Abstract
BackgroundThe Objective Structured Clinical Exam (OSCE) is a useful means of generating meaningful feedback. OSCE feedback may be in various forms (written, face to face and audio or video recordings). Studies on OSCE feedback are uncommon, especially involving Asian medical students.MethodsWe compared two methods of OSCE feedback delivered to fourth year medical students in Malaysia: (i) Face to face (FTF) immediate feedback (semester one) (ii) Individualised enhanced written (EW) feedback containing detailed scores in each domain, examiners’ free text comments and the marking rubric (semester two). Both methods were evaluated by students and staff examiners, and students’ responses were compared against their OSCE performance.ResultsOf the 116 students who sat for both formative OSCEs, 82.8% (n=96) and 86.2% (n=100) responded to the first and second survey respectively. Most students were comfortable to receive feedback (91.3% in FTF, 96% in EW) with EW feedback associated with higher comfort levels (p=0.022). Distress affected a small number with no differences between either method (13.5% in FTF, 10% in EW, p=0.316). Most students perceived both types of feedback improved their performance (89.6% in FTF, 95% in EW); this perception was significantly stronger for EW feedback (p=0.008). Students who preferred EW feedback had lower OSCE scores compared to those preferring FTF feedback (mean scores ± SD: 43.8 ± 5.3 in EW, 47.2 ± 6.5 in FTF, p=0.049). Students ranked the “marking rubric” to be the most valuable aspect of the EW feedback. Tutors felt both methods of feedback were equally beneficial. Few examiners felt they needed training (21.4% in FTF, 15% in EW) but students perceived this need for tutors’ training differently (53.1% in FTF, 46% in EW)ConclusionWhilst both methods of OSCE feedback were highly valued, students preferred to receive EW feedback and felt it was more beneficial. Learning cultures of Malaysian students may have influenced this view. Information provided in EW feedback should be tailored accordingly to provide meaningful feedback in OSCE exams.
Highlights
The Objective Structured Clinical Exam (OSCE) is a useful means of generating meaningful feedback
Of the 116 students who sat for both OSCEs, 96 students participated in the survey on face to face (FTF) feedback in semester 1 and 100 responded to the survey on enhanced written (EW) feedback in semester 2
Most students felt comfortable to receive both forms of feedback with EW feedback scoring higher (p= 0.022) in mean responses implying a higher level of comfort for the written feedback
Summary
The Objective Structured Clinical Exam (OSCE) is a useful means of generating meaningful feedback. Medical students may receive feedback in a variety of clinical and non-clinical contexts where opportunities for feedback on clinical competencies are especially valuable. With this regard, an Objective Structured Clinical Examination (OSCE) can offer a unique opportunity to provide feedback on clinical competencies. During an OSCE, students rotate through structured stations designed to assess competencies and examiners assess their performance objectively using predetermined criteria [3]. This offers a valuable opportunity to provide feedback which is personalised and timely to help students improve their clinical skills
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