Objective Structured Clinical Examination Experience Research Articles

PERSPECTIVE ON OBJECTIVE STRUCTURED CLINICAL EXAMINATION AMONG UNDERGRADUATE NURSING STUDENTS

An important trend in nursing education has been the move to an OUTCOME or COMPETENCY-BASED model, where the learning outcomes are defined and decisions about the curriculum are based on these. The aim of the study was to explore the perspectives of the students regarding OSCE (Objective structured clinical examination). A descriptive survey using 19 item three-point Likerts scale questionnaire was conducted. The study sample consisted of 190 B.Sc., (N) students. 76.31% students were agreed that OSCE is well structured and sequenced, 76.31% students agreed that OSCE represented an objective evaluation method of psychomotor skills and 76.42% students perceived their OSCE experience positively than traditional examination. In conclusion, the OSCE appears to be single gold-standard assessment tool for clinical competency. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experience gave new nursing graduates confidence to work as registered nurses in health care settings.

Objective structured clinical examination to teach competency in planetary health care and management – a prospective observational study

BackgroundHealth professionals are increasingly called upon and willing to engage in planetary health care and management. However, so far, this topic is rarely covered in medical curricula. As the need for professional communication is particularly high in this subject area, this study aimed to evaluate whether the objective structured clinical examination (OSCE) could be used as an accompanying teaching tool.MethodsDuring the winter semester 2022/2023, 20 third- and fifth-year medical students voluntarily participated in a self-directed online course, three workshops, and a formal eight-station OSCE on planetary health care and management. Each examinee was also charged alternatingly as a shadower with the role of providing feedback. Experienced examiners rated students’ performance using a scoring system supported by tablet computers. Examiners and shadowers provided timely feedback on candidates` performance in the OSCE. Immediately after the OSCE, students were asked about their experience using a nine-point Likert-scale survey and a videotaped group interview. Quantitative analysis included the presentation of the proportional distribution of student responses to the survey and of box plots showing percentages of maximum scores for the OSCE performance. The student group interview was analyzed qualitatively.ResultsDepending on the sub-theme, 60% -100% of students rated the subject of planetary health as likely to be useful in their professional lives. Similar proportions (57%-100%) were in favour of integrating planetary health into required courses. Students perceived learning success from OSCE experience and feedback as higher compared to that from online courses and workshops. Even shadowers learned from observation and feedback discussions. Examiners assessed students’ OSCE performance at a median of 80% (interquartile range: 83%-77%) of the maximum score.ConclusionsOSCE can be used as an accompanying teaching tool for advanced students on the topic of planetary health care and management. It supports learning outcomes, particularly in terms of communication skills to sensitise and empower dialogue partners, and to initiate adaptation steps at the level of individual patients and local communities.

A Telehealth Module and Virtual Objective Structured Clinical Examination of Health Literacy in Pharmacy Education

ObjectiveTo implement an online health literacy (HL) module and evaluate its impact through virtual Objective Structured Clinical Examination (OSCE) on students’ abilities to manage patients with low HL. MethodsStudents virtually engaged in several learning activities related to HL, including practicing using HL assessment tools, designing an information booklet suitable for low HL patients, using readability formulas to lower text readability level to ≤ sixth grade, role-playing scenarios related to HL, and undergoing a virtual OSCE. Student performance on course assessments was tested using Spearman’s rank-order. Students evaluated their OSCE experience in terms of case content, virtual assessment, and logistics; and effectiveness of the HL module and confidence related to HL. ResultsA total of 90 students completed the virtual OSCE; the mean score was 8.8 out of 10 (88%), which correlated with similar course assessments. The average score was 3.46 out of 3.7 for the “gathering information” domain (recognizing risk factors and behaviors, assessing HL and adherence, etc.), and 4.06 out of 4.9 for the “patient management” domain (counseling patients on taking medications, focusing on repeating key messages, offering adherence interventions, etc.). Students responded positively regarding case content and virtual assessment, but less favorably regarding logistics. Feedback on effectiveness of the HL module and confidence in managing patients with low HL was positive. ConclusionAn HL module delivered online was effective in improving student knowledge, abilities, and confidence related to HL. Students achieved high scores in all items in the virtual OSCE, and considered it a measure of communication and clinical skills that is comparable to traditional in-room assessments.

