Today I took part in a Gynaecology Pilot Study, to see how one could better assess communication skills in the context of cervical screening. We were required to play the role of the doctor in three scenarios: one, involving a nervous girl attending for her first smear; another, concerning a repeat smear for an inadequate sample; and thirdly, in the context of a Muslim couple, where the husband is controlling and upset that a male doctor is performing the smear.
We filled out feedback forms on our own performance, and those watching from a video link also graded us on various aspects of the consultations, as well as practical skills. We then gave our thoughts on the whole set-up and what we thought was good and could be improved in the future.
The system is a new approach implemented by Imperial College and called Integrated Procedural Performance Instrument (IPPI), whereby instead of performing a procedure on a dummy (and pretending it's a real patient) with an examiner present, the idea is a more natural approach, allowing more freedom and avoiding the contrived circumstances currently available for assessment. One can be graded by an examiner watching from another room, which aids the candidate's ease and flow.
Experiencing the trial first hand was interesting, not least as I had the chance to reflect on the way I deal with patients, as well as how I explain things to them. But it's also exciting to be involved in the evolution of medical assessment, and I commend the direction it is taking - currently we are assessed by Objective Structured Clinical Examinations (OSCEs), in which the time limits, lack of actors and patients to interact with and the presence of examiners makes the whole affair unrealistic and false. IPPI also encourages more personality than simply 'ticking all the boxes.'