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Vercio C, Tan G, Maxson IN, Matta Y, Cacho B, Calaguas D, Hayton A, Kim S. Stress and value: the student perspective on utilizing real vs. actor patients in objective structured clinical examinations. BMC MEDICAL EDUCATION 2024; 24:760. [PMID: 39010096 PMCID: PMC11247776 DOI: 10.1186/s12909-024-05673-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/19/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Studies have shown objective structured clinical examinations (OSCEs) to be one of the most reliable tools in assessing clinical performance; however in Pediatrics they primarily use manikins, simulators or parent actors which limits the comprehensiveness of the assessment. In our Pediatric Clerkship, medical students are evaluated using a standardized rubric during a clinical evaluation exercise (CEX) with real patients. This study assessed medical students' perceived stress levels and the educational value of the CEX compared an OSCE. We hypothesized there would be equal stress and value for students with the CEX experience compared to the OSCE. METHODS Third year students anonymously completed questionnaires after required Pediatric CEX and Internal Medicine OSCE evaluations from July 2016-June 2017. The questionnaire included questions from the Intrinsic Motivation Inventory, a validated tool used to assess feelings of stress and perceived value of an exercise. RESULTS A total of 147 and 145 questionnaires were completed after the CEX and OSCE. There were no differences between groups regarding levels of "nervousness" (p = 0.543) and "relaxation" (p = 0.055); students felt more "at ease" (p = 0.002) and less "pressure" (p < 0.001) during the CEX. Students perceived the CEX to be more useful and important to improve skills compared to the OSCE for the history taking, physical exam and interpersonal skills. CONCLUSIONS Our results indicate that the CEX was associated with lower stress levels and had higher perceived value when compared to the OSCE. This study supports the usefulness of incorporating real patients into the clinical evaluation of medical students.
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Affiliation(s)
- Chad Vercio
- Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda University School of Medicine, 11234 Anderson St, Loma Linda, CA, 92354, USA.
| | - Gordon Tan
- Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda University School of Medicine, 11234 Anderson St, Loma Linda, CA, 92354, USA
| | - Ivanna N Maxson
- Department of Pediatrics, UCLA, UCLA School of Medicine, Los Angeles, CA, USA
- Loma Linda University Children's Hospital, Los Angeles, CA, USA
| | - Yara Matta
- Palomar Health Medical Group- Graybill, Internal Medicine and Pediatrics, Murrieta, CA, USA
- Loma Linda University Medical Center and Loma Linda Children's Hospital, Murrieta, CA, USA
| | - Bradley Cacho
- Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda University School of Medicine, 11234 Anderson St, Loma Linda, CA, 92354, USA
| | - Daniel Calaguas
- Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda University School of Medicine, 11234 Anderson St, Loma Linda, CA, 92354, USA
| | - Amy Hayton
- Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Soo Kim
- Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda University School of Medicine, 11234 Anderson St, Loma Linda, CA, 92354, USA
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Ouldali N, Le Roux E, Faye A, Leblanc C, Angoulvant F, Korb D, Delcour C, Caula C, Wohrer D, Rybak A, Delafoy M, Carrié C, Strullu M, Oualha M, Levy R, Mimoun C, Griffon L, Nuzzo A, Eyraud C, Levy M, Ellul P. Early formative objective structured clinical examinations for students in the pre-clinical years of medical education: A non-randomized controlled prospective pilot study. PLoS One 2023; 18:e0294022. [PMID: 38060541 PMCID: PMC10703252 DOI: 10.1371/journal.pone.0294022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/12/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The value of formative objective structured clinical examinations (OSCEs) during the pre-clinical years of medical education remains unclear. We aimed to assess the effectiveness of a formative OSCE program for medical students in their pre-clinical years on subsequent performance in summative OSCE. METHODS We conducted a non-randomized controlled prospective pilot study that included all medical students from the last year of the pre-clinical cycle of the Université Paris-Cité Medical School, France, in 2021. The intervention group received the formative OSCE program, which consisted of four OSCE sessions, followed by debriefing and feedback, whereas the control group received the standard teaching program. The main objective of this formative OSCE program was to develop skills in taking a structured medical history and communication. All participants took a final summative OSCE. The primary endpoint was the summative OSCE mark in each group. A questionnaire was also administered to the intervention-group students to collect their feedback. A qualitative analysis, using a convenience sample, was conducted by gathering data pertaining to the process through on-site participative observation of the formative OSCE program. RESULTS Twenty students were included in the intervention group; 776 in the control group. We observed a significant improvement with each successive formative OSCE session in communication skills and in taking a structured medical history (p<0.0001 for both skills). Students from the intervention group performed better in a summative OSCE that assessed the structuring of a medical history (median mark 16/20, IQR [15; 17] versus 14/20, [13; 16], respectively, p = 0.012). Adjusted analyses gave similar results. The students from the intervention group reported a feeling of improved competence and a reduced level of stress at the time of the evaluation, supported by the qualitative data showing the benefits of the formative sessions. CONCLUSION Our findings suggest that an early formative OSCE program is suitable for the pre-clinical years of medical education and is associated with improved student performance in domains targeted by the program.