Application of OSCE using a Virtual Assessment Platform

Introduction: This study describes the development and implementation of a virtual objective structured clinical examination (OSCE) at the Harvard School of Dental Medicine (HSDM) as an alternative to in-person OSCEs during the COVID-19 pandemic and evaluates its efficacy and reception by students and faculty.Methods: The virtual OSCE was conducted over Zoom (Zoom Video Communications, Inc. San Jose, CA) with students rotating through each discipline via Breakout Rooms. This study examined all 241 OSCE results from the HSDM classes of 2016-2022, with 170 in-person OSCE results and 71 virtual OSCE results. Descriptive and linear regression analysis were used to report the difference in OSCE experience and scores between virtual and in-person OSCEs.Results: Out of 100, the adjusted average score difference was 0.66 higher in virtual OSCE experience compared to in-person assessment, but it was not statistically significant (95%CI=-0.45, 1.78). A total of 35 students (49%) and 14 faculty responded to a survey regarding their virtual OSCE experience. Most students surveyed agreed that the virtual OSCE was effective (94%), accessible (97%), and should be offered post-pandemic (74%). The majority of faculty were neutral regarding the virtual OSCE as a comparable learning experience (76%) and in its accessibility (71%), and only 14% agreed that virtual OSCE should be offered in the future.Conclusion: The results show that the virtual OSCE can be a reasonable alternative to the in-person OSCE when primarily considering its clinical impact and suggest a viable role for virtual OSCE post-pandemic. Technological proficiency training could improve perceptions regarding future virtual OSCE implementation.

Implementation of Objective Structured Clinical Examination on Diagnostic Musculoskeletal Ultrasonography Training in Undergraduate Traditional Korean Medicine Education: An Action Research.

This study aimed to report the specific methods and investigate the educational effects of diagnostic musculoskeletal ultrasound training and the Objective Structured Clinical Examination (OSCE) for traditional medicine students. Scanning volar wrist and diagnosing carpal tunnel syndrome were selected for musculoskeletal ultrasound to train students to use the basic functions of the ultrasound device and scan various structures including tendons, nerves, and arteries. The students were divided into two groups: one group had 8 weeks of training with mock OSCE experience and received feedback about their scan images, and the other group had 3 weeks of training with flipped learning. The OSCE was implemented on the last day of the training. The subjective learning outcomes were analyzed as students’ evaluation with a 5-point scale, and the objective learning outcomes were analyzed using OSCE scores evaluated with a pre-validated checklist. Of the 111 students, 60 (54.1%) responded to the questionnaire. Overall satisfaction with this ultrasound training was high (4.5 ± 0.60). The average OSCE score in the 8-week group was significantly higher than that in the 3-week group. The students’ self-assessment showed no significant differences between the two groups. Proficiency in using ultrasound is affected by the practice time and feedback. Ultrasound training should be further expanded as a required curriculum to meet students’ needs and achieve learning objectives in the clinical skills education of Korean medicine colleges. Further studies are needed on ultrasound education, especially guided interventions for traditional medicine students.

