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To investigate the research status and trends of application of objective structured clinical examination (OSCE) in medical education in China and globally, and to provide a reference for clinical teaching and medical education research. CNKI and Web of Science Core Collection were searched to identify journal articles related to OSCE published up to the present day. CtieSpace V software was used to visually analyze the research institutions, authors, highly cited literature, and keyword changes of the articles based on scientific knowledge maps. The overall number of publications on OSCE published in China and globally showed an increasing trend, but foreign publications were significantly more than Chinese publications. The institutions and authors were widely distributed. Comprehensive universities were the main institutions in foreign publications, with relatively little cooperation between each other. Domestic research primarily focused on medical education in the early stage, SP training and standardization in the middle stage, and clinical competence for resident physicians, nurses, and other clinical professionals in the late stage. Early foreign research focused mainly on medical education and clinical competence, while later research focused primarily on communication with patients and ability assessment. It is expected that future domestic research will focus on building clinical competence evaluation systems based on the OSCE model, while future foreign research will focus on patient communication and humanistic care assessment.
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Objective: This study aimed to explore and describe the sixth level nursing students’ perception regarding the use of OSCE assessment approach. Specifically, it investigated the students’ perception in terms of preparation, quality, and organization, format, validity, and reliability of OSCE. Methods: Observational study design of 50 female nursing students was utilized in this study. The OSCE consisted of 10 stations; the students’ perceptions about OSCE were evaluated using a structured questionnaire. Data were related to the organization of the OSCE measured by scoring scale Likert-scale questionnaires and Pierre, et al., questionnaire 2004. For the purpose of this study, only 18 items of the questionnaire were used to measure the preparation, quality and organization, format, validity, and reliability of OSCE. Results: The majority of students provided positive feedback about the OSCE quality attributes and organization, and provided positive feedback about the OSCE format, validity, and reliability. Results revealed that there is a positive and direct significant correlation between using OSCE sessions in training and OSCE examination. Conclusion: OSCE is a meaningful, fair, useful and an acceptable method for evaluating the nursing students’ clinical performance because of various positive specifications such as objectivity and fairness. Relevance to clinical practice: There is a far reaching understanding for clinical learning as it has a focal significance in nursing training. Compelling clinical stations are fundamental to turning into a skillful expert nursing caretaker. Learning in the nursing clinical area gives present reality to nursing students to build up the information, abilities, dispositions, and skills.
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Objective To investigate the current situation of empathy and self-efficacy, and relation with perform-ance of objective structured clinical examination in residents of standardized training. Methods Questionnaire sur-veys with Jefferson scale of empathy health professionals and general self-efficacy scale were conducted among resi-dents of grade 2015 and grade 2016 from department of internal medicine of Peking Union Medical College Hospital (PUMCH). Results Totally 101 questionnaires were delivered,and 99 were collected back. The average empathy score was 111.3±1.2,with that of grade 2015 slightly higher than that of grade 2016. The empathy score from resi-dents of different degree and different sources showed no significant difference. The average self-efficacy score was 22.77±0.50. The score of residents of grade 2015 was significantly higher than that of grade 2016. The score was higher in residents with higher degree. The score of residents from PUMCH was higher than the other subgroups. The score of empathy showed no significant correlation with OSCE scores, while the score of self-efficacy of resi-dents of grade 2015 significantly positively correlated with scores of medical recording (R=0.35,P<0.05),case analyzing (R=0.31,P<0.05) and average score(R=0.33,P<0.05) of OSCE. Conclusions The empathy and self-efficacy of residents remained to be improved, and could be improved through clinical training. Psychological evaluation could be inducted into standardized resident training system,and provide helpful supplementary to OSCE with more comprehensive evaluation of residents.
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Objective To explore the value of OSCE system combined with intelligent network in-formation platform in clinical skills assessment of obstetrics and gynecology. Methods 112 clinical medi-cal students who participated in the practice of gynecology and obstetrics in Second Military Medical Uni-versity in 2017 were randomly divided into the experimental group (network information OSCE) and the control group (traditional OSCE). The teaching results were evaluated by the questionnaire survey of teachers and students and the examination results as well. The statistical analysis was made with the Chi-square test and the t test respectively. Results According to the questionnaire survey of two skills assessment methods, the satisfaction index of the experimental group was higher than that of the control group in both teachers and students, and the difference was statistically significant (P<0.05). The total time of examination in the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). The final total score and the results of case analysis and clinical operation examination of experi-mental group were all higher than those of the control group, but there was no statistical difference (P>0.05). Conclusion OSCE combined with the network information system has an unparalleled advantage in the assessment of the obstetrics and gynecology department. The system will promote clinical education of ob-stetrics and gynecology and the evaluation of the clinical ability of the medical students to a new height, which deserves popularization.
