Abstract
This article was migrated. The article was marked as recommended. Introduction: Little is known about the medical student's cognitive ability in diagnostic and therapeutic accuracy. Literature does not suggest a methodology to quantify students' cognitive processing. Situation Awareness (SA) is described as having the proficiency to obtain awareness of the surrounding and to integrate this consciousness into the situational context and potential forthcoming development. OSCEs might be a suitable instrument to evaluate students' awareness of the situation. Methods: Consecutive guided training was provided to obtain a consistent comprehension of the model of SA. 4 independent researchers consecutively examined 6 randomised OSCE forms in a qualitative and quantitative method. Final interrater agreement was expressed as Cohens kappa. Generalisability theory determined the impact of the main facets on the variation in disagreement. Results: Evaluation of identifying and categorising elements of SA within OSCE forms demonstrated a moderate to very good interrater agreement. The G-Theory revealed key facets for variance: OSCE forms, Levels of SA, Items embedded in the Levels, Interaction between Forms and Levels and Forms and Items embedded within Levels. Conclusion: Consecutive guided training improved the identification of elements of SA within OSCE assessments. Further research is necessary to improve the assessment of SA in undergraduate medical curricula.
Highlights
Little is known about the medical student’s cognitive ability in diagnostic and therapeutic accuracy
The G-Theory revealed key facets for variance: Objective Structured Clinical Examination (OSCE) forms, Levels of Situation Awareness (SA), Items embedded in the Levels, Interaction between Forms and Levels and Forms and Items embedded within Levels
Consecutive guided training improved the identification of elements of SA within OSCE assessments
Summary
Little is known about the medical student’s cognitive ability in diagnostic and therapeutic accuracy. Deficient information processing of physicians is reported throughout the literature, suggesting the exigency to develop strategies to foster more competent cognitive reasoning abilities (La Pietra et al, 2005; Graber, Wachter and Cassel, 2012). Not much evidence exists on the issue in professional healthcare settings such as primary care or speciality training (Singh et al, 2017) Findings within these clinical areas support the identification of subdomains within the CR process that contribute to erroneous consequences. Conclusions of these studies are pointing towards the necessity to develop methods to assess the clinicianscognitive ability for diagnostic reasoning (Cutrer, Sullivan and Fleming, 2013; Zwaan, Schiff and Singh, 2013; Wood, 2014). Research outcomes direct the focus on the development of educational strategies which can be implemented into early medical training including assessments such as the Objective Structured Clinical Examination (OSCE) (Graber, 2009)
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