Assessment Of Clinical Competence Research Articles

International medical graduates' experiences of clinical competency assessment in postgraduate and licensing examinations: A scoping review protocol.

An international medical graduate (IMG) is a doctor who has received their basic medical qualification from a medical school located in a different country from that in which they practice or intend to practice. IMGs are known to face difficulties in their working lives, including differential attainment in assessment. The objective of this review is to map key concepts and types of evidence in academic and gray literature relating to international medical graduates' experiences of clinical competency assessment and to identify knowledge gaps on this topic by systematically searching, selecting, and synthesizing existing knowledge. All studies will relate to IMGs. The concept of interest will be IMGs' experiences of assessment. The context will be postgraduate, licensing or credentialing medical assessments of clinical competence. This review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Seven electronic databases will be searched for literature published between 2009 and 2024: the Australian Education Index, British Education Index, ERIC, PubMed, PsycINFO, Scopus, and SocINDEX. Gray literature will be searched using Google, Google Scholar, and published reports from postgraduate training bodies and medical licensing organizations. Documents will be independently screened, selected, and extracted by two researchers using a piloted data-extraction tool. Data will be analyzed and presented in tables and in a narrative format. Trial resgistration: Scoping review registration: Open Science Framework: https://osf.io/8gdm7.

The equivalence of a high-stakes objective structured clinical exam adapted to suit a virtual delivery format.

The COVID-19 pandemic necessitated rapid adaptation of clinical competence assessments, including the transition of Objective Structured Clinical Examinations (OSCE) from in-person to virtual formats. This study investigates the construct equivalence of a high-stakes OSCE, originally designed for in-person delivery, when adapted for a virtual format. A retrospective analysis was conducted using OSCE scores from the Internationally Educated Nurse Competency Assessment Program (IENCAP®). Data were collected from 15 exam administrations between January 2018 and June 2022, encompassing 2021 examinees (1936 in-person, 85 virtual). The Many-Facet Rasch Measurement (MFRM) model was employed to analyze the invariance of examinee ability, case difficulty, and criteria difficulty across in-person and virtual formats. Results revealed overall examinee ability estimates remained invariant regardless of the OSCE format, while invariant violations were identified in only three of the 15 cases (N = 20%) adapted to suit the virtual format. The most significant adaptation, namely the use of a verbal physical examination to suit the virtual context achieved equivalence to its hands-on in-person counterpart given evidence of invariance across criteria estimates. Interestingly, criteria scores in invariant violated cases displayed a higher level of stability or consistency across the virtual OSCE formats versus their in-person counterpart highlighting a potential benefit of the virtual versus in-person format and potentially linked to the verbal physical examination. The study found that while examinee ability and case difficulty estimates exhibited some invariance between in-person and virtual OSCE formats, criteria involving physical assessments faced challenges in maintaining construct equivalence. These findings highlight the need for careful consideration in adapting high-stakes clinical assessments to virtual formats to ensure fairness and reliability.

The Next Era of Assessment Within Medical Education: Exploring Intersections of Context and Implementation.

In competency-based medical education (CBME), which is being embraced globally, the patient-learner-educator encounter occurs in a highly complex context which contributes to a wide range of assessment outcomes. Current and historical barriers to considering context in assessment include the existing post-positivist epistemological stance that values objectivity and validity evidence over the variability introduced by context. This is most evident in standardized testing. While always critical to medical education the impact of context on assessment is becoming more pronounced as many aspects of training diversify. This diversity includes an expanding interest beyond individual trainee competence to include the interdependency and collective nature of clinical competence and the growing awareness that medical education needs to be co-produced among a wider group of stakeholders. In this Eye Opener, we wish to consider: 1) How might we best account for the influence of context in the clinical competence assessment of individuals in medical education? and by doing so, 2) How could we usher in the next era of assessment that improves our ability to meet the dynamic needs of society and all its stakeholders? The purpose of this Eye Opener is thus two-fold. First, we conceptualize - from a variety of viewpoints, how we might address context in assessment of competence at the level of the individual learner. Second, we present recommendations that address how to approach implementation of a more contextualized competence assessment.