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OBJECTIVE: As the demands of pharmacist's role and quality performance have increased, the verification of pharmacist's ability has been required. In this study, we aimed to select appropriate items for assessment of pharmacist's knowledge, attitude and performance. METHODS: Based on the pharmacist job analysis, we selected duties and tasks in consideration of applying pharmacy practical examination through brainstorming of internal researchers and group discussion with experts. Survey was conducted to evaluate the tasks according to the criteria detailed below: Realistic, Understandable, Measurable, Behavioral and Achievable (RUMBA). The subjects included professors at colleges of pharmacy and instructors of institutional or community pharmacy settings. RESULTS: Nine duties including 41 tasks were drawn for the survey through primary internal researchers. Of the 90 respondents, 95.6% were professors or preceptors who was engaged in practical training, and 62.2% had more than five years of practical experience. As a result of survey and discussion with expert panel, selected seven duties were selected as followings: ‘Patient (customer) reception’, ‘Drug preparation and distribution’, ‘Patient care’, ‘Administration’, ‘Patient counseling’, ‘Non-prescription medication counseling’, and ‘Provision of drug information’. The final 20 tasks from seven duties were chosen to assess skills that a pharmacist should be able to perform. CONCLUSION: This is the first study to select the items that can be included in pharmacist practical examination in the future, based on the RUMBA criteria. As a next step, it is necessary to study how to implement these items.
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Humans , Licensure , Pharmacies , Pharmacists , Pharmacy , Surveys and QuestionnairesABSTRACT
Objective To investigate the effectiveness and rationality of objective structured clinical examination (OSCE) used as achievement assessment for Postgraduate Year 1 surgery residents.Then the form and content of training and examination can be improved according to test results.Methods 31 Postgraduate Year 1 surgery residents were involved in the examination.The examination was composed of 5 stations,which were case analysis,wound dressing change,plaster fixation,laparoscopic simulator basic skills and irregular wound debridement suture.Each station was evaluated by centesimal system score and limited in 15 minutes.A questionnaire on their opinion and perception of the examination was given to each resident at the end of examination.A total number of 31 questionnaires were issued and recycled.The difficulty,discrimination and reliability of each station were calculated,and the correlation between each station was analyzed.Results The average OSCE score was (74.66 ± 4.39).The difficulty of total stations was 0.747.The distinction was 0.578 and the reliability was 0.402.The second station was lowest difficulty,and the fifth station was most difficult.Every station's discrimination was larger than 0.400.The reliability of the second and the fourth station was low.There was moderate correlation between the first station and the second station,as well as the first station and the fourth station.But there was no significant correlation between other stations.Residents' questionnaire survey showed that the fourth and the fifth stations were considered as the most difficult,and the second station was the simplest.They thought the fourth was most helpful for clinic.They performed best at the second station and worst at the fifth station.Conclusions OSCE can effectively evaluate the efficacy of the resident training.The residents' practical competency skills can be assessed better by examination simulating complex clinical scenario.Besides,after examination,we need to objectively evaluate the assessment efficiency,and dynamically adjust the training content and examination form according to residents' subjective opinions.
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Objective To assess standardized patients (SP) in resident general practitioners training for their consultation skills to explore its role in clinical competence training. Methods SP are employed in standardized training for 52 resident general practitioners in Shanghai during May to July 2008 to assess trainees' clinical consultation skills, including medical history taking and physical examinations, as well as clinical competencies of trainers including medical history taking, physical examinations, clinical thinking (diagnosis, differential diagnosis and treatment plans), health education, medical record writing,and reception time management. Feedback and appraisal for their consultation skills were provided by SP later. Problems encountered in trainees' consultation were discussed in group manner with their trainers.And two mouths later, assessment with SPs was undergone again for their consultation skills to compare their scores in consultation skills and percentages of them passing the assessment before and after training. Results Trainees were enrolled in the training aged (28±1 ) years in average ( with a ratio of men to women of 19/33 ). Percentage of trainees passing the assessment by SP for consultation skills was significantly higher after training (88.5%) than that before it (46. 2% ) ( P < 0. 01 ). Percentage of trainees with scores passing assessment by trainers was also significantly higher after training than that before it (86.5% vs. 51.9%, P < 0.01 ), with a percentage of those qualified for clinical skills and health education after training of 80. 8% and 88.5%, respectively, as compared to those of 46. 2% and 67. 3%,respectively before it, ( P < 0. 01 ), and with a percentage of trainees qualified for clinical thinking, out-patient medical record writing and reception time management not changed after training (71.2%, 100. 0%,100. 0%, respectively) as compared to those before it (51.9%, 100. 0% and 100. 0%, respectively)(P > 0. 05 ). Conclusions Application of SP can effectively enhance consultation skills of the trainees,especially in their medical history taking and physical examinations. However, there is still rooms to improvein their clinical thinking.