Use of an objective structured clinical examination (OSCE) to assess intern performance in an advanced pharmacy practice experiences (APPE) Ambulatory Care rotation

PurposeIntern assessment during advanced pharmacy practice experiences (APPEs) are generally based upon each individual preceptor’s perceptions without an objective measurement of intern understanding and performance. Therefore, we sought to determine whether a pre- and post-OSCE could be used to confirm that interns achieved the goals and objectives of the Ambulatory Care rotation. The aims of this study were to determine whether a pre-rotation OSCE can help pharmacy interns self-assess their clinical strengths and weaknesses and assess whether their knowledge and skills improved after completing a post-rotation OSCE. MethodsPharmacy interns undergoing APPE Ambulatory Care rotations from September 2018 to March 2020 participated in a pre- and post-rotation OSCE to assess their knowledge of various chronic disease states. Interns completed pre- and post-OSCE surveys to assess their perceptions about their knowledge and the OSCE experience. ResultsPharmacy intern knowledge about diabetes, hypertension, dyslipidemia, and atrial fibrillation significantly improved post-OSCE compared to their pre-OSCE scores (p < 0.001). The mean post-OSCE scores for diabetes (p < 0.001), dyslipidemia (P = 0.046), anticoagulation (P = 0.006), and the overall mean post-OSCE scores (P = 0.005) were significantly higher compared to interns’ pre-OSCE scores. Students believed that the post-OSCE significantly highlighted their strengths and weaknesses in skills and knowledge compared to the pre-OSCE (P = 0.008). ConclusionPre- and post-APPE OSCE assessments are important tools that can provide interns and preceptors with objective evaluations of student performance. OSCEs can either be used as an alternative to perception-based assessments or integrated into existing preceptor evaluations. Furthermore, OSCEs can help preceptors identify areas that require more emphasis in their rotations.

Pharmacy students’ views on the objective structured clinical examination (OSCE): findings from two Malaysian universities

Objectives: To investigate and compare the views of undergraduate pharmacy students in two Malaysian pharmacy schools (one private and one public) regarding the organisation, quality, and objectivity of Objective Structured Clinical Examination (OSCE). Methods: A cross-sectional study was undertaken among penultimate and final year students in two Malaysian pharmacy schools between October to December 2019 (International Islamic University Malaysia [IIUM] and University of Cyberjaya [UoC]). A questionnaire was developed, tested, validated and then distributed to study participants through online Google forms. Results: A total of 221 undergraduate pharmacy students participated in the study. Students from the public university disagreed with the allocated time for the OSCE stations (IIUM 63.9% and 48.7% vs UoC 11.6% and 14.3%). Relatively few students agreed that OSCE is a less stressful type of assessment compared to other traditional methods (IIUM 7.2% and 10.3% vs UoC 39.5% and 23.8%). Both groups of students’ also disagreed that OSCE marks were likely to be affected by the student’s gender (IIUM 73.2% and 66.7% vs UoC 67.4% and 78.6%). Conclusion: The majority of participants had positive views on the organisation, quality, and objectivity of OSCE, with several differences between students in public and private universities. There are few areas to be further considered to ensure more positive OSCE experience for students such as revision on the time allocation for every station and on the provision of timely constructive feedback.

Remote OSCE Experience: What First Year Pharmacy Students Liked, Learned, and Suggested for Future Implementations.

During the wake of the COVID-19 pandemic, many schools quickly transitioned their teaching and assessment strategies to online formats. In Spring 2020, a 3-station remote Objective Structured Clinical Examination (OSCE) was implemented for first-year pharmacy students. The day following the remote OSCEs students answered three open-text prompts about the remote OSCE experience: (1) “I liked...”, (2) “I learned…”, and (3) “I suggest…”. Responses were open-coded and frequency counts were calculated to determine the most prevalent codes. Concept maps were created to visualize and explore connections between the codes. Out of 157 students, 156 students completed the reflection assignment, a 99.36% response rate. The three major themes in the Liked data were: Logistics (n = 65, 41.7%), Differences In-person Versus Remote (n = 59, 37.8%), and Skill Development (n = 43, 27.6%). The three major themes in the Learned data were: Technology (n = 66, 42.3%), Communication (n = 58, 37.2%), and Skill Development (n = 56, 35.9%). The three major themes in the Suggest data were: Logistics (n = 89, 57.1%), Technology (n = 31, 19.9%), and Continuation of Remote OSCE (n = 