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Affiliation(s)
- Naïm Ouldali
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France
- Infectious Diseases Division, CHU Sainte Justine - Montreal University, Montreal, Quebec, Canada
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Paris Cité University, INSERM UMR 1137, IAME (Infection, Antimicrobials, Modelling, Evolution), Paris, France
| | - Enora Le Roux
- Paris Cité University, INSERM UMR 1137, IAME (Infection, Antimicrobials, Modelling, Evolution), Paris, France
| | - Albert Faye
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Claire Leblanc
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - François Angoulvant
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France
- INSERM, Cordeliers Research Center, UMRS 1138, Sorbonne Université, Université Paris Cité, Paris, France
| | - Diane Korb
- Department of Obstetrics and Gynecology, Robert Debré University Hospital, Paris University, Paris, France
- Paris University, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
| | - Clémence Delcour
- Department of Obstetrics and Gynecology, Robert Debré University Hospital, Paris University, Paris, France
| | - Caroline Caula
- Pediatric Emergency Department, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Delphine Wohrer
- Pediatric Emergency Department, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Pediatric Emergency Department, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Manon Delafoy
- Department of Hematology, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Claire Carrié
- Department of Hematology, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Marion Strullu
- Department of Hematology, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Mehdi Oualha
- Pediatric Intensive Care Unit, Necker University Hospital, Paris Cité University, Paris, France
| | - Romain Levy
- Immunology-Hematology and Rheumatology Department, Necker University Hospital, Paris Cité University, Paris, France
| | - Camille Mimoun
- Department of Gynecology and Obstetrics, Lariboisiere Hospital, Paris Cité University, Paris, France
| | - Lucie Griffon
- Pediatric Non-Invasive Ventilation and Sleep Unit, Necker Hospital, Paris Cité University, Paris, France
| | - Alexandre Nuzzo
- Department of Gastroenterology, IBD and Intestinal Failure, Beaujon Hospital, Paris Cité University, Paris, France
| | - Clara Eyraud
- Paris Cité University, INSERM UMR 1137, IAME (Infection, Antimicrobials, Modelling, Evolution), Paris, France
| | - Michael Levy
- Pediatric Intensive Care Unit, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Pierre Ellul
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Paris Cité University, Paris, France
- INSERM, Immunology-Immunopathology-Immunotherapy (i3), Sorbonne University, Paris, France
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Al-Hashimi K, Said UN, Khan TN. Formative Objective Structured Clinical Examinations (OSCEs) as an Assessment Tool in UK Undergraduate Medical Education: A Review of Its Utility. Cureus 2023; 15:e38519. [PMID: 37288230 PMCID: PMC10241740 DOI: 10.7759/cureus.38519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
The Objective Structured Clinical Examination (OSCE) is a globally established clinical examination; it is often considered the gold standard in evaluating clinical competence within medicine and other healthcare professionals' educations alike. The OSCE consists of a circuit of multiple stations testing a multitude of clinical competencies expected of undergraduate students at certain levels throughout training. Despite its widespread use, the evidence regarding formative renditions of the examination in medical training is highly variable; thus, its suitability as an assessment has been challenged for various reasons. Classically, Van Der Vleuten's formula of utility has been adopted in the appraisal of assessment methods as means of testing, including the OSCE. This review aims to provide a comprehensive overview of the literature surrounding the formative use of OSCEs in undergraduate medical training, whilst specifically focusing on the constituents of the equation and means of mitigating factors that compromise its objectivity.
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Affiliation(s)
| | - Umar N Said
- Trauma and Orthopaedics, Huddersfield Royal Infirmary, Huddersfield, GBR
| | - Taherah N Khan
- General Medicine, Worcestershire Acute Hospital NHS Trust, Worcestershire, GBR
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Alkhateeb N, Salih AM, Shabila N, Al-Dabbagh A. Objective structured clinical examination: Challenges and opportunities from students’ perspective. PLoS One 2022; 17:e0274055. [PMID: 36054202 PMCID: PMC9439190 DOI: 10.1371/journal.pone.0274055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 08/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Objective structured clinical examination (OSCE) has been used in evaluating clinical competence in health professions education around the world. Despite its implementation in Iraq for around a decade, limited studies investigated the challenges and opportunities to improve the standard and quality of this examination from student’s perspective.
