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How to make a Marking Rubric for your own PCE Mock Scenarios

If you have read our blog on How to Write a Mock Station for the PCE Practical Exam, you will understand the value of using mock scenarios to practice for the PCE and the extra benefits you gain from creating your own scenarios. What we have yet to cover is how to create a marking rubric for your stations. 

Creating a marking rubric is important so you have a standardized measure to evaluate the performance of the candidate.  However, it can be a bit tricky to come up with a system to make sure the candidate’s performance is evaluated both fairly and comprehensively. Marking rubrics used on the actual PCE are fairly complex. They evaluate not only how the candidate performs on the station, but how the candidate’s performance compares to other candidates for that same station nationally. For the purpose of creating your own scenarios and marking rubric, we have simplified the process to give you a complete but not overly complicated way to develop a standard for your own stations.  Here’s how to do it. 

Make a checklist.

We suggest you use a checklist for your marking rubric. This is a more simplistic rubric than you will be evaluated against for the actual PCE, but those examiners are trained for the station on how to mark performance on a scale rather than a simple ‘check if complete’ system. Since you will not gain any additional exam experience by learning this type of marking, we don’t recommend wasting time doing so. It is very different to referee a sport than it is to play it.  Although there may be some crossover in knowledge of the game, being good at one doesn’t necessarily translate to being good at the other. Same goes for this. Keep the evaluation process simple, but enough that you will have a good indication if you are doing well on a station. 

What to include.

1. Start with mandatory items.  These are simple. Every station requires the candidate to introduce themselves, explain the purpose of what they will be doing with the patient (purpose of the interaction), and consent for the interaction. These are not only mandatory items for each station, they should be routine for every station you practice. 

2. Include all contraindication and precautions. Although a station may not explicitly ask the candidate to vocalize these, they should always be built into the station checklist.  In our blog on How to Write a Mock Station for the PCE Practical Exam, we asked you to brainstorm a list of these potential issues, making sure each one has a line on your checklist. 

3. Note ethical considerations.  Not all stations will have ethical considerations, but if you have identified any from your brainstorming exercise, include a line for them in your checklist.  This is a fairly simplified way to evaluate ethics, but it will at least allow you to identify whether the candidate has acknowledged the ethical issues at play. Further analysis of ethics should occur as group discussions after the candidate has completed the station. 

3. Identify safety fails.  Similar to contraindications, all potential safety issues should have their own line on your checklist. This may include checking lines or tubes, ambulating with shoes, transferring with a belt, etc.  Make sure each identified item is listed and highlighted on your marking checklist. Missed safety considerations will mean a station fail on your actual exam.

4. Work through the station slowly. Step-by-step, write out exactly how you see the station going. Make each necessary step a box to check. This can be the tricky part but once you get going, it can roll pretty easily. (See my example below).

5. Body mechanics and positioning. There are always some points awarded for proper handling and body mechanics. Include this as a line in every checklist. This will not be a mandatory item to pass the station, but will be evaluated with points awarded for good technique.  It is definitely something to keep in mind as you and your partners work through mock stations.

If you are wondering how I created this station, check out our blog on How to Write a Mock Station for the PCE Practical Exam.

Here is the case, in case you missed it:

You are working as an inpatient physiotherapist in your local hospital. Your patient, Shayne, is a 15-year old boy who is one day post-operative ORIF for a right tibial metaphyseal fracture that was traumatic, simple, and complete. You are helping plan his discharge so he can go home today. 

Teach 2 home exercises to complete for the next week before he begins outpatient physiotherapy. 

Discuss the importance of early exercise intervention with the patient and his parent.

Here’s the checklist I created:

  1. Candidate introduces self to the patient.
  1. Candidate introduces self to the parent.
  1. Explains purpose of the interaction to BOTH patient and parent (note: this can happen at the same time but  should be directed at both).
  1. Gains consent for the interaction from the PARENT.
  1. Exercise #1:
  • Chooses an exercise that is appropriate to the stage of healing.
  • Adequately explains the exercise in easy to understand language.
  • Demonstrates the exercise using good positioning and body mechanics.
  • Has the patient practice the exercise in an appropriate position.
  • Enquires about level of comfort with the exercise.
  • Includes dosage (sets and reps) for the exercise.
  1. Exercise #2:
  • Chooses an exercise that is appropriate to the stage of healing.
  • Adequately explains the exercise in easy to understand language.
  • Demonstrates the exercise using good positioning and body mechanics.
  • Has the patient practice the exercise in an appropriate position.
  • Enquires about level of comfort with the exercise.
  • Includes dosage (sets and reps) for the exercise.
  1. Explains the importance of early exercise intervention. (must mention the following):
  • Prevent blood clots (DVT)
  1. Explains the importance of early exercise intervention (must mention 2 of the following):
  • Increase circulation
  • Decrease swelling
  • Prevent muscle atrophy
  • Stimulate bone healing
  • Decrease recovery time

In the above example, I highlighted safety and consent considerations in red. Those considerations would be mandatory for this station and if the candidate does not check either of these boxes, it would be an automatic station fail. The rest of the station is scored on percentage of boxes checked. Although there is no standard to percentage required for a pass or fail grade, it will give the candidate an indication of approximately how well they are performing on the station, and areas they are missing in performance.  It will also give the group a performance evaluation tool that can be used for discussion after the station is complete. 

Marking Written Questions for 5 minute stations.

We suggest that while you are practicing 5 minute stations, you also have the candidate answer written questions following the completion of the station, just as you will during the actual PCE.  It is best to pre-determine acceptable answers to the questions so the candidate’s answer can be scored afterward. Again, these questions will make good discussion points for the study group. It is not uncommon for group discussion to elicit additional answers that would be considered correct beyond what the marking sheet has indicated. If deemed appropriate by the group, these answers would also be considered correct. A similar process occurs during the actual PCE, and sometimes additional answers will be added to the scoring sheet on the day of the exam. 

Below I listed the follow-up questions and answers key for my mock station. 

  1. What is the legal age of consent in Canada? 

– 16

  1. What instructions would you give the patient if he was having trouble with high levels of pain during his exercises? 

– Do less sets or reps.

– Take pain medications prior to completing exercises.

– Try a different time of day.

– Take a break and try again later.

– Use ice/ heat before or after.

– Consult a doctor or physiotherapist.

  1. What concerns, if any, would you have for a metaphyseal fracture in a 15-year-old boy?

– DVT

– Alteration in growth plate function

 

That covers it! Don’t worry, it actually gets pretty easy with practice. Good luck with your exam!