care," management" planning" and"patient"safety." " Each" station" is" standardized" ensuring" a" fair" examination" during" which" each" student" sees" the" same" group" of" cases" and" is" asked" to" perform" the" same" clinical" tasks" with" the" same" set" of" questions" as" all" the" other" students" taking" the" examination" on" your" particular" day," so" that" everyone’s" examination" experience" is" equivalent." Instructions" will" be" on" display" outside" each" station"but"may"be"repeated/clarified"by"the"examiners"as"necessary." " In"order"to"avoid"overload,"and"to"facilitate"you"having"the"best"opportunity"to"demonstrate"your" knowledge" and" skills" in"all" areas," the"12" stations" are" organised" across" 3" consecutive" days,"with" each" of" you"undertaking" 4" stations" per" day." You" will" be"notified" approximately" 2" weeks" before" the"ISCE"week"your"specific"rotation"timings,"venues"and"dates"via"Learning"Central."" " Normally,"six"stations"are"based"on"physical"examination."You"will"be"expected"to"assess"patients" presenting"to"any"speciality"or"to"primary"care."There"will"also"normally"be"six"simulated"patient" based" stations," two"acute" stations," during" which" you" will" be"assessed" on" your’" ability" to" assess" and" manage" patients" presenting" acutely," two" which" will" assess" your" ability" to" assess" and" 5" "

communicate" with" patients" presenting" in" psychological" medicine" and" finally" two" stations" assessing"learning"outcomes"and"competencies"based"on"the"Women,"Child"and"Family"module." " Different"stations"will"be" used"for"each"day"of"examinations,"in"order"to"ensure"fairness"to"all" of" you"as"you"will"be"sitting"the"stations"across"different"days"in"varying"sequence."Please"note,"each" type" of" station" may" be" undertaken" in" any" of" the" exam" venues" and" are" randomly" arranged" in" 2019/20"across"the"3"days"of"exams."This"is"based"upon"feedback"from"students"in"previous"years" that"specific" venues"for" particular"stations" would"increase" anxiety"for" a"particular" day"of" exams" for"some"students." " You! should! expect! to! be! corralled! on! the! day! of! exams! to! ensure! that! students! on! different! rotations/!timings!on!any!one!day!do!not!communicate!with!one!another,!which!could!provide! an! unfair! advantage! to! some! students." The! exact! times! that! students! are! corralled! will! vary! depending!on!the!rotation!to!which!you!have!been!allocated.!Please!note!you!are!permitted!to! bring! drinks! and! snacks! to! these! holding! rooms! and! you! will! be! required! to! hand! in! all! electronic!devices.! ! You"are"being"assessed"on"your"clinical"and"communication"skills"and"taking"notes"during"stations" may"detract"from"your"communication"directly"with"the"patient!therefore!you"are"not"permitted" to"use"pens"and"paper"to"take"notes"during"the"ISCE"stations"unless"it"is"a"specific"component"of" the"station"for"example"documenting"a"procedural"skill"result,"of"making"note"sin"an"SBAR" station."" ! ! When?" and"Where ?" The"summative"ISCE"will"be"conducted"in"three"parallel"venues"across"three"days."At"each"venue," a" number" of" parallel" circuits" will" run" in" order" to" accommodate" everyone" across" the" 3" days" of" exams."Please!refer! to!Learning!Central!for! specific!dates!of!the! exam!within!the! assessments! calendar." You" will" be" informed" of" your" allocation" to" a" specific" venue," date" and" time" approximately"2"weeks"before"the"examination"for"each"of"the"three"days."" " " Timings" An"alarm"will"sound"at:" 0"minutes" 7"minutes" 11"minutes" 13"minutes" 15"minutes" " These"alarms"will" sounds" at"these" times" regardless"of" the"format" of" the"station" you" are"sitting-" your"examiner"will"guide"you"if"the"timings"vary"for"a"particular"station." " If"you"finish"early,"you"MUST"stay"in"the"room"until"the"end"of"station"alert"sounds,"If"you"haven’t" finished"by"the"end"of"the"time"allowed"for"the"station,"you"MUST"move"on"to"the"next"station"in" order"that"you"get"the"appropriate"preparation"time"for"the"next"station." " "

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You" will" have" 3" minutes" in-between" stations" in" order" to" move" between" stations" and" read" the" station" briefing." The" examiners" use" this" time" to" complete" mark" sheets" and" write" formative" domain"linked"feedback"for"you,"in"order"to"support"your"further"learning." " These"sub-timings"are"given"to"guide"you"through"the"various"elements"of"the"station"in"order"to" ensure" you" have" sufficient" time" to" answer" as" many" elements" of" the" station" as" possible." The" examiner/"station"guide"will"normally"allow"you"to"move"on"to"the"next"element"of"the"station"if" you" have" completed" the" previous" element," however" if" you" the" subsequently" want" to" go" back," you" would" not" normally" be" permitted" and" would" not" normally" be" credited" for" answers" given" after"the"allotted"time"for"that"element"of"the"station." " You" will" have" 3" minutes" in-between" stations" in" order" to" move" between" stations" and" read" the" station" briefing." The" examiners" use" this" time" to" complete" mark" sheets" and" write" formative" domain" linked" feedback" for" you," in" order" to" support" further" learning." Further" details" regarding" the"station"timings"for"the"various"different"kinds"of"station"are"detailed"on"pages" 16-25,"noting" in" the" acute" stations" the" station" guide" will" be" responsible" for" guiding" you" through" the" various" elements"of"the"station." ! Attendance!is!compulsory.!You!must!display!your!University!ID."Students"who"are"either"absent" with" good" cause" (as" defined" by" the" University)," or" who" cannot" take" an" assessment" on" the" due" date" and"have" obtained" prior" approval" for"that" absence," must" take"the" assessment" at" the" next" available"opportunity."In"most"cases,"this"means"sitting"the"examination"as"a"‘first"sit’"during"the" re-sit"examination" period."If"this" re-sit"examination" is"missed,"then" the"next"opportunity"will" be" the"following"academic"year,"necessitating"the"repeating"of"Year"4.""" " Should!you!be!acutely!unwell!and!are!going!to!be!absent!from!an!assessment!you!must!notify! the!Year!coordinator!on!5th!floor!Cochrane!ASAP.!You!must!submit!Extenuating!Circumstances,! together! with! appropriate! evidence,! to! account! for! your! absence." You" can" find" further" information"regarding"Extenuating"Circumstances,"including"deadlines"and"dates"for"submission," on"Learning"Central."We"do"not"accept"self-certification"or"medical"notes"written"by"members"of" your"family"for"absence"from"an"assessment."" " "