Methods
This qualitative study was based on an online open-ended questionnaire survey that was carried out in the College of Medicine, Hawler Medical University, Iraq at the beginning of the 2018–2019 academic year. A convenience sample of 180 students in the clinical phase (4th, 5th, and 6th) year of study were invited to participate.
Results
A total of 141 students responded to the online questionnaire. The participants were generally happy with the OSCE, and they recognized many positive aspects, including the role of the OSCE in increasing confidence, engagement and motivating learning, the role of the OSCE in achieving a higher level of learning, the content validity of the OSCE, and the quality of the OSCE. The main weak points of the OSCE identified by the students included unfairness, gender discrimination, duration of the OSCE, and the behavior of the examiners. Suggestions to improve the OSCE examination included improving the examiners’ behavior, with the focus on the training of the examiners, and avoiding discrimination among students.
Conclusions
Most of the students were generally satisfied with the current OSCE examination. The main concern of the students was related to the organization of the OSCE. Valuable suggestions were raised to improve the OSCE quality including examiners’ and simulated patients’ training.
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Affiliation(s)
- Nazdar Alkhateeb
- Department of Medical Education, College of Medicine, Hawler Medical University, Erbil, Iraq
| | - Abubakir Majeed Salih
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
- Faculty of Nursing, Tishk International University, Erbil, Iraq
- * E-mail:
| | - Nazar Shabila
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
| | - Ali Al-Dabbagh
- Department of Medical Education, College of Medicine, Hawler Medical University, Erbil, Iraq
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Kirwan C, Szafranska M, Coveney K, Horton S, Carroll L. Midwifery students' experiences of objective structured clinical examinations: A qualitative evidence synthesis. NURSE EDUCATION TODAY 2022; 113:105381. [PMID: 35489328 DOI: 10.1016/j.nedt.2022.105381] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To identify and synthesise the evidence of midwifery students' views and experiences of Objective Structured Clinical Examinations (OSCEs). DESIGN A qualitative evidence synthesis was undertaken using Thomas and Harden's synthesis methods and reported according to the ENTEREQ guidelines. DATA SOURCES PubMED, CINAHL Plus, Embase, ERIC, PsycINFO, Social Science Citation Index (via Web of Science) and Scopus were searched from inception to 19th February 2020 and an updated search was performed on 12th May 2021 to identify qualitative and mixed method studies, reporting qualitative data of undergraduate midwifery students' views and experiences of OSCEs. REVIEW METHODS Studies were independently screened by title and abstract according to a predetermined inclusion and exclusion criteria. Full text review was then conducted independently by two authors. Studies providing qualitative data on undergraduate midwifery students' views and experiences of OSCEs during their midwifery registration education programmes were included. Quality appraisal was performed using the Critical Appraisal Skills Programme (CASP) tool. Data synthesis was performed using Thomas and Harden's thematic synthesis method. RESULTS Eleven studies were identified and included. Thematic synthesis identified 13 descriptive themes which translated into four analytical themes that represented midwifery students' views and experiences of OSCEs: the preparation phase, the assessment phase, the feedback phase and the translation phase. CONCLUSIONS This synthesis offers insight into undergraduate midwifery students' views and experiences of OSCEs and how they are experienced across four phases. This is determined to be a useful structure to guide midwifery educators and researchers in their consideration of the student experience of OSCEs in the future. Midwifery students in this synthesis reported high levels of nervousness, anxiety, and stress during the OSCE process. The findings reveal that there are a number of controllable factors impacting on midwifery students' feelings of safety in the assessment environment, and that these should be addressed to maximise the advantages that the OSCE has to offer in terms of learning and preparation for clinical practice.
