Hands up if performance evaluations are the bane of your existence?

That’s definitely my case. It’s interesting, because I like performing on its own. Auditions? Not so much those – but I’m considerably less nervous when I’m standing on stage, where my objective is to enjoy whatever it is I’m presenting. Raise the stakes, however slightly, and you’ll definitely find me tachycardic and shaky, unable to downregulate this unwanted sympathetic response. This is easy enough to hide if I’m taking a history – my already fast speech accelerates and I’ll usually hold my hands in my lap to hide their shaking. If I’m taking vitals, that same shaking makes finding a radial pulse nearly impossible.

As referred to above, auditions – for various musical activities – and swim tests were the most stressful things for me between the ages of 9 and 15. Then began oral exams and driving tests – I actually cried when the person at the DSM told me I’d passed the written component required for my beginner’s license, so let’s not even talk about my subsequent in-car driving tests. I’m fine in panel or one-on-one interviews because there’s real-time feedback, but when there’s someone standing off to the side evaluating me without engaging, I become visibly nervous.

Medical school has challenged me in many ways. First, it taught me that I could, in fact, study and semi-retain vast quantities of written information, and that I was capable of taking the time out of my week and away from all other activities to do so (the next step in this learning has been to scale back on the studying and reprioritize myself, which could be a blog entry in and of itself). Then, it required me to remain actively engaged in my learning (which taught me that I’ve had tendencies of dissociating from some of my activities, treating them as tasks to be accomplished rather than lessons and skills to be acquired.) Finally, it has pushed me directly in the path of my largest discomfort – these dreaded performance evaluations – not only once, but regularly.

One of the nicest things about being in the French stream at uOttawa is that we have mandatory simulated clinics biweekly. I’ve been subjected to performance evaluations since my first weeks of medical school, which at first I dreaded but eventually came to  appreciate and even like. I’ve begun to feel more competent, to develop clinical reasoning, and to actually study history taking and physicals regularly – if there’s a risk of performing badly, then I think that most of us can’t help but practice.

Tonight’s OSCE serves as the final evaluation for our undergraduate physical skills development course. Because I’m been worried and stressing about it since September I’ve been practicing and studying with friends quite a lot, and am at the point where I’m confident in what I know and also confident that there’s still a lot to learn. At our stage most of us haven’t had a lot of clinical exposure yet, and so (for me at least) it feels like I’m going through rehearsed motions within a rigorous time limit at a time when I’d normally be in bed, sleeping (my group and session is quite late, and I go to bed relatively early). I’m far more relaxed than I thought I’d be, however, and am actually looking forward to self-evaluating my learning so far. I have a summer to practice and hopefully perfect any skills I’m lacking in before we start on the wards, and I’m as ready as I’ll ever be for this challenge – obligatory shaky hands and all. 🙂

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