Development and Implementation of an Objective Structured Clinical Examination (OSCE) in Neuromuscular Physical Therapy

Abstract

Background and Purpose. Designing evaluative experiences that can objectively assess clinical performance in didactic settings to ensure adequate skills preparation allows students to be “practice ready” to perform in clinical settings. Objective structured clinical examinations (OSCEs), commonly used by health professions, effectively assess clinical performance of students; however, little literature exists about using OSCEs to assess clinical skills with primarily neuromuscular populations. This project investigated the ability to assess clinical performance in neuromuscular physical therapy using OSCEs. Method/Model Description and Evaluation. Examination stations were developed, validated for content by experts, field tested on recent graduates, pilot tested, and analyzed for reliability. An 8-station OSCE tested performance of examination and intervention procedures, interaction with patients, interpretation of observations, and analysis of clinical situations via 4 interactive, standardized patient stations and 4 scenario-based, written/video stations. Third-year doctor of physical therapy students (n = 66) in their last didactic semester before a 6-month final clinical rotation participated in the pilot testing over a 1-year period. Outcomes. Test stations were valid and reliable (Cronbach's alpha = 0.72). Factor analysis confirmed 2 components to the OSCE, isolating domains representing standardized patient stations and written/video stations. All stations significantly correlated with the total OSCE score, and significant correlations were identified among patient interaction stations (r = .533 to .884). OSCE scores were highly correlated to the final grade in the course and overall grade point average (GPA). Discussion and Conclusion. Aside from higher than normal anxiety prior to and after the OSCE, students' perception of ability to perform examinations, interventions, or interpret results did not change before and after the OSCE. Successful use of OSCEs in physical therapy programs to assess knowledge and skills related to the management of patients with neuromuscular dysfunction is feasible. More studies investigating the relationship between OSCE performance and clinical performance need to occur.