An advanced objective structured clinical examination using patient simulators to evaluate pharmacy students' skills in physical assessment.

OBJECTIVE: To implement an advanced objective structured clinical examination (OSCE) in the curriculum and to evaluate Japanese pharmacy students' skills in physical assessment such as measuring pulse and blood pressure, and assessing heart, lung, and intestinal sounds. DESIGN: An advanced OSCE was implemented in a hospital pharmacy seminar as a compulsory subject. We programmed patient simulators with 21 different patient cases in which normal and abnormal physiological conditions were produced. The virtual patients were then used to evaluate the physical assessment skills of fifth-year pharmacy students. ASSESSMENT: Significant differences were observed between the average of all the detailed evaluations and the mean results for the following skills: pulse measurement, blood pressure measurement, deflating the cuff at a rate of 2-3 mmHg/sec, listening to heart sounds, and listening to lung sounds. CONCLUSION: Administering an advanced OSCE using virtual patients was an effective way of assessing pharmacy students' skills in a realistic setting. Several areas in which pharmacy students require further training were identified.

Study of correlations between the examinees' results on the basic objective structured clinical examination (OSCE), computer-based testing, and the advanced OSCE / 医学教育

Studying the correlation between the results of the Common Achievement Test (basic objective structured clinical examination [OSCE] and computer-based testing [CBT]) and the results of advanced OSCE in the same examinees is necessary to improve clinical clerkships and to establish the role of each examination.<BR>1) Ninety-seven students took the Common Achievement Test CBT and the basic OSCE in their fourth year and took the advanced OSCE in their sixth year. The Common Achievement Test basic OSCE were composed of interview, chest, abdomen, neurology, and head and neck stations, and the CBT included blocks 1-4 and 5-6. The advanced OSCE had 3 scenarios in the chest station, 2 in the abdomen station, and 4 in the neurology station. Each scenario had 3 items. We also examined the pass analysis on the basis of these 3 items in the advanced OSCE.<BR>2) The results of the Common Achievement Test basic OSCE interview did not correlate significantly with the results of the interview station of the advanced OSCE. The results of physical examinations in the Common Achievement Test basic OSCE, excluding the chest, did not correlate significantly with the results of the physical examination stations of the advanced OSCE.<BR>3) In the advanced OSCE, an adequate medical interview is necessary for the physical examination. An adequate physical examination is also necessary for answering the written tests (e.g., differential diagnosis). 4) Students should have sufficient basic knowledge and motivation for successfully performing clinical clerkships, because the correlations among the results of the advanced OSCE interview, the OSCE total score, the Common Achievement Test basic OSCE and CBT score were extremely strong.<BR>5) The advanced OSCE, the Common Achievement Test basic OSCE, and CBT have distinct characteristics and roles.

Experiences at the Advanced OSCE Osaka Trial / 医学教育

We participated in the “Advanced Objective Structured Clinical Examination (OSCE) Osaka Trial, ” which was part of the 10th Medical Education Seminar and Workshop in Osaka. OSCEs have been used to assess students' clinical ability before the clinical clerkship program, where the medical interview and the medical examination are introduced as basic clinical skills. The Advanced OSCE is used to assess students' clinical ability after they have done clinical clerkships; it will soon be a part of the national board examination. In the present trial, the students and residents took the Advanced OSCE with 6 themes: pharyngeal pain, palpitations, dyspnea, abdominal pain, hypertension, and cardiac arrest. We examined questionnaires completed by students and residents just after they had taken the Advanced OSCE. We believe that the use of simulators is important for medical students and residents to improve their clinical skills and that appropriate feedback is also extremely important.