The Objective Structured Clinical Examination as an Educational Tool in Patient Safety

Abstract

The Objective Structured Clinical Examination (OSCE) is an assessment tool characterized by the use of "lay" people trained to respond to questions in a standardized fashion. The learner's performance is observed and scored against a checklist of responses or behaviors. An OSCE station related to the communication and management of prescription errors was introduced in 2003 as part of a quality improvement (QI) curriculum at Mayo Medical School. All 42 third-year medical students took part in this pilot study, which was designed to evaluate the usefulness of an OSCE station as an assessment and educational tool for managing prescription errors. Thirty-three (76.7%) students agreed that the OSCE station enhanced their awareness of medication errors. Thirty (71.4%) students felt that their comfort level with communicating prescription errors to patients increased. Specific feedback regarding root cause analysis, collaboration with the pharmacist for error analysis, interpersonal and communication skills feedback from the faculty, and use of the standardized patient and of an actual prescription that led to a medication error, were found especially valuable. This pilot study demonstrates the potential use of the OSCE as an assessment and educational tool in QI and patient safety. The OSCE approximates a "live clinical setting" and provides an opportunity for the assessment of situational awareness and response, as well as formative and summative feedback to students.