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Objective To set up methods for objective structured clinial examination(OSCE)for its application in assessment for clinical competencies of trainees in standardized training for general practice at its completion in Shanghai.Methods Trainees in standardized training for general practice in Shanghai were assessed at its completion in July 2009 at Zhongshan Hospital of Fudan University,which was organized and implemented by establishment of OSCE management framework and design of assessment stations,including writing-up medical records for cases,training standardized patients,selecting assessment itemsfrom checklists of clinical skills.as well as working-out a form for assessment scoring.Results Six assessment stations were set up for OSCE,including clinical data collection,medical record writing,case analysis,clinical skills,diagnostic decision-making based on electrocardiograms(ECGs)and x-ray films.Totally,32 trainees took part in OSCE and all passed examination.Score of medical record writing Was higher than that of clinical data collection [86(IQR 74-91)vs.79(IQR 67-85),P＜0.05].There was no significant difference in scores between medical reeord writing and case analysis [86(IQR 74-91)vs.80(IQR 73-86),P＞0.05].Score of X-ray film diagnosis Was higher than that of ECG diagnosis and clinical skills[99(IQR 96-100) vs.95(IQR 91-98),and 99(IQR 96-100)vs.90(IQR 83-94),all P＜0.01].Conclusions Clinical competeneies of trainees of general practice Can be assessed by OSCE in multiple aspects,which provides a new examination method for GP training.
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Objective To assess clinical competencies of trainees with standardized patients(SPs)and explore reform in methods of assessment for trainees at their completion in standardized training for general practice.Methods Totally,52 trainees in clinical training bases for general practice in Shanghai attended the examinations.Their skills in commanication skills,information and data gathering,comprehensive consultation,clinical thinking and decision-making in diagnosis and treatment were examined by rotation of three serial assessment stations in a specified time to perform standardized tasks,including medical history-taking,physical examinations(PE),medial record writing and oral tests.Results Scoresof history-taking,PE and skills of communication with SPs were higher than those agsessed by examiners themselves.but they both correlated each other with a P-value less than 0.01,with the highest coefficient of correlation of 0.774 between score of PE and that assessed by examiners.There was significant difference in average score among all clinical skills(F=9.867,P＜0.01),with the lowest one of comprehensive consultation skills of 64±22(P＜0.01).Skills of communication with patients had the highest correlation with data gathering ability(r=0.582,P＜0.01).Results of analysis for influential factors showed no significant difference in average score for all skills between men and women trainees(P＜0.05).Average score of comprehensive consultation ability in those with work experience was lower than that in thoge without it(P＜0.05)and no significant difference in scores of all the other skills wag found between those with varied length of working(P＞0.05).There was significant difiefence in average scores of communication skills,medical record writing,and case analysis between various trainees(P＜0.01).In addition,average scores of information collecting and medical record writing also differed among trainees from varied bases for general practice training(P＜0.05).Conclusions Clinical skills,ability to direct teaching work,and improvement of teaching model can be assessed in a comprehensive and objectively way using standardized patients in general practice training.
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1) Simulation-based learning is well organized in Universities of Dundee and Glasgow.Medical students use skills centre to brush up their clinical skills frequently.<BR>2) University of Glasgow developed clinical final OSCE using 50 stations.In the United Kingdom, where national board examination is not necessary to be a doctor, OSCE using 50 stations is organized to foster good doctors.
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PURPOSE: The purpose of this study is to report the opinions of the students on the OSCE and how to improve this exam. METHODS: 135 students at Pusan National University School of Medicine were asked to perform the OSCE. Data were collected through a questionnaire (Cronbach's alpha = .965). Analysis was done using SPSS statistics program. RESULTS: In summary, the students thought the content of the OSCE was all very important but practically, it was difficult to perform due to a lack of practice. Through this exam, thestudents said that they realized their insufficiencies, and they felt more motivated to learn. The BLS station scored very high in the 'validity of contents', 'validity of difficulty', 'validity of time limit', and 'fostering learning motivation'. The opinions of the students on the areas requiring improvement were: the control of information exchange among them, the connection with training, the establishment of a permanent training space, and increasing exposure to the exam. CONCLUSION: The OSCE, now more than ever, definitely has an educating role in preparing physicians for clinical practice.