Patients! Real"patients" Real" patients" are" used" in" some" stations." Please" remember" that" many" real" patients" will" have" physical"signs"that" you"are"expected"to" identify"and"recognise"and" other"patients"may"not" have" abnormal"physical"signs."" " Please"also"remember"that"patients"of"all"ages"tire"easily"or"may"need"to"go"to"the"toilet"etc.,"and" therefore" you" should" be" aware" that" it" may" be" necessary" for" the" time" between" stations" to" be" extended"or"for"you"to"be" placed"on"a" rest"station"during" your"circuit,"should"a"patient"become" unwell"during"the"examination"and"require"substitution." " " " 7" "

Simulated"(actor)"patients" Actors" enable" us" to" assess" clinical" competencies" that" would" be" difficult" to" provide" in" a" standardized"manner"to"all" of"you"with" real"patients."All" are"experienced"role"players" and" some" will"be"familiar"faces"from"the"communication"skills"workshops."The"actors"have"detailed"scripts" for"their"roles"and"attend"training"sessions"before"the"exams"to"go"through"these"roles"to"ensure" they" are" able" to" play" them" consistently," however" there" will" inevitably" be" minor" variations" and" these"are"taken"into"account"by"examiners"when"marking." " Feedback" from" simulated" patients" themselves" do" not" currently" contribute" towards" the" summative"mark" for"your"performance"in"ISCEs,"but"their"feedback"does"contribute"towards"the" formative"feedback" you"will"receive" after"the"exam" and"gives"you" a"useful" insight"into"how" you" are"perceived"by"patients"in"terms"of"your"interaction"with"them."" " "

Examiners! Examiners" are" experienced" teachers" who" are" aware" of" the" expected" level" of" performance" and" knowledge" of" the" students" assessed." In" addition," examiners" are" required" to" undertake" regular" Cardiff"University"School"of" Medicine"undergraduate"examiner"training"and" provide"evidence" of" regular"Equality"and"Diversity"training." Examiner"conduct"is"monitored"by"the"University"through" a"combination"of"peer"review,"psychometric"performance"monitoring"and"by"External!Examiners," present" during" clinical" assessments." This" ensures" that" the" process" is" fair" and" that" the" standard" expected"from"you"are"equivalent"to"students"at"the"same"level"at"other"medical"schools."On"the" day" of" each" clinical" assessment," examiners" attend" a" briefing" and" attend" station" calibration" discussions" in" order" to" ensure" consistent" application" of" marking" schedule" and" student" experience." " Each"examiner"marks"objectively,"stays"within"the"station"and"marks"the"same"station"all"the"way" through"the"circuit."External"examiners"may"also"be"present"during"the"examination,"ensuring"fair" process."Examiners"in"training"may"also"be"present"observing"the"stations." On"some"stations,"for"example"the"acute"stations,"there"is"a"second"member"of"staff,"the"‘station" guide’"who" is"responsible"for" guiding"you" through"the"station" and"asking" all"questions,"allowing" the"examiner"who"is"marking"the"station"to"focus"upon"your"demonstrated"skills." " "

Student!conduct! ! Student!conduct-!please"also"refer"to"the"Student"Intranet"(Academic"Regulations)." " You! are! expected! to! conduct! yourself! in! a! professional! manner! throughout! all! examinations,! both! formative! and! summative." You" should" wear" smart" clothes," appropriate" to" a" clinical" environment-" making" sure" that" your" name" and" your" number" are" clearly" displayed" for" the" examiner"and" ensuring"sleeves" are"rolled" up,"hair" is"tied" back"etc." Please"refer"to" the"All" Wales" NHS" Dress" Code-found" on" Learning" Central." You" are" required" to" bring" your" Cardiff" University" student"ID" badge"with"you" to"the" ISCE"and"this" will"need" to"be"visible" to"the" examiners"in"each" station."You"must"however"ensure"that"whilst"examining"patients"and"performing"any"procedural" skills"that"your"lanyard"doesn’t"present"an"infection"control"hazard."" "

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" You" must" follow" all" instructions" given" by" the" assessment" team" and" invigilators." You! are! permitted! to! bring! your! stethoscope! and! a! watch! (EXCLUDING! smart! watches! e.g." Apple" Watches,"Samsung"Gear" etc)."All"other" possessions"should"be" placed"for"secure" handling"as"per" instru...