How to do it ... be an examiner

H A Dudley
1979 BMJ (Clinical Research Edition)  
Your own self-image may be of a person as mild as milk, and your view of an oral that it is an exploration of what the candidate knows in an endeavour to lift him up over the examination hurdle. Rest assured that to the candidate you are inevitably an ogre, the examination a confrontation, and its objective to put him down. If you have been examining for any length of time you can also be certain that distortions and misconceptions about you abound. Usually the stories originated with the
more » ... d behaviour of someone else, but they will undoubtedly live on with you. The best you can hope for is that your reputation is of a beast, but a just beast. Because of this, though outwardly composed, the candidate must always be assumed to be uneasy and over the top of the arousal efficiency curve-that is, so tense that his performance is prone to fall off when any minute additional stress is applied-much as the performance of a failing heart does under increased load. Three things follow: make an extra effort not to be irascible, difficult, contrary, and ultimately exasperated; allow a warm-up period which can be up to 10% of the allotted time; and pose initial questions that are likely to be answered successfully by all candidates. In the warm-up, you can (if the examination regulations permit) ask about the candidate's background, present or future intended employment, and prospects. It is then usually easy to make a gentle transition to a simple question. It is no use switching straight from "I knew your father well" to "Just tell me how 2-3 DPG fits into the haemoglobin molecule." The velvet glove All questions should in fact start by telling the candidate the particular topic on which he is going to be interrogated: "Let's talk about gas exchange in the lungs," and "Now I am going to ask you about your plans for this patient," are examples of how to orientate the mind. If a glazed expression comes over the candidate's face on hearing this preliminary you must decide quickly whether to repeat the orientation or to try another subject. Repetition usually suffices. Now that the candidate is orientated and launched on a subject, the next point is to check on one's own expectations about his replies. Oral examinations in Britain are nearly always judged on what one might call a "floating standard"-an idea drifting about in the examiner's brain of what this examination requires in knowledge or performance or both. It is unusual for this standard to be well formulated and, though the lack of external reference points does not prevent the system from working reasonably well, it is good to keep constancy by asking the same or related questions of each batch of candidates. To do so is boring, but may expose, for example, that one or more of your questions is outside the ken of 95 % of the examinees. Then it should be eliminated or at least relegated to the last part of an oral that is going well, when it becomes desirable to stretch the candidate's performance in the interests of determining his position relative to others, or because it introduces a glimmer of intellectual light into what tends to be a gloomy task. It is only in the latter stage that one can usually expect a candidate to think as he goes, so questions that require concepts rather than facts are not usually well handled. If you want to introduce them, an even more careful preliminary build-up is necessary. To take a simple example: if I want to persuade a candidate to tell me the difference between the capillary and cell membrane in the context of water and electrolyte transfer, I start by drawing the total body water diagram and getting the facts about ionic content of the extra and intracellular compartments, then-and only then-move on to the question that I want answered. This
doi:10.1136/bmj.1.6161.471 pmid:427412 pmcid:PMC1597725 fatcat:ldtwfxtnvffalk34ebsrcljqie