5 ESSENTIAL SKILLS YOU NEED FOR YOUR SPECIALIST MEDICAL COLLEGE EXAMINATIONS
“I know how to do what I am trained to do, but at the actual moment when I am expected to demonstrate that knowledge and skill, I don’t perform optimally.”
Whether you’re about to face the Divisional Clinical Examination for The Royal Australasian College of Physicians (RACP), the viva component of The Australian and New Zealand College of Anaesthetists’ (ANZCA) anaesthesia exams, or the clinical or oral examination for one of our many other specialist medical colleges here in Australia, it’s normal to feel a little nervous or anxious about what’s coming up ahead.
Here are five practical skills you need to master to set yourself up for success in your specialist medical college clinical or oral exam.
BEFORE THE EXAM OR BETWEEN CASE STUDIES
1. MINDFULNESS
Lomas et al. (2017) performed a systematic review of mindfulness research papers and discovered that mindfulness has a beneficial impact upon mental health; with the strongest results for improvement linked to anxiety and stress. This systematic review included 153 publications, involving 12,571 participants, covering a wide range of occupations including physicians (10 studies), nurses (16), disability professionals (4), therapists, psychologists and counsellors (24), mixed (non-specific) mental health professionals (8), mixed (non-specific) healthcare professionals (20) to name a few.
One of my favourite mindfulness techniques is the 5-4-3-2-1 Grounding Technique which helps you to manage your anxiety by anchoring to the present. It only takes a few moments and not only is it the perfect way to dampen those nerves and worries, it’s a great way to help you familiarise and get comfortable with your exam environment.
Take a few slow, deep breaths and then:
look for 5 things that you can see,
become aware of 4 things that you can touch,
acknowledge 3 things that you can hear,
notice 2 things that you can smell, and finally
become aware of 1 thing that you can taste.
That’s it!
For a more comprehensive coverage of 5-4-3-2-1, head over to https://insighttimer.com/blog/54321-grounding-technique/
2. BREATHE
Hopper et al. (2019) performed a quantitative systemic review to evaluate the effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults 18 years and over; with positive results.
One of my favourite breathing techniques is the Box Breathing Technique which is also used by the United States Navy SEALs. Like 5-4-3-2-1, this too only takes a few moments to implement.
The name “box breathing” is a reference to the fact that a two dimensional box (or square) has four sides. To perform this technique, you breathe whilst slowly counting to four for a total of four times:
breathe in slowly for four counts,
hold your breath for four counts,
breathe out slowly for four counts, and finally
hold your breath for four counts.
Repeat this as many times as you need until you feel yourself enter into a relaxed, calm state. If it helps, visualise yourself drawing the four sides of the box whilst breathing.
That’s it!
For a more comprehensive coverage of the Box Breathing Technique, head over to https://health.clevelandclinic.org/box-breathing-benefits/
DURING THE EXAM
3. KEEP BREATHING
Seriously, keep breathing. Slowly.
After studying 78 people (41 men and 37 women with a mean age of 23), Laborde et al. (2022) concluded that slow-paced breathing improved one’s executive function performance. Executive function essentially describes the set of skills that underly your cognitive capacity - your ability to make decisions, plan and solve problems; all of which depend on the three core executive functions at the heart of this study - inhibition, working memory, and cognitive flexibility.
4. LOOK AND SOUND CONFIDENT, EVEN IF YOU’RE NOT FEELING IT
“You are being judged on your confidence and competence, not just your content, and the way you appear and how you sound matters.”
- Gallo (2018)
Blankespoor et al. (2017) demonstrated that it only takes 30-seconds for your audience to formulate a judgment on your competence, with that judgment having a direct flow through to your results in a corresponding manner (i.e. positive impressions leading to positive results vs negative perceptions leading to negative results).
Gallo’s recommendations on how to look confident include:
making eye contact with your audience,
keeping an open posture,
using gestures, and
dress 25% better than anyone else in the room.
Gallo’s recommendations on how to sound confident include:
eliminating filler words,
taking time to pause,
varying your pace,
replacing long words with short ones, and
rehearsing under stress.
One I would add in here would be to speak loudly and clearly.
For a more comprehensive coverage of Gallo’s recommendations, head over to https://hbr.org/2019/10/how-to-look-and-sound-confident-during-a-presentation and https://hbr.org/2018/05/5-ways-to-project-confidence-in-front-of-an-audience
AFTER THE EXAM OR BETWEEN CASE STUDIES
5. SAVOUR THE MOMENT
When it comes to our own personal performance, we tend to be quite tough on ourselves; critical and judgmental in ways that others may not be.
After an event is over, in this case your exam or a component of the exam, there is nothing further you can do to influence the outcome. Everything within your locus of control happened in the moments preceding this one. What is within your control is the ability to enjoy, or savour, the moment.
You may have just completed the last hurdle to your very long journey towards specialist registration. Bask in the moment and revel in the accomplishment of having made it this far. You will never get this moment back. Be proud, whatever the outcome. Don’t skip past this moment in your rush to get to the next hurdle. Bryant (2017) outlined the existence of 10 identified savouring strategies which included things such as sharing with others, memory building, self-congratulating and the counting of blessings.