Association between physicians’ maldistribution and core clinical competency of resident physicians: a nationwide cross-sectional study

ObjectivesWith physician maldistribution recognised as a global issue, Japan implemented the physician uneven distribution (PUD) index as a strategic measure. Currently, there is a lack of objective assessment of core...

PROMOTE: An Innovative Curriculum to Enhance the Maternity Care Workforce.

Maternal morbidity and mortality disproportionally affect marginalized populations in both rural and urban settings. While the workforce of family physicians (FPs) who provide maternity care is declining, an enhanced obstetrics (OB) curriculum during residency training can help prepare future FPs to provide competent pregnancy care, particularly in marginalized communities. We developed an innovative OB curriculum-PROMOTE: Primary care obstetrics and maternal outcomes training enhancement-in an urban underserved residency program in Pennsylvania that directly addressed barriers previously known to impact maternity care practice. We created a clinical competency assessment aligned with Accreditation Council for Graduate Medical Education requirements, and we reviewed resident feedback and logs throughout and upon completion of the track. After 3 years of implementation, 23 of 48 (48%) total residents entered and/or completed PROMOTE, compared to 17 of 45 (38%) total residents who chose the OB track in the 5 years prior to implementation. Postimplementation, 29.6% of total graduates practice inpatient obstetrics, compared to 26.6% prior to implementation. Twice annual competency evaluations were completed for all residents on the track. Our review of resident submitted feedback, logs, and competency assessments suggests that the curriculum has positively impacted their knowledge, skills, and clinical care provision. PROMOTE's curricular innovation enhances obstetrical training by addressing known facilitators and barriers to practicing family medicine obstetrics. PROMOTE was implemented in an existing family medicine residency with an obstetrics track and could be adapted by other residency programs to enhance the future maternity care workforce.

Clinical reasoning and clinical judgment in nursing research: A bibliometric analysis.

To characterize the thematic foci, structure, and evolution of nursing research on clinical reasoning and judgment. Bibliometric analysis. We used a bibliometric method to analyze 1528 articles. We searched the Scopus bibliographic database on January 7, 2024. Through a keyword co-occurrence analysis, we found the most frequent keywords to be clinical judgment, clinical reasoning, nursing education, simulation, nursing, clinical decision-making, nursing students, nursing assessment, critical thinking, nursing diagnosis, patient safety, nurses, nursing process, clinical competence, and risk assessment. The focal themes, structure, and evolution of nursing research on clinical reasoning and judgment were revealed by keyword mapping, clustering, and time-tracking. By assessing key nursing research areas, we extend the current discourse on clinical reasoning and clinical judgment for researchers, educators, and practitioners. Critical challenges must still be met by nursing professionals with regard to their use of clinical reasoning and judgment within their clinical practice. Further knowledge and comprehension of the clinical reasoning process and the development of clinical judgment must be successfully translated from research to nursing education and practice. This study highlights the nursing knowledge gaps with regard to nurses' use of clinical reasoning and judgment and encourages nursing educators and professionals to focus on developing nurses' clinical reasoning and judgment with regard to their patients' safety. In addressing nurses' use of clinical reasoning and judgment, and with regard to patient safety in particular, this study found that, in certain clinical settings, the use of clinical reasoning and judgment remains a challenge for nursing professionals. This study should thus have an effect on nursing academics' research choices, on nursing educators' teaching practices, and on nurses' clinical practices. Relevant EQUATOR guidelines have been adhered to by employing recognized bibliometric reporting methods.

