患者シミュレータを使用した新たなアドバンストOSCEによるフィジカルアセスメントの技能評価とその問題点

Abstract

The new advanced OSCE for “physical assessment in the hospital ward” using the patient simulator was conducted to evaluate clinical skills at the Department of Pharmacy of Kyushu University of Health and Welfare. Four items of the measurement of [pulse (achievement score 66.7％)], [blood pressure (71.8％)], and [cardiac sound (74.4％)] as practical exams and the detailed assessment item regarding “deflate the cuff at a rate of 2-3 mmHg per second (57.7％)” were significant different from the average achievement score of detailed assessment items (93.5％). The results revealed that it was particularly difficult to assess arrhythmia in the measurement of [pulse] and hypertension in [blood pressure], and detect the S3 gallop in the measurement of [cardiac sounds]. We analyzed the results of students who marked “incorrect” for practical exams, and found that these students had only judged heart sounds heard with a stethoscope, suggesting that they did not assess the mechanism of generating abnormal sounds and its subsequent course in a comprehensive manner. The results also showed a defect of the exam in which the difficulties associated with physical assessment can be lowered by understanding the characteristics of the patient simulator. We hope that this report can provide evidence for the implementation of the advanced OSCE for new pharmacy education at all Faculty of Pharmaceutical Sciences.