What we pay attention to has a significant impact on our overall wellbeing. If you allow critical thoughts to enter your mind and let them consume you, it could impact your mood and hamper your ability to perform as well as you could in your next case study or impact how you show up and experience the things that occur for the remainder of your day or even your week.
WHAT’S NEXT?
IT’S TIME TO BALANCE YOUR BOOK SMARTS OUT WITH YOUR STREET SMARTS
Don’t just focus on studying the books and acquiring more knowledge, or applying that knowledge intellectually on paper, when it comes to preparing for your specialist medical college clinical or oral exam.
Get up and role play it. Go practice on willing family members, friends, peers, colleagues and other supporters where possible. When doing your job and working the floors of the hospital, be more conscious about your words and actions to learn from every case and every interaction you have with a patient.
Get professional help.
“Great coaches...are your external eyes and ears, providing a more accurate picture of your reality...they’re breaking your actions down and then helping you build them back up again.”
- Dr. Atul Gawande
A non-doctor coach with rigorous coaching psychology training and decades of professional wisdom in leadership, relationship, performance and wellbeing can offer you fresh perspectives gained from an evidence base and lived experiences outside of healthcare and medicine (Bozer et al., 2014).
Lai-Ling has spent decades helping executives and leaders at all levels to:
overcome their barriers to public speaking,
confidently communicate,
present information to their audiences in impactful ways, and
build strong interpersonal relationships with their customers, colleagues and communities.
These are human skills that transcend all industries, professions, titles or stages of training. This is how you fundamentally connect and interact with others, human to human. These skills will not only help you lift your confidence levels as you prepare for your specialist medical college clinical or oral exams, they will help you establish solid foundations in your professional practice and in your personal life for years to come.
A non-doctor coach can help you see what you don’t see, spot where you’re veering off course, and help you find ways forward because we’re not focused on your medical or technical expertise. You have a myriad of other support mechanisms for that already. We focus on helping you improve your confidence in connecting and interacting with others, your human skills.
For more information on how Lai-Ling can help you prepare for your specialist medical college clinical or oral exams, head over to https://www.helloagility.com.au/thriving-in-healthcare-medicine/preparation-for-specialist-medical-college-clinical-or-oral-examinations
REFERENCES
Blankespoor, E., Hendricks, B. E., & Miller, G. S. (2017). Perceptions and Price: Evidence from CEO Presentations at IPO Roadshows. Entrepreneurship & Finance eJournal.
Bozer, G., C. Sarros, J., & C. Santora, J. (2014). Academic background and credibility in executive coaching effectiveness. Personnel Review, 43(6), 881-897. https://doi.org/http://dx.doi.org/10.1108/PR-10-2013-0171
Bryant, F. B., & Veroff, J. (2017). Savoring: A new model of positive experience. Psychology Press.
Cleveland Clinic. (2021). How Box Breathing Can Help You Destress. Retrieved 08 May 2023 from https://health.clevelandclinic.org/box-breathing-benefits/
Gallo, C. (2018). 5 Ways to Project Confidence in Front of an Audience. Retrieved 08 May 2023 from https://hbr.org/2018/05/5-ways-to-project-confidence-in-front-of-an-audience
Gallo, C. (2019). How to Look and Sound Confident During a Presentation. Retrieved 08 May 2023 from https://hbr.org/2019/10/how-to-look-and-sound-confident-during-a-presentation
Gawande, A. (2017). Want to get great at something? Get a coach. https://www.ted.com/talks/atul_gawande_want_to_get_great_at_something_get_a_coach?language=en
Hays, K. F. (2009). Performance Anxiety. In K. F. Hays (Ed.), Performance Psychology in Action (pp. 101-120). American Psychological Association. http://www.jstor.org/stable/j.ctv1chs4mh.11
Hopper, S. I., Murray, S. L., Ferrara, L. R., & Singleton, J. K. (2019). Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review. JBI Database System Rev Implement Rep, 17(9), 1855-1876. https://doi.org/10.11124/jbisrir-2017-003848
InsightTimer. (2020). The 5-4-3-2-1 Grounding Technique: Manage Anxiety By Anchoring In The Present. Retrieved 08 May 2023 from https://insighttimer.com/blog/54321-grounding-technique/
Laborde, S., Allen, M. S., Borges, U., Hosang, T. J., Furley, P., Mosley, E., & Dosseville, F. (2022). The Influence of Slow-Paced Breathing on Executive Function. Journal of Psychophysiology, 36(1), 13-27. https://doi.org/10.1027/0269-8803/a000279
Lomas, T., Medina, J. C., Ivtzan, I., Rupprecht, S., Hart, R., & Eiroa-Orosa, F. J. (2017). The impact of mindfulness on well-being and performance in the workplace: an inclusive systematic review of the empirical literature. European Journal of Work and Organizational Psychology, 26(4), 492-513. https://doi.org/10.1080/1359432X.2017.1308924