Development and validation of a new satisfaction scale for objective structured clinical assessments (S-OSCA): A multicenter cross-sectional study

BackgroundNursing clinical competence assessment has acquired a special relevance at the undergraduate and postgraduate levels in recent years. In this context, the Objective Structured Clinical Assessment (OSCA) has emerged as a valid and feasible method of assessing nursing competence. The Satisfaction with Nursing Skill Examination: Objective Structured Clinical Assessment (SINE-OSCA) scale is a valid and reliable 10-item measure that has been developed to evaluate nursing students' satisfaction with the OSCA in the Australian context. Given the importance that OSCA has gained in Spain, it is necessary to validate this tool to be used in one of the most spoken languages in the world. ObjectivesThe purpose of the study was to carry out a modification of the SINE-OSCA, cross-cultural adaptation and a psychometric analysis of the new S-OSCA with Spanish nursing students. DesignA multicenter study of questionnaire development and validation was carried out in 2023 in four Spanish university nursing centers. The study was carried out in 3 phases: design, pilot implementation, and construct validation. Participants/settingThe total population of students from these centers amounted to 1350 students. The final sample consisted of 364 nursing students, selected by convenience sampling. MethodsThe process of translation and cultural adaptation of SINE-OSCA to the Spanish population was carried out following the guidelines proposed by Beaton et al. Content validation, Internal consistency and temporal reliability were evaluated. ResultsThe S-OSCA presents values in the psychometric indicators (V AIKEN, Bland-Altman diagram, and IVC Lawshe) that exceed the cut-off values established even considering the lower limit of the confidence intervals. This spanish version of the SINE-OSCA has a Cronbach's alpha value that is slightly higher than that reported for that original version (0.928 CI 95 % (0.913–0.94)). Regarding temporal reliability, the S-OSCA scale was completed in 40 nursing students at two times separated by an interval of 15 days. The Intraclass Correlation Coefficient (ICC) obtained was 0.974 CI 95 % (0.952–0.986). ConclusionsThe S-OSCA instrument proves to be robust enough to guarantee the quality of its results up to 15 days post-OSCA.

Bridging School and Practice? Barriers to the Integration of 'Boundary Objects' for Learning and Assessment in Clinical Nursing Education.

In clinical health professions education, portfolios, assignments and assessment standards are used to enhance learning. When these tools fulfill a bridging function between school and practice, they can be considered 'boundary objects'. In the clinical setting, these tools may be experienced as time-consuming and lacking value. This study aimed to investigate the barriers to the integration of boundary objects for learning and assessment from a Cultural-Historical Activity Theory (CHAT) perspective in clinical nursing education. Nineteen interviews and five observations were conducted with team leads, clinical educators, supervisors, students, and teachers to obtain insight into intentions and use of boundary objects for learning and assessment. Boundary objects (assessment standards, assignments, feedback/reflection/patient care/development plan templates) were collected. The data collection and thematic analysis were guided by CHAT. Barriers to the integration of boundary objects included: a) conflicting requirements in clinical competency monitoring and assessment, b) different application of analytical skills, and c) incomplete integration of boundary objects for self-regulated learning into supervision practice. These barriers were amplified by the simultaneous use of boundary objects for learning and assessment. Underlying contradictions included different objectives between school and practice, and tensions between the distribution of labor in the clinical setting and school's rules. School and practice have both convergent and divergent priorities around students' clinical learning. Boundary objects can promote continuity in learning and increase students' understanding of clinical practice. However, effective integration requires for flexible rules that allow for collaborative learning around patient care.

Integration of Virtual and Traditional Medical Education: Scholarship Pivots from the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic required an unprecedented transformation of medical education, shifting from traditional, in-person learning to distanced, online learning. This study aimed to review changes to medical education and describe the advantages and disadvantages of virtual medical education experienced by medical students during the pandemic. An online survey study was conducted at two medical schools, University of Michigan Medical School in the United States and Koc University School of Medicine in Turkey. Medical students completed questionnaires regarding their educational experience before and during the pandemic. Survey instruments were designed to assess differences in the educational curriculum, study methods, clinical skills self-evaluations, perceptions of the quality of in-person and online learning, and overall satisfaction. A total of 184 medical students completed the survey. There was an increase in the use of online study tools since the pandemic. There was no statistically significant difference in self-reported assessments of clinical preparedness and overall clinical competence during surgical clerkship. The percentage of students interested in pursuing a career in surgery has nearly doubled from 34% to 63%. A majority of students (83%) believed that the time available for self-study and research increased during the pandemic. Fifty-two percent of students believed that online education is less efficacious than in-person education, but 86% of students still preferred a blended approach. Medical schools have continued to update their curricula following the COVID-19 pandemic. This study illustrates the transformations in medical education to ensure that the most effective and suitable teaching is delivered.

