Comparison of Objective Structured Practical Examination (OSPE) Versus Conventional Pathology Practical Examination Methods Among the Second-Year Medical Students-a Cross-sectional Study.

INTRODUCTION: The medical education in India is moving towards competency-based medical education (CBME) with many cognitive and psychomotor skills needed to be taught and assessed in the various subjects of the undergraduate medical curriculum. In the Pathology subject, psychomotor skills such as haemoglobin estimation, blood grouping, urine examination, liver function test/cerebrospinal fluid interpretation, histopathology and haematology slide interpretation are taught and assessed for many years. Skill assessment by the conventional method, which is followed since many years, is subjective in nature and lack of scope for direct observation of the performance of skills. Objective structured practical examination (OSPE) is one of the methods to minimize the variations in subjectivity, thus enhancing the objectivity. Due to a technicality and labour intensity, it is implemented only in a few medical colleges and universities across India. Because of CBME curriculum on the roll, the assessment of practical skills in medical education needs to be shifted from conventional subjective methods to more objective OSPE methods. MATERIAL AND METHODS: After institutional ethical clearance, the second-year medical students appearing for practical in Pathology were selected for the study. Practical skills of the students were assessed by both the conventional way and OSPE after obtaining the written consent. Among 104 students, 89 students were assessed by both methods. Adequate instructions about the pattern of the examination were given in both assessment methods. For the OSPE group, specific instructions about the role of observer, response stations and method of scoring were given. Practical performance of haemoglobin estimation and blood grouping by slide method was assessed, and scores were compared. Student and faculty perception regarding OSPE was assessed by a prevalidated questionnaire. RESULTS: In the conventional group, the mean score of 6.91 ± 1.08 was obtained, while in OSPE, it was 8.43 ± 1.41. In comparing both, a p value of > 0.001 was obtained, which is found to be significant. Student's perceptions appeared to favour the OSPE format rather than the traditional examination. CONCLUSION: This study showed a significant difference in scores obtained by OSPE in comparison with conventional practical examination. Thus, this information suggests that OSPE format was perceived better by the students, and resulted in a higher average score. Hence, the use of OSPE as a formative assessment tool will help in modifying teaching-learning strategies so that it is beneficial to students and teachers.

Giant cystic thymoma with haemorrhage and necrosis: an unusual case.

Extreme degree of cystic, haemorrhagic and necrotic changes in a thymoma is rare. A 22-year-old male presented with cough, grade 2 dyspnoea, and occasional chest pain for the past six months. Radiological investigations revealed a large cystic lesion in the anterior mediastinum. A benign cystic tumour was suspected. Surgical resection of the tumour was done. Grossly, the almost entirely cystic and haemorrhagic dumb-bell shaped encapsulated tumour showed a subcapsular residual nodule. Histopathological examination was suggestive diagnosis of benign thymoma (World Health Organization [WHO] Type A, medullary type) associated with the rare features of cells with dendritic processes containing melanin pigment seen singly scattered throughout the tumour.