Paul Warren

Objective: To determine whether the marks in the third year Objective Structured Clinical Examination were affected by the collusion reported by the students themselves on an electronic discussion board.Design: A review of the student discussion, examiners’ feedback and a comparison of the marks obtained on the 2 days of the OSCE.Participants: 255 third year medical students.Setting: An OSCE consisting of 15 stations, administered on three sites over 2 days at a UK medical school.Results: 40 students contributed to the discussion on the electronic discussion board. The main points raised were perceived inequity between students who did, or did not, have prior knowledge of the station content, and the lack of honesty and professionalism of their peers. Most contributors claimed to have received, or knew of others receiving, prior knowledge, but none confessed to passing on information. No significant difference was observed in the overall mark for the OSCE on day 1 ) and day 2 ). On day 2, marks were considerably greater for four stations and markedly lower for three stations. It was not obvious why collusion should affect these station marks. A clear indication of the effects of collusion could only be obtained from a single subsection of an individual station where 82 students on day 2 incorrectly gave the diagnosis from day 1.Conclusion: Marks do not provide a sound inference of student collusion in an OSCE and may mask the aspects of professional development of students

I argue that we can find in Marx two objections to exploitation: an entitlement objection according to which it is wrongful because of the unjust distribution of benefits and burdens it generates; and an expressivist objection according to which it is objectionable because of the kind of social relation it is. The expressivist objection is predicated on a communitarian strand in Marx's thought, whereas the entitlement objection is grounded in a more liberal account of the wrongfulness of capitalist exploitation. I conclude by connecting my analysis to the current debate between proponents and critics of market socialism. While market socialism could be a vehicle for realizing the values associated with the entitlement objection, this is not true for the expressivist objection. Furthermore, because the entitlement objection does not depend on a thick conception of the human good, it is in accord with the liberal ideal of political neutrality whereas the expressivist objection is not.