Relationship between learning styles and clinical competency in nursing students

BackgroundThe acquisition of clinical competence is considered the ultimate goal of nursing education programs. This study explored the relationship between learning styles and clinical competency in undergraduate nursing students.MethodsA descriptive-correlational study was conducted in 2023 with 276 nursing students from the second to sixth semesters at Abhar School of Nursing, Zanjan University of Medical Sciences, Iran. Data were collected using demographic questionnaires, Kolb’s learning styles, and Meretoja’s clinical competence assessments completed online by participants. Data were analyzed using SPSS version 16, employing descriptive statistics and inferential tests (independent T-test, ANOVA, Pearson correlation) at a significance level 0.05.ResultsThe predominant learning styles among nursing students were divergent (31.2%), and the least common was convergent (18.4%). The overall clinical competency score was 77.25 ± 12.65. Also, there was a significant relationship between learning styles and clinical competency, so the clinical competency of students with accommodative and converging learning styles was higher. (P < 0.05).ConclusionThe results of this study showed the association between learning styles and clinical competence in nursing students. It is recommended that educational programs identify talented students and provide workshops tailored to strengthen various learning styles associated with enhanced clinical competence.

Compare the Effectiveness of Objective Structured Clinical Evaluation (OSCE) versus Checklist in Demonstration of Antenatal Abdominal Examination among Final Year G.N.M. students.

The OSCE is an approach to the assessment of clinical competence in which the components of competence are assessed in a planned or structured way with attention being paid to the objectivity of the evaluation” Harden, 1988 .The Objective Structured Clinical Exam (OSCE) is a performance- based exam. During the exam, trainees are observed and evaluated as theygo through a series of stations where they interview, examine and treat standardized patients presenting with some type of problem. An OSCE is: • Objectivity, because examiners use a checklist for evaluating the trainees. • Structured, because every trainee sees the same problem and performs same tasks in the same time frame. • Clinical based, because the tasks are representative of those faced in real clinical situations • An evaluation method II – Materials and Methods Comparative research design was used with group I &amp; group II to assess the effectiveness of objective structured clinical evaluation (OSCE) versus checklist in demonstration of antenatal abdominal examination among final year G.N.M students. The study conducted on 30 samples in each group. Data was collected using Objective Structured Clinical Evaluation and checklist for assessing performance of G.N.M final year students on abdominal examination. III – Results The overall mean and S.D. of OSCE was 11.03 with a percentage mean of 91.39% and 16.59 whereas the overall mean and S.D. of Checklist was 55.73 with a percentage mean of 79.62% and 11.24. The calculated ‘t’ value was higher than the table value (t58 = , P&lt; 0.01). Hence, the null hypothesis was rejected and research hypothesis was accepted and it was inferred that in the present study there was significant difference between the effectiveness of demonstration on antenatal abdominal examination during pregnancy assessed by Objective Structured Clinical Evaluation (OSCE) &amp; checklist among G.N.M final year students. Comparing the mean percentage of OSCE and Checklist 91.39% and 79.62%, it is inferred that the mean percentage of OSCE i.e. 91.39% is higher than the mean percentage of Checklist i.e. 79.62%. Therefore, it can be concluded that the OSCE is more effective than the checklist for evaluating the demonstration of abdominal examination during pregnancy. IV – Conclusion This study concluded that in comparison to, OSCE was found to be a more effective assessment tool than traditional method checklist. Use of OSCE as formative tool will help in modifying teaching- learning strategies so that both, the teachers as well as the students can derive maximum benefit

