Stephenson, C, Yeates, P and Lefroy, J (2020) Comparing the influence of ‘describing findings to the examiner’ or ‘examining as in usual practice’ on the students’ performance and assessors’ judgements during physical examination skills assessment. MedEdPublish, 9 (1). ISSN 2312-7996

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Within assessment of physical examination skills, two approaches are common: “Describing Findings” (students comment throughout); and examining as “Usual Practice” (students only report findings at the end). Despite numerous potential influences on both students’ performances and assessors’ judgements, no prior studies have investigated the influence of either approach on assessments.


Two group, randomised, crossover design. Within a 2-station simulated physical examination OSCE, we manipulated whether students “described findings” or examined as “usual practice”, collecting 1/. performance scores; 2/. Students’/examiners’ cognitive load ratings; ratings of the 3/. fluency and 4/. completeness of students’ presentations and 5/. Students’ task-finishing, comparing all 5 end-points across conditions.


Neither students’ performance scores nor examiners’ cognitive load were influenced by experimental condition. Students reported higher cognitive load (7/9) when “describing findings” than “usual practice” (6/9, p=0.002), and were less likely to finish (4 vs 12, p=0.007). Presentation completeness was higher for “describing findings” (mean=2.40, (95CIs=2.05-2.74)) than “usual practice” (mean=1.92 (1.65-2.18),p=0.016), whilst fluency ratings showed a similar trend.


The decision to “Describe Findings” or examine as “Usual Practice” does not appear neutral, potentially influencing students’ efficiency, recall and (by inference) learning. Institutions should explicitly select one option based on assessment goals.

Item Type: Article
Additional Information: MedEdPublish: rapid, post-publication, peer-reviewed articles on healthcare professions’ education. For more information please visit or contact This has been published under Creative Commons "CC BY 4.0" (
Uncontrolled Keywords: influence, examiner, practice, physical exercise,
Subjects: Q Science > Q Science (General)
R Medicine > R Medicine (General)
R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Depositing User: Symplectic
Date Deposited: 23 Jan 2020 09:08
Last Modified: 29 Jul 2020 10:14

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