I came out of one station in my disaster exam feeling incredibly annoyed with the world because I’d done a good examination, and nobody paid any attention to my findings.
What I’d actually done was found clinical signs, but I hadn’t demonstrated any of them. I knew they were there, but the examiner had no way of knowing that I’d seen them. I came out feeling very aggrieved: I’d found the signs, identified the diagnosis… what more did they want??
And then, I remembered my experiences of examining the medical students a few years ago. It was a summer afternoon; it was hot; I was tired and I’d left my registrar on my ward. By the time the 3rd candidate came through, it was really hard to focus on exactly what they were doing. Added to which it was a tiny room, and I couldn’t see half the examination. I was completely dependent on the candidate’s approach to telling me what they were doing, and the reaction of parent and child to decide if I felt they were competent.
The clinicals were the same. I hadn’t been clear in what I was doing, and as a result, the examiner had no way of knowing what I’d actually done. Finding the answer/diagnosis at the end isn’t what the exam is really measuring: it’s about how you get the answer. And you have to show your working; demonstrate your findings (not just identify them).
It’s like a driving test…
I failed my driving test first time around too, btw. Just saying. And I can’t drive: I have a licence, but please don’t get me behind the wheel of a car. It’s so long since I drove that my photocard has expired, and I can no longer use it for ID. Not that I get asked anymore…
Digression aside, just like in the driving test, you have to demonstrate that you’re doing all the right things. Especially if the examiner is crammed into a tiny corner, or isn’t feeling too good (or just really, really needs a coffee).
Everyone has their own way of doing this. But if your practice group don’t think that you’ve demonstrated the clinical signs, then the chances are, the examiner won’t think that you have either.