Virtual assessment in Physiotherapy: Examining perceptions, constructs, and tool characteristics

Introduction: Objective structured clinical examinations have traditionally been used to assess clinical skills. However, these face-to-face clinical assessments were hindered by physical and social restrictions imposed during COVID-19. This created a need to develop novel approaches for reliable assessment of clinical skills. We explored and evaluated a virtual exercise teleconsultation assessment (VETA) to replicate a teleconsultation setting where physiotherapy students were assessed on exercise prescription and coaching skills. Methods: We conducted a cross-sectional mixed-methods study using convenience sampling. A VETA was implemented for 172 physiotherapy students via Zoom to allow synchronous interaction with standardised patients (SPs). 67 students and 9 SPs completed two separate post evaluation surveys on themes relating to administration, support, authenticity, effectiveness, and value of the VETA. Likert-type responses were categorised as positive, neutral, or negative while coded qualitative responses were consolidated into themes by inductive content analysis. Results: 76% of students agreed that the assessment was authentic while 93% felt that the SPs were realistic and believable. Responders also highlighted important challenges including the limited camera viewing angle, time and space constraint, adequacy of equipment and reliability of connectivity. Exploratory factor analysis of responses revealed three latent constructs: (1) clarity of assessment, (2) clinical relevance, and (3) value of assessment. Conclusion: Despite the technical challenges, VETA demonstrated clarity and value as an alternative assessment and showed relevance to future telehealth practice, which is increasingly pervasive in clinical settings. This paper demonstrates a feasible approach for the virtual assessment of clinical competencies. Keywords: Health Sciences Education, Virtual Assessment, Clinical Skills, OSCE, Physiotherapy, Exercise Prescription

Implementation of nurse’s clinical competency: A scoping review

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt;:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Nursing care provided to patients, especially in hospitals, is expected to be of high quality, and its implementation is in accordance with the nurse's clinical competence. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;&lt;strong&gt;Objectives:&lt;/strong&gt; This scoping review aimed to assess the implementation of the clinical competence of nurses in hospitals so that a clear picture of the implementation of these competencies is obtained. In addition, this study can be evidence-based and related to implementing these clinical competencies. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;This literature review used PICO framework to develop articles questions (P: nurses, I: not applicable, C: not applicable, and O: application of clinical nursing competency). Articles search for literature review was conducted during April and May 2023. &lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;This study used Pubmed and ScienceDirect Databases and other sources. The keywords that used in this scoping review was &lt;/em&gt;&lt;em&gt;“nursing competency” OR “clinical nursing competency” AND “evaluation” OR “implementation” AND “hospital”.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;There were 1,150 articles from the search results, but only seven were included for review. One article is a descriptive comparative study using a qualitative approach, and six articles are cross-sectional studies. The articles are publications within five years (2019-2023). In its implementation, the average clinical competency of nurses is at a low to moderate level, and only one study found was at high nurse competency. The results of the supervisor's clinical competency assessment were significantly lower than those assessed by oneself and the group. In addition, &lt;/em&gt;&lt;em&gt;the nurse competency level was moderate, and there was no significant difference in the clinical competency of nurses before and during the COVID-19 pandemic.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;strong&gt;&lt;em&gt;Conclusions: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The implementation of nurses' clinical competence has yet to be optimal, so hospital management needs to improve nurses' clinical competence so that nurses can provide higher quality and professional nursing care in the hospital.&lt;/em&gt;

The validity of the selection methods for recruitment to UK core psychiatry training: cohort study.

Selection into core psychiatry training in the UK uses a computer-delivered Multi-Specialty Recruitment Assessment (MSRA; a situational judgement and clinical problem-solving test) and, previously, a face-to-face Selection Centre. The Selection Centre assessments were suspended during the COVID-19 pandemic. We aimed to evaluate the validity of this selection process using data on 3510 psychiatry applicants. We modelled the ability of the selection scores to predict subsequent performance in the Clinical Assessment of Skills and Competencies (CASC). Sensitivity to demographic characteristics was also estimated. All selection assessment scores demonstrated positive, statistically significant, independent relationships with CASC performance and were sensitive to demographic factors. All selection components showed independent predictive validity. Re-instituting the Selection Centre assessments could be considered, although the costs, potential advantages and disadvantages should be weighed carefully.