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Affiliation(s)
- Ciara Kirwan
- School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
| | - Marcelina Szafranska
- School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
| | - Kate Coveney
- School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
| | | | - Lorraine Carroll
- School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
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Leclercq M, Vannier M, Benhamou Y, Liard A, Gilard V, Auquit-Auckbur I, Levesque H, Sibert L, Schneider P. Identification des facteurs associés à la réussite aux examens cliniques objectifs et structurés dans la faculté de médecine de Rouen. Rev Med Interne 2022; 43:278-285. [DOI: 10.1016/j.revmed.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
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Fisseha H, Desalegn H. Perception of Students and Examiners about Objective Structured Clinical Examination in a Teaching Hospital in Ethiopia. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:1439-1448. [PMID: 34924781 PMCID: PMC8674149 DOI: 10.2147/amep.s342582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The objective structured clinical examination (OSCE) has become a standard assessment tool in undergraduate medical school training. It is considered an objective assessment of practical skill of students. OSCE is a resource demanding assessment method that can have numerous challenges. Comprehensive assessment of perception regarding OSCE can help identify areas that need improvement. The aim of this study was to assess the perception of students and examiners towards OSCE. METHODS A cross-sectional study was conducted on students and examiners undertaking OSCE from May 1 to July 30, 2021, using a structured questionnaire. Comparison of variables was done using Mann-Whitney U-Test and Chi-square test. P-value <0.05 was considered statistically significant. RESULTS A total of 141 students and 39 examiners participated in the study. The majority of the students and examiners had a positive response regarding the attributes, structure, organization and validity of OSCE. It was recommended to be used in future exams compared to other assessments by 38.3% of students and 51.3% of examiners. There were certain challenges reported by students and included stressfulness of the exam (51.1%), inadequate time (27.6%), and unsatisfactory orientation (30.5%). One-third of examiners considered it stressful, while 20.5% considered the time provided to be inadequate. Equipment to conduct the exam was considered inadequate by 39.1% and 56.4% of students and examiners, respectively. Around 80.1% of students recommended mock sessions and 23.1% of examiners did not have any prior training on OSCE. CONCLUSION An overall positive perception of OSCE by students and examiners was seen. Certain challenges that need improvements were identified. Continuing evaluation and refinement of OSCE by departments is needed. We recommend further wide-scale national evaluation of the OSCE examination system of medical students.
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Affiliation(s)
- Henok Fisseha
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Hailemichael Desalegn
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Cosker E, Favier V, Gallet P, Raphael F, Moussier E, Tyvaert L, Braun M, Feigerlova E. Tutor-Student Partnership in Practice OSCE to Enhance Medical Education. MEDICAL SCIENCE EDUCATOR 2021; 31:1803-1812. [PMID: 34956698 PMCID: PMC8651844 DOI: 10.1007/s40670-021-01421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Training of examiners is essential to ensure the quality of objective structured clinical examination (OSCE). We aimed to study a perceived effectiveness of tutor-student partnership in a practice OSCE module by novice OSCE tutors and medical students. METHOD We implemented a practice OSCE at a medical faculty in France with novice tutors and third year medical students as partners. Each tutor (n = 44) served as a partner for the group of 5 students in the conception of the scenario and as an evaluator of the tutored station. Students (n = 303) were involved in the conception of a case and the roles of a physician, evaluator and a simulated patient. Data were obtained through self-assessment questionnaires. Descriptive statistics were used to analyze items of the questionnaires. Free-form answers were coded and analyzed thematically. RESULTS A total of 36 tutors (82%) and 185 students (61%) responded to the questionnaires. The intervention was well perceived. Thirty-two percent of the tutors reported some difficulties in the assessment of student performance and were disposed to receive further training. Fifty-five percent of the students considered the participation in the OSCE case development appropriate to their level of knowledge, and 70% perceived it as beneficial allowing them to set their learning goals. CONCLUSION This initiative provides a relevant method beneficial to OSCE tutors, medical students, and the faculty. Tutors learn how to assess student performance according to expected achievement levels. It allows students to be engaged as partners in co-creation of learning and teaching. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01421-9.