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Humans , Learning , Surveys and QuestionnairesABSTRACT
PURPOSE: The third year students at Gyeong-Sang National University College of Medicine were asked to perform objective structured clinical examination (OSCE) at the end of the 2004 academic year. In this article, we analysed the correlation among the scores of OSCE with those of Final Term Examination in Internal Medicine (FTE), Clerkship Performance in Internal Medicine (CP) and Case Conference Examination (CCE), which assess knowledge, skill and attitude, and problem solving ability in medicine, respectively. We also analyzed difficulty and discrimination indexes of the test questions or evaluation criteria, and assessed their objectivity. METHODS: 1) Relevance: the pearson correlation analysis was performed on the scores of 85 students from 6 OSCE stations, FTE, CP and CCE. 2) Analysis on the evaluation criteria: the difficulty and discrimination indexes of the 59 evaluation criteria were calculated. 3) Objectivity: in order to assess objectivity in the scores, the Student t-test was performed on the scores of students from 4 OSCE stations where there was a change in the examiners after the morning sessions and on the students from 2 OSCE stations that had no change of examiners. RESULTS: 1) Relevance: Correlation coefficients between the scores of OSCE and FTE, CP or CCE were 0.335, 0.326 and 0.421, respectively (p < 0.01). 2) Analysis on the evaluation criteria: difficulty indexes of the 59 criteria ranged from 0.15 to 0.98, and 43% of the criteria belonged to the acceptable range. Discrimination indexes ranged from -0.22 to 0.61, and 69% of the criteria were acceptable. 3) Objectivity: The student t-test showed significant differences between the scores of the morning and afternoon sessions in 2 of the 4 stations, where the examiners were changed in the afternoon (p < 0.01). CONCLUSION: Our results suggest that OSCE performed in 2004 may have relevance to a valid tool in assessing clinical competence of medical students in terms of knowledge, skill, attitude and problem solving ability. However, in order to reuse the test materials in the future, evaluation criteria need to be refined further based on difficulty and discrimination indexes, and measures to improve objectivity of examiners should also be studied.
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Humans , Clinical Competence , Discrimination, Psychological , Internal Medicine , Problem Solving , Students, MedicalABSTRACT
PURPOSE: The standardized patient (SP) is a person carefully trained to represent a real patient case for consistent and accurate use in student performance evaluation and/or training, has added a very important dimension in OSCE. The purpose of this study is compared a well-trained professional SP (PSP) and a amateur SP (ASP) in OSCE. METHODS: We surveyed 378 students apprentices and staffs involving OSCE of Daegu-Kyungbuk Consortium and analysed the validity between the PSP and ASP after OSCE. RESULTS: Of 92 total stations in which students were evaluated by staff evaluator, SP were used in 47 stations (48%). Of the 47 stations, professional SP 7 stations (16%). The questionnaires were made to know the effectiveness and realistics of SP. The results were different between station used PSP and ASP. Moreover, it was significantly different between the staffs and the students. The SP can offer advantages such as availability, adaptability and effectivity. If trained well, they also can provide positive effects to the students and the staffs. The PSP provides efficient and reliable opportunity to assess clinical skills in a safe situation without any harm to the real patients. CONCLUSION: It is suggested that the use of SP is stimulating and challenging way of evaluating the OSCE. Also, It appeared to be financially and availably feasible if it commonly owned in the boundary of the land such Daegu-Kyungbuk Consortium.
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Humans , Clinical Competence , Viperidae , Surveys and QuestionnairesABSTRACT
The aim of this study is to evaluate the clinical competence of medical student using Objective Structured Clinical Examination (OSCE) in plastic surgery field. Development of OSCE with definition of an assessment of subject, choice of clinical stations sampling, identification of components of clinical competence to be evaluated, the level of performance required, development of specification table, editing of OSCE presentation page and assessment of praticability and results exploitation. Fourty-nine students were examined. Seven station stimuli with simulated patient participation were carried out. The mean OSCE score was 79.9+/-6.9. The reliability of the total station was 0.79. There was no significant logistic problem and the examinees showed positive response to the OSCE. Our experience suggests OSCE feasibility for Plastic Surgery during the initial course of education. This method should be considered as a useful tool to assess medical student competence or even in examination for board certification.
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Humans , Certification , Clinical Competence , Education , Mental Competency , Patient Participation , Students, Medical , Surgery, PlasticABSTRACT
Standardized patient(SP)is used to simulate clinical practice for examining medical students so as to train clinical skills and promote practicality and sociality in evidence-based education,through which important information of individual patient can be gained.It is the foundation and precondition for searching the best clinical evidences and accumulating abundant clinical experiences.Evidence-based medicine emphasizes the teaching model which centers on patients.Different patients should receive distinct strategy of treatment while making evidence-based decision.