Cross-Sectional Survey of Student and Faculty Experiences with Feedback and Assessment of Clinical Competency on Final Year Rotations at American Association of Veterinary Medical Colleges (AAVMC) Member Institutions.

The clinical experiences, feedback, and assessment that veterinary students receive during final year rotations have a significant impact on whether they will achieve entry-level competency at the time of graduation. In this study, a cross-sectional survey was administered to American Association of Veterinary Medical Colleges (AAVMC) member institutions to collect baseline data about current feedback and assessment practices to identify key target areas for future research and educational interventions. Responses were received from 89 faculty and 155 students distributed across 25 universities. The results indicated that there are significant gaps between evidence-based approaches for delivering feedback and assessment and what was being implemented in practice. Most feedback was provided to students in the form of end-of-rotation evaluations sometimes several weeks to months after the rotation finished when faculty were unlikely to remember specific interactions with students and there were limited opportunities for students to demonstrate progress towards addressing identified concerns. Although the most valuable type of feedback identified by students was verbal feedback delivered shortly after clinical experiences, this method was often not used due to factors such as lack of time, poor learning environments within veterinary teaching hospitals, and lack of faculty training in delivering effective feedback. The results also indicated potential challenges with how non-technical domains of competence within the AAVMC Competency-Based Veterinary Education (CBVE) Framework are currently evaluated. Finding avenues to improve feedback and assessment processes in final year clinical settings is essential to ensure that veterinary students are adequately prepared for practice.

Competency in medical training: current concepts, assessment modalities, and practical challenges.

In the past two decades, competency-based medical education (CBME) has rapidly become the cornerstone of medical training and accreditation programmes worldwide. It has increasingly replaced traditional time-based educational approaches which were often rigid, fragmented, and overly emphasized clinical content knowledge over practical skillsets and attitudes. CBME adoption was in the hope of better preparing medical graduates for the demands and responsibilities of real-world clinical practice. For all the supposed merits of CBME, there hitherto remains difficulties in arriving at comprehensive and practical 'competency' definitions, and actual challenges with implementation of clinical competency assessment modalities pertaining to construct validity, reliability, and applicability with the use and interpretation of evaluation metrics. Therefore, in this article, we describe the various conceptualizations of 'competency' in medical education literature and attempt to refine its usage in practice to meet the evolving needs and expectations of healthcare stakeholders, as well as incorporate emerging concepts in the medical education discourse. We herein propose that clinical 'competencies' should be defined as multi-domain clinical expertise, comprising medical knowledge, skills, attitudes and metacognitive capabilities that reflects the prevailing needs of healthcare stakeholders, and is inferred from performance evaluations of medical trainees. In order to attain 'competence', there must then be a process of integrating multi-domain competencies into meaningful professional identity formation that is commensurate with the context and stage of medical training. In addition, we review the current competency assessment modalities, including common pitfalls with their usage, and sought to provide practical strategies to mitigate the identified challenges.

Book Reviews: Toolbox for Assessment of Clinical Competence. Principles of Medical Education.

Book Reviews: Toolbox for Assessment of Clinical Competence. Principles of Medical Education.

Use of Mini-CEX as Formative Assessment Tool in the Training of Undergraduate Medical Students in ENT Situation Analysis and the Way Forward.

