Maximizing Opportunities for Anatomy Learning: Use of Authentic OSPE as Part of Assessment in Anatomy

Abstract

In the care of patients, a practicing physician performs a selected and integrated set of individually skillful acts that are pertinent to each patient encounter. These include, for example, engaging the patient in a professional relationship, taking a clinical history, performing a mental and physical examination, performing, or initiating clinical tests or procedures, and undertaking diagnostic and therapeutic interventions. From an analytic perspective, these component acts of medical care reflect the generic competencies which comprise the practitioner’s basic clinical method1.Skill learning requires the demonstration of skill proficiency that must be observable. This observation is necessary to evaluate performance. Moreover, learners need repeated and deliberate practice followed by constructive feedback to continually refine and improve their performance of the skill. Therefore, the evaluation of skill proficiency requires the direct involvement of a trained observer, such as a supervising expert or an experienced patient2.The utility or value of assessment items (question used in an examination) depends on; their validity, reliability, educational impact, cost, and acceptability3. For instance, a written examination item had good value and utility if it tests learning in the knowledge domain. In the same way, a written examination item has poor utility if used for testing psychomotor skills.The so‐called OSPE (Objective Structured Practical Examination) has its origins in physiology4 where competence in performing physiological tests (e.g. Rinne’s test) are examined through observation by an examiner using a structured checklist (similar to Objective Structured Clinical Examination, OSCE). Within the context of medical education, an activity could be regarded as a clinical skill if it satisfies three conditions namely, the activity must be demonstrable, observable, and employs using knowledge, psychomotor and attitude components of learning (Fig 1).Anatomy learning in medical education underpins the development of clinical reasoning, understanding of medical imaging, the basis of clinical procedures, and physical examination of patients. An authentic utilization of the concept of OSPE in anatomy education should be in the context of evaluating a true skill competence. This will include evaluating competence in physical examination and/or clinical procedural skill (Fig 2). In current undergraduate medical education, these skills and more are now part of a comprehensive and integrated clinical skills curriculum.References AAMC, (2005). Recommendations for Clinical Skills Curricula for Undergraduate Medical Education. Association of American Medical Colleges. Duvivier et al. (2011) BMC Medical Education 11:101 Van der Vleuten CPM, (1996). Advances in Health Sciences Education 1 (1), 41‐67 Nayar U et al. (1986). Med Educ 20 (3):204‐9