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Affiliation(s)
- Eve Cosker
- Pôle Hospitalo-Universitaire de psychiatrie d’adultes et d’addictologie du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, F-54520 France
- Université de Strasbourg Unité de Physiopathologie et Médecine Translationnelle, INSERM U1114, Strasbourg, F-67000 France
| | - Valentin Favier
- Centre hospitalier, régionale et universitaire de Nancy, Otorhinolaryngology, Université de Lorraine, Nancy, F-54000 France
| | - Patrice Gallet
- Centre hospitalier, régionale et universitaire de Nancy, Otorhinolaryngology, Université de Lorraine, Nancy, F-54000 France
- Centre universitaire d’enseignement par simulation (CUESiM), Hôpital virtuel de Lorraine, Faculté de médecine, Nancy, F-54000 France
- Faculté de Médecine, Université de Lorraine,, Nancy, F-54000 France
| | - Francis Raphael
- Faculté de Médecine, Université de Lorraine,, Nancy, F-54000 France
| | | | - Louise Tyvaert
- Faculté de Médecine, Université de Lorraine,, Nancy, F-54000 France
- Centre hospitalier régionale et universitaire de Nancy, Department of Neuro, Université de Lorraine, Nancy, F-54000 France
| | - Marc Braun
- Centre universitaire d’enseignement par simulation (CUESiM), Hôpital virtuel de Lorraine, Faculté de médecine, Nancy, F-54000 France
- Faculté de Médecine, Université de Lorraine,, Nancy, F-54000 France
| | - Eva Feigerlova
- Centre universitaire d’enseignement par simulation (CUESiM), Hôpital virtuel de Lorraine, Faculté de médecine, Nancy, F-54000 France
- Faculté de Médecine, Université de Lorraine,, Nancy, F-54000 France
- Centre hospitalier régionale et universitaire de Nancy, Department of endocrinology, Université de Lorraine, Nancy, F-54000 France
- Université de Lorraine, Inserm, UMR S 1116 – DCAC, Nancy, F-54000 France
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Robertson C, Al-Moasseb Z, Noonan Z, Boyle JG. The 3-D Skills Model: a Randomised Controlled Pilot Study Comparing a Novel 1-1 Near-Peer Teaching Model to a Formative OSCE with Self-regulated Practice. MEDICAL SCIENCE EDUCATOR 2021; 31:1789-1801. [PMID: 34950527 PMCID: PMC8651955 DOI: 10.1007/s40670-021-01369-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Near-peer teaching is a popular pedagogical teaching tool, with well-recognised benefits for students and tutors. There are multiple existing models to structure these interventions, but it is often unclear how they translate to academic attainment. We designed a novel near-peer teaching model that expands on previous research. METHODS Our model was piloted in a formative Objective Structured Clinical Examination (OSCE) setting, trialled on 22 pre-clinical medical students to establish feasibility, acceptability and descriptive outcomes that could inform the design of a larger study. Students were randomly assigned to intervention or control cohorts. Each cohort undertook 5 min formative OSCE assessments with either 3 additional minutes of structured teaching or 3 min of self-regulated practice before reattempting the first OSCE station. Checklist marking sheets for 1st and 2nd sittings were collected by independent external markers, in addition to a global assessment rating in which we used the Borderline Regression Method to establish the station pass mark. RESULTS A quantitative and qualitative result analysis was performed, demonstrating that students gained on average 3 additional marks after teaching with this model. Students and student-tutors reported increased confidence, high course satisfaction and evidence of reflective practice. DISCUSSION We established acceptability and feasibility outcomes. The descriptive outcomes will support the design of a larger, adequately powered study required to demonstrate translation to summative exam performance. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01369-w.
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Affiliation(s)
- C. Robertson
- NHS Greater Glasgow and Clyde, Glasgow, Scotland
- Undergraduate Medical School, The University of Glasgow, Glasgow, Scotland
- Anaesthetics Department, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF Scotland
| | - Z. Al-Moasseb
- NHS Greater Glasgow and Clyde, Glasgow, Scotland
- Undergraduate Medical School, The University of Glasgow, Glasgow, Scotland
| | - Z. Noonan
- Undergraduate Medical School, The University of Glasgow, Glasgow, Scotland
| | - J. G. Boyle
- Undergraduate Medical School, The University of Glasgow, Glasgow, Scotland
- Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, Scotland
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Vishwanathan K, Joshi AN, Patel MJ. Perception of Medical Undergraduate Students about an Electronic Practical Examination In Orthopaedics During the COVID-19 Pandemic. Indian J Orthop 2021; 56:689-698. [PMID: 34866651 PMCID: PMC8628820 DOI: 10.1007/s43465-021-00578-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/21/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND/PURPOSE OF STUDY No study has evaluated the perception of medical undergraduate students to the electronic objective structured practical examination (e-OSPE) in orthopaedics. The aim of the present study is to evaluate the feasibility and perception of the medical undergraduate students to e-OSPE conducted by the department of Orthopaedics to assess problem-solving and clinical decision-making skills of medical undergraduate students. METHODS Medical undergraduate students of second and third year at our medical college who completed the orthopaedic clinical posting and appeared for the orthopaedic practical examination during the second wave of the COVID-19 pandemic were included in this prospective observational study. Students appearing for the exams from 20th March 2021 to 26th June 2021 were invited to complete the questionnaire immediately after the e-OSPE. Internal consistency of the survey questions was assessed using Cronbach's alpha. RESULTS 272 out of 312 eligible students completed the survey and the survey response rate was 87.2%. Nine groups of medical undergraduate students gave the orthopaedic practical exams from 20th March 2021 to 26th June 2021. 91.2% students felt that the e-OSPE represented a valid modality of evaluation of essential orthopaedic practical knowledge during the COVID-19 pandemic. The overall reliability of the 19 questions included in our survey was very high (Internal consistency: Cronbach's alpha = 0.88). CONCLUSION The e-OSPE was well received by the medical undergraduate students at our institute and the students had a positive perception about the new examination technique used in orthopaedics during the COVID-19 pandemic.
