Jinelle Ramlackhansingh¹
Fern Brunger¹
1 Memorial University 

This work is part of a critical ethnography examining professional identity development of pre- clinical medical students at one Canadian medical school. The research examined the hidden curriculum conveyed through the OSCE evaluation process. 

Focus groups with students were conducted every six weeks. Faculty and administrative staff were interviewed. The data was supplemented by participant observation of some classes and governance meetings. The theoretical frameworks of Bourdieu and Foucault were used in analysis. 

Students described the OSCE as a space in which they were placed on display for the purpose ofjudging. As“Mila”putit,“youhavetoknockonthedoorandgoin,there’speoplewatching you behind the glass... ...watching you in the corner and grading you...” 

The students unknowingly identified Foucault’s description of the panopticon in their discussion of the OSCE experience. They described how they are under surveillance and are self-disciplined as they are watched and judged during their examination. The power of the panopticon ensures that the students' performance/examination is correctly completed: disciplinary power is exercised through hierarchical observation and examination of students to confirm that the standardized performance is acceptable. 

The OSCE perpetuates a disciplinary discourse as the students are under surveillance. Students are disciplined in the standardization of patient management and run the risk of developing pseudo-competence and hiding patient discrimination in their OSCE. 

Medical educators should consider that during the OSCE, students are self-disciplined to perform correctly. This surveillance risks students hiding unprofessional prejudices to perform what they understand to be the required mould of a "good doctor." 

References (maximum three) 

Foucault, M. (1979). Discipline and punish: The birth of the prison (Vintage Books ed.). Vintage Books. 

Foucault, M. (1982a). The subject and power. In H. Dreyfus & P. Rabinow (Eds.), Michael Foucault: Beyond structuralism and hermeneutics. (Vol. 1–Book, Section, pp. 208–226). Chicago University Press. 

Hyslop-Margison, E., & Rochester, R. (2016). Assessment or surveillance? Panopticism and higher education. Philosophical Inquiry in Education, 24(1), 102–109. https://doi.org/10.7202/1070559ar