Stations consist of several elements. There is a construct that is used by the examiner to assess candidates’ performance, instructions to candidates, instructions to the role player and marksheets.
The purpose of the construct is to define what the station is set out to assess in such a way that the examiner is clear as to what constitutes a competent performance.
These have a standardised format with elements in common between stations of a similar type. For example, a history taking station may include directions such as:
The candidate can be expected to
The candidate should
- explore the duration and extent of the problem
- elicit features of the presenting problem
- explore with the patient the effects of his or her problem
- obtain a comprehensive and relevant physical history
- explore how the patient’s work, family life, marriage and social life have been affected
There will be guidance about what particular areas of the history a competent candidate would cover followed by some general comments about interview/ communication skills that differ little between stations e.g.
The candidate should
- show an appropriate mix of open and closed questioning
- demonstrate advanced listening skills
- elicit information in a structured, focused, fluent manner
- demonstrate empathy with the patient’s experience
- avoid the use of jargon”
In some stations the, focus of the task may centre around interview/ communication skills.
The instructions to candidates
Outside each booth the candidates will, in the preparation time, be given access to a series of instructions that detail what is expected of them in the station.
These will consist of some information required to set the scene followed by explicit instructions as to what candidates are expected to carry out.
These specific instructions will be in bold and bullet point format to assist clarity. Sometimes, negative instructions will be included e.g. “The candidate is not expected to obtain a risk history.”
This is to assist the candidate in establishing the focus of the station.
The instructions to role players
All role players are professional role-players and have been thoroughly trained in the specifications of their roles.
Please note that following successful piloting of stations involving learning disabilities played by role-players with a learning disability, such stations are active and may appear as part of the examination.
The instructions for role players are designed to give role players sufficient information to play the required role and also to deal with eventualities when candidates stray from the defined tasks.
They are set up in such a way that the response to candidates will vary according to the degree of skill elicited by candidates.
An example would be that a candidate who is rude or abrupt may be met by irritability and/ or hostility just as would be the case in a real clinical setting.
For overall failing grades, examiners will also mark against a number of detailed feedback statements to enable useful feedback to be given to candidates.
These are not part of a marking checklist and are to be used for feedback only.
Examiners can also mark against a number of detailed feedback statements during their examination of a station, if they are applicable.
These do not form part of the marking checklist, but purely to enable candidates to reflect on their performance in the station.
Please note, the CASC is designed for purposes of accreditation and not training, and as such, the feedback statements will inevitably be limited in informing this.
Only those candidates who were unsuccessful at the CASC will be sent this formative feedback, so it may assist them in preparing for the next attempt.
Classification of diseases
Candidates are reminded that they are expected to know the principles of classification and to have a working knowledge of both ICD-10 and DSM-IV.
Use of alcohol gel
Health services, the public, patients and role players are increasingly aware of hygiene and infection control issues.
Therefore, there should be an expectation that candidates will cleanse their hands properly using the alcohol gel provided before and after physical examination of the simulated patient.
The gel will be placed in a prominent position within the station.
The candidate should take care not to splash gel on the role players’ skin or examine sensitive areas, such as the eyes, before the gel has dried.
Failure to use the gel will not in itself lead to the examiner failing a candidate but will result in the mark being one grade lower than performance of their physical examination would otherwise achieve.
Candidates do not need to remove ties or roll up sleeves.
This Guide forms part of the Eligibility Criteria and Regulations for the MRCPsych Examinations.