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Affiliation(s)
- Karthik Vishwanathan
- Department of Orthopaedics, Medical Education Unit, Parul Institute of Medical Sciences and Research, Parul University, PO Limda, Tal Waghodia, Vadodara, 391760 India
| | - Ankit Nitinkumar Joshi
- Parul Institute of Medical Sciences and Research, Parul University, PO Limda, Tal Waghodia, Vadodara, 391760 India
| | - Mit Jitendra Patel
- Parul Institute of Medical Sciences and Research, Parul University, PO Limda, Tal Waghodia, Vadodara, 391760 India
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Merrick D, Mbaki Y, Pratten MK, Simpson TG. Exploring wellbeing in first year medical students amidst a curriculum change. BMC MEDICAL EDUCATION 2021; 21:252. [PMID: 33933050 PMCID: PMC8088313 DOI: 10.1186/s12909-021-02678-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/20/2021] [Indexed: 05/17/2023]
Abstract
BACKGROUND The support of student wellbeing features highly in all higher education institutional agendas. For medical students good physical and mental health can help prevent burnout, equip students for their future healthcare setting and indirectly improve patient care. At the University of Nottingham (UK), we were keen to explore undergraduate medical students perceived wellbeing before, during, and after an early years' (years 1-3) curriculum change. A restructure of the curriculum enabled personal wellbeing sessions to be embedded and directly linked to the pastoral support system. METHODS Students' perceived wellbeing was assessed through a questionnaire distributed to three cohorts of first year students at the start and end of the autumn semester. RESULTS The data showed a clear improvement of perceived physical health at the end of the first semester following the curriculum change, alongside increased mood and ability to relax. A surprising outcome of this study was that students reported increased stress levels at the end of the semester, which we believe may be attributed to the change in assessment within the new curriculum. Our medical students are now facing end of year summative examinations, but are acutely aware of their progress as they undertake frequent formative assessments during the year. We propose that comparison of performance with peers is having a direct impact on perceived stress in these cohorts. CONCLUSIONS The study has shown that embedding wellbeing in the curriculum can have positive effects even within a changing curriculum. The importance of evolving wellbeing provision and support based on the needs of the student population is essential and probably never more in need than at this moment in time.
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Affiliation(s)
- Deborah Merrick
- School of Life Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
| | - Yvonne Mbaki
- School of Life Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Margaret K Pratten
- School of Life Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Timothy G Simpson
- School of Life Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK
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Ferreira ÉDMR, Pinto RZ, Arantes PMM, Vieira ÉLM, Teixeira AL, Ferreira FR, Vaz DV. Stress, anxiety, self-efficacy, and the meanings that physical therapy students attribute to their experience with an objective structured clinical examination. BMC MEDICAL EDUCATION 2020; 20:296. [PMID: 32912221 PMCID: PMC7488334 DOI: 10.1186/s12909-020-02202-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/18/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND Excessive stress and anxiety can impair learning. The objective structured clinical examination (OSCE) is a valuable tool to assess and promote the acquisition of clinical skills. However, significant OSCE-related stress and anxiety are frequently reported. The aim of this study was to investigate the relationships between physiological stress, self-reported levels of anxiety due to an OSCE, self-efficacy, and the meanings that physical therapy students attribute to their experience with the exam. DESIGN Concurrent mixed methods study. METHODS A total of 32 students took part in this study. All were enrolled in the third semester of a 10-semester Physical Therapy Bachelor Program. Salivary cortisol levels, self-reported anxiety (State-Trait Anxiety Inventory, STAI) were measured before the OSCE. Exam scores and self-efficacy ratings were also recorded. Correlations between variables were tested with the Pearson correlation, with ɑ at 0.05. Semi-structured interviews were used to explore the personal perspectives of students. Thematic analysis was used to investigate emergent themes. RESULTS Trait anxiety scores were significantly higher than normative values (p < 0.001). A high proportion of students showed high (STAI> 49) state anxiety (37.5%) and trait anxiety (65.6%). Salivary cortisol was not associated anxiety (p > 0.05). Neither stress nor anxiety correlated with OSCE scores. A moderate and significant direct correlation was found for self-efficacy scores and OSCE scores (r = 0.475, p = 0.007). Students reported that confidence had a calming effect and led to better self-perceived performance. They also reported that the OSCE can provide meaningful learning experiences despite being stressful. CONCLUSIONS A high proportion of our students reported a stable/lingering negative affect. However, neither stress nor anxiety related to OSCE scores. Students' confidence in their capabilities was correlated with their performance. Their subjective reports suggest that self-confidence may have protected them from the negative effects of stress and anxiety on academic performance.