Mini-CEX assesses clinical competency and is mainly used as a formative assessment tool. Its use in postgraduate training is well documented. However, Mini-CEX would play a significant role in training undergraduate medical students, especially with the commencement of competency-based medical education in India. This work reports the situational analysis of the Mini-CEX implementation in the department of ENT. The Department of ENT is using Mini-CEX for formative assessment of students' clinical competence since 2017. Each student had to complete a minimum of five Mini-CEX encounters before the summative assessment. We reviewed the Mini-CEX assessment records of 149 undergraduate medical students who appeared for the summative exam in 2018. We analysed the records of 874 Mini-CEX encounters. Each Mini-CEX encounter took 11min on average. Each student completed five such assessments, which accounted for 55min of one-to-one teacher-student interaction focused on clinical skills learning. The feedback time varied from 1 to 30min. Feedback was focused on the cognitive (46%) and psychomotor (42%) domains. However, the majority of students reflected that they learned psychomotor skills during the Mini-CEX. Students selected only a few skills for the Mini-CEX, ignoring many must-know skills. Mini-CEX is feasible as a formative assessment tool for medical undergraduates' ENT training. It improves the assessor-student interaction, provides effective feedback, and develops the practice of reflection among students. However, regular review and training of the assessors and students are needed as a quality assurance measure.

Assessment of clinical competence of graduating medical students and associated factors in Ethiopia

BackgroundEthiopia has scaled up medical education to improve access to healthcare which presented challenges to maintaining training quality. We conducted a study to assess the clinical competence of graduating medical students and the associated factors.Methods and materialsA pretest assessment of a quasi-experimental study was conducted in 10 medical schools with a sample size of 240 students. We randomly selected 24 students per school. Clinical competence was assessed in a 12-station objective structured clinical examination. The clinical learning environment (CLE), simulation training, and practice exposure were self-rated. Mean scores for clinical competence, and satisfaction in the CLE and simulation training were calculated. Proportions of students with practice exposure, and who agreed on CLE and simulation items were done. Independent t-tests were used to look at competence differences among subgroups. Bivariate and multiple linear regression models were fitted for the outcome variable: competence score. A 95% statistical confidence interval and p-value < 0.05 were used for making statistical decisions. A 75% cut-off score was used to compare competence scores.ResultsGraduating medical students had a mean competence score of 72%. Low scores were reported in performing manual vacuum aspiration (62%), lumbar puncture (64%), and managing childbirth (66%). Female students (73%) had a significantly higher competence score than males (70%). Higher cumulative grade point average (CGPA), positive appraisal of the CLE, and conducting more clinical procedures were associated with greater competence scores. Nearly half of the students were not satisfied with the clinical practice particularly due to the large student number and issues affecting the performance assessment. About two-thirds of the students were not satisfied with the sufficiency of models and equipment, and the quality of feedback during simulation training. Nearly one-third of the students never performed lumbar puncture, manual vacuum aspiration, and venipuncture.ConclusionsMedical students had suboptimal clinical competence. A better clinical learning environment, higher cumulative GPA, and more practice exposure are associated with higher scores. There is a need to improve student clinical practice and simulation training. Strengthening school accreditation and graduates’ licensing examinations is also a way forward.

Evaluation of the objective structured clinical examination by the nursing students

The objective structured clinical examination (OSCE) represents a pivotal innovation in the assessment of clinical proficiency within nursing education. This method is crucial as nurses are anticipated to exhibit competence across diverse healthcare settings, ensuring comprehensive, safe, and high-quality care throughout the patient's lifespan. A key challenge in evaluating clinical competence lies in the inherent subjectivity and complexity of the task. This demands educators to perpetually seek and refine tools apt for gauging nursing competence. Our study, a descriptive cross-sectional analysis encompassing 150 undergraduate nursing students, utilized a modified standardized survey questionnaire to appraise student perceptions of their OSCE experiences. Findings indicate a predominant classification of the OSCE as "good," with a notable preference for the planning phase over the implementation phase. Pre-test orientation was highly valued, whereas the provision of materials was critiqued. Gender and academic year were identified as significant variables influencing OSCE evaluations, particularly in the implementation phase and regarding examiner roles. This research offers foundational insights for future studies aiming to enhance OSCE methodology and substantiates the necessity of integrating OSCE into nursing curricula for robust clinical competence assessment.