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Guidelines for MD Paediatric Residents
XII Final examination
Components of the Final Examination:
The knowledge and psychomotor skills of the students are assessed through two systems: internal assessment and final examination. Examination has two components: through theory and practical examinations.

Examination in theory is done through two papers: general paediatrics and recent advances. General paediatrics consists of MCQ and recent advances consist of short answer questions.

Practical examination is conducted under the four headings: Long case, short case, OSCE and Viva voce.

Practical examination
Components Time allowed Max. Marks Min. Pass Marks
A. CLINICAL      
LONG CASE
(One)
60 minutes 30 minutes for
history taking and
30 minutes for
discussion
50 25
SHORT CASE 60 minutes 50 25
(Four) (includes both
examination and
discussion)
   
`B. OSCE AND VIVA VOCE
OSCE 75 minutes (2 minutes per
station. It consists
of slides, heart sounds, dummy,
X-rays, pictures, ECG,
Lab. reports, patients, parents)
50 25
VIVA VOCE 30 minutes (15 minutes in each
table. Each table will
ask 5 questions relating
to the areas as mentioned
in the assessment form)
50 25
Candidates have to pass clinical examinations (long case , short case, OSCE and Viva Voce separately).
Assessments methodology:
A pair of examiners ( one external and one internal) duly appointed by the examination section will assess the candidates in each subcomponent.

Each examiner will be provided with separate assessment sheets for each candidate. Areas on which the candidate has to be assessed are listed on these forms. Examiner examining the long case will not examine the short cases and vice versa.

Each examiner has to rate the candidate on all the areas identified in the assessment form even though he/she will ask questions from on section only.
Hence, at the end of assessment each examiner would have given ratings for all the areas identified in the assessment form for each subcomponent. Assessment forms have to be filled with ink and will be collected immediately. The examiner shall not communicate the marks given to the candidate or to the co-examiner.
If the disparity of marks given by the two examiners in each subcomponent is more than 50% it should be decided by the meeting of all the examiners for that subcomponent.

Objectives of the clinical examination:

Long case:
The objectives of the long case examination is to assess:
-history taking and clinical examination skills in identifying relevant information and presenting them effectively and efficiently.
-Critical thinking and problem solving skills including investigations and management.
-Knowledge of the latest advances relevant to a particular health problem.

What do the examiners do during the "long" case examination?

During history and clinical examination part:

The candidates will be given 30 minutes for the history taking and clinical examination.
During this period examiners will stay two feet apart (minimum) at the foot end of the bed and observe the candidates performance without any discussion.
The examiner should not interrupt the candidate nor comment on his/her performance while the candidate is taking the history or performing the clinical examination.
When the candidate finishes this part in 30 minutes each examiner will give the marks with ink in the respective column of the long case form.

During case presentation and discussion:
After completion of 30 minutes the examiners will ask the candidate to present the findings and history and examination and discuss the case with him/her.

The total time for this section is 30 minutes (15 minutes per examiner). The areas to be assessed are listed in the assessment form.
The two examiners should mutually divide the areas amongst themselves before examining the candidate and may interchange the areas while examining the second candidate
In case the candidate asks for the results of investigations, these should be provided, if available.

Short cases
Objectives:

The objectives of the short case examination are to assess:
- performance on a particular component of the systemic examination or regional examination.
-detection and interpretation of clinical findings.
-developing a management plan.

What do the examiners do during the "short case" examination?

During this period the pair of examiner should stand at a reasonable distance and at a position from where they can observe the candidate's performance.
The examiner should ask the candidate to present the findings on examination and discuss the case. Total time for one patient is 15 minutes (8 minutes for examination and 7 minutes for discussion).
The two examiner should mutually decide who will take lead in questioning a candidate and may interchange the next candidate.
The areas to be assessed are listed in the assessment form.


Viva voce examination

Objective:
The objectives of the viva voce examination is to:
-Determine whether the candidate possesses a sound knowledge of the key features of the issue under discussion i.e. definitions, explanations etc.
-Determine whether the candidate is able to apply the possessed knowledge in interpreting related information and formulating a management plan.
-Determine whether the candidate is able to justify an action related to the key feature in curative, preventive and promotive paediatrics.
-Determine whether the candidate is able to comprehend the questions correctly, organize his/her thought and respond correctly.

What do the examiners do during the viva voce examination?

It is important that the viva voce examination is structured.
Examiners will meet one day ahead and will identify the topics, which should be covered in the examination. Each examiner should prepare a five set of questions and answers for this part of examination. These prepared questions and answers should be discussed on the morning of examination date. 10 questions should be selected in the morning of the examination date and it will be divided in two tables.

The areas to be questioned are grouped in two sections. One examiner should ask questions from one section and the other from the second. These sections may be interchanged while interviewing the next candidate.

All the candidates should receive the same questions. The two examiners should mutually decide who will take lead in questioning a candidate and may interchange the next candidate.

OSCE examination
Objective
The objective of OSCE are to assess the skills in
-clinical decision making.
-Detection and interpretation of clinical findings and laboratory data.
-Performance of a particular component of the clinical examination and counseling.
-Identification of a management plan.

What do the examiners do for the "OSCE" examination?

Examiners will select the slides, x-rays, laboratory reports, ECG reports, heart sounds and other items to be kept in the OSCE stations one day prior to the date of examination.

These stations will consist of unobserved/static and observed/interactive stations.

On unobserved/static stations the candidate will be presented with a clinical case, laboratory data, x-ray, ultra sound, CT scan, instrument, heart sounds etc and will be asked to give written responses to questions asked.

In the observed/interactive stations the candidate will have to perform a procedure for example counseling, assembling the instrument etc. One examiner will be present in these stations who will rate candidates performance based on the check lists.

         
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