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Affiliation(s)
| | - Rafael Zambelli Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG Brazil
| | | | - Érica Leandro Marciano Vieira
- Interdisciplinary Laboratory of Medical Investigation, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG Brazil
| | - Antônio Lúcio Teixeira
- Interdisciplinary Laboratory of Medical Investigation, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG Brazil
| | - Fabiane Ribeiro Ferreira
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG Brazil
| | - Daniela Virgínia Vaz
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG Brazil
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Couto LB, Durand MT, Wolff ACD, Restini CBA, Faria M, Romão GS, Bestetti RB. Formative assessment scores in tutorial sessions correlates with OSCE and progress testing scores in a PBL medical curriculum. MEDICAL EDUCATION ONLINE 2019; 24:1560862. [PMID: 31023185 PMCID: PMC6327919 DOI: 10.1080/10872981.2018.1560862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 11/07/2018] [Accepted: 12/12/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Effective assessments programs are a challenge in problem-based learning (PBL). One of the main principles of this educational setting is the Formative Assessment (FA). We hypothesized that students' performance assessed by FA in tutorial sessions in a PBL curriculum is related to other summative assessments. OBJECTIVE To investigate the correlation among FA in tutorial sessions with grades obtained in Objective Structured Clinical Evaluation (OSCE) and Progress Testing (PT) to better understand the assessment process in PBL medical teaching approach and to predict student's future performance. DESIGN An observational cross-sectional study was conducted comparing FA, OSCE and PT scores from 4th to 8th semester medical students. Correlation analyses were performed using pooled and separate data from the 4th and 8th semesters. RESULTS From the 5th to 8th semester, OSCE scores were smaller compared to the FA, while PT scores were lower in all stages. In the pooled data, the correlation analysis showed a significant positive relationship between grades on FA and OSCE, FA and PT and OSCE and PT. A significant correlation among the three assessments strategies was also detected in the 8th semester, but not in the 4th semester. CONCLUSIONS Assessment strategies in PBL approach, including FA, OSCE and PT, have positive correlations, which increases as the medical course becomes more complex.
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Affiliation(s)
- Lucélio B. Couto
- Department of Medicine, University of Ribeirão Preto, Ribeirão Preto, Brazil
| | - Marina T. Durand
- Department of Medicine, University of Ribeirão Preto, Ribeirão Preto, Brazil
| | - Amora C. D. Wolff
- Department of Medicine, University of Ribeirão Preto, Ribeirão Preto, Brazil
| | | | - Milton Faria
- Department of Medicine, University of Ribeirão Preto, Ribeirão Preto, Brazil
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Alkhateeb NE, Al-Dabbagh A, Ibrahim M, Al-Tawil NG. Effect of a Formative Objective Structured Clinical Examination on the Clinical Performance of Undergraduate Medical Students in a Summative Examination: A Randomized Controlled Trial. Indian Pediatr 2019. [DOI: 10.1007/s13312-019-1641-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Fischer MA, Kennedy KM, Durning S, Schijven MP, Ker J, O’Connor P, Doherty E, Kropmans TJB. Situational awareness within objective structured clinical examination stations in undergraduate medical training - a literature search. BMC MEDICAL EDUCATION 2017; 17:262. [PMID: 29268744 PMCID: PMC5740962 DOI: 10.1186/s12909-017-1105-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/12/2017] [Indexed: 05/30/2023]
Abstract
BACKGROUND Medical students may not be able to identify the essential elements of situational awareness (SA) necessary for clinical reasoning. Recent studies suggest that students have little insight into cognitive processing and SA in clinical scenarios. Objective Structured Clinical Examinations (OSCEs) could be used to assess certain elements of situational awareness. The purpose of this paper is to review the literature with a view to identifying whether levels of SA based on Endsley's model can be assessed utilising OSCEs during undergraduate medical training. METHODS A systematic search was performed pertaining to SA and OSCEs, to identify studies published between January 1975 (first paper describing an OSCE) and February 2017, in peer reviewed international journals published in English. PUBMED, EMBASE, PsycINFO Ovid and SCOPUS were searched for papers that described the assessment of SA using OSCEs among undergraduate medical students. Key search terms included "objective structured clinical examination", "objective structured clinical assessment" or "OSCE" and "non-technical skills", "sense-making", "clinical reasoning", "perception", "comprehension", "projection", "situation awareness", "situational awareness" and "situation assessment". Boolean operators (AND, OR) were used as conjunctions to narrow the search strategy, resulting in the limitation of papers relevant to the research interest. Areas of interest were elements of SA that can be assessed by these examinations. RESULTS The initial search of the literature retrieved 1127 publications. Upon removal of duplicates and papers relating to nursing, paramedical disciplines, pharmacy and veterinary education by title, abstract or full text, 11 articles were eligible for inclusion as related to the assessment of elements of SA in undergraduate medical students. DISCUSSION Review of the literature suggests that whole-task OSCEs enable the evaluation of SA associated with clinical reasoning skills. If they address the levels of SA, these OSCEs can provide supportive feedback and strengthen educational measures associated with higher diagnostic accuracy and reasoning abilities. CONCLUSION Based on the findings, the early exposure of medical students to SA is recommended, utilising OSCEs to evaluate and facilitate SA in dynamic environments.
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Affiliation(s)
- Markus A. Fischer
- National University Ireland Galway, School of Medicine, University Road, Galway, H91TK33 Ireland
| | - Kieran M. Kennedy
- National University Ireland Galway, School of Medicine, University Road, Galway, H91TK33 Ireland
| | - Steven Durning
- Department of Internal Medicine, University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 USA
| | - Marlies P. Schijven
- Department of Surgery, Academic Medical Center Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, The Netherlands
| | - Jean Ker
- University of Dundee. Clinical Skills Centre Level 6, Ninewells Hospital & Medical School, Dundee, UK
| | - Paul O’Connor
- National University Galway Ireland, Discipline of General Practice, Distillery Road, Galway, H91TK33 Ireland
| | - Eva Doherty
- Royal College of Surgeons in Ireland, 123 St Stephen’s Green, Dublin 2, Ireland
| | - Thomas J. B. Kropmans
- National University Ireland Galway, School of Medicine, University Road, Galway, H91TK33 Ireland
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Quintero GA, Vergel J, Arredondo M, Ariza MC, Gómez P, Pinzon-Barrios AM. Integrated Medical Curriculum: Advantages and Disadvantages. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2016; 3:JMECD.S18920. [PMID: 29349303 PMCID: PMC5736212 DOI: 10.4137/jmecd.s18920] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 05/10/2023]
Abstract
Most curricula for medical education have been integrated horizontally and vertically--vertically between basic and clinical sciences. The Flexnerian curriculum has disappeared to permit integration between basic sciences and clinical sciences, which are taught throughout the curriculum. We have proposed a different form of integration where the horizontal axis represents the defined learning outcomes and the vertical axis represents the teaching of the sciences throughout the courses. We believe that a mere integration of basic and clinical sciences is not enough because it is necessary to emphasize the importance of humanism as well as health population sciences in medicine. It is necessary to integrate basic and clinical sciences, humanism, and health population in the vertical axis, not only in the early years but also throughout the curriculum, presupposing the use of active teaching methods based on problems or cases in small groups.
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Affiliation(s)
- Gustavo A. Quintero
- School of Medicine and Health Sciences, Universidad del Rosario, Bogota, DC, Colombia
| | - John Vergel
- Universidad del Rosario, Bogota, DC, Colombia
| | - Martha Arredondo
- Facilitators of the Integrated-Systems Learning Activities at the School of Medicine and Health Sciences, Universidad del Rosario, Bogota, DC, Colombia
| | - María-Cristina Ariza
- Facilitators of the Integrated-Systems Learning Activities at the School of Medicine and Health Sciences, Universidad del Rosario, Bogota, DC, Colombia
| | - Paula Gómez
- Facilitators of the Integrated-Systems Learning Activities at the School of Medicine and Health Sciences, Universidad del Rosario, Bogota, DC, Colombia
| | - Ana-Maria Pinzon-Barrios
- Facilitators of the Integrated-Systems Learning Activities at the School of Medicine and Health Sciences, Universidad del Rosario, Bogota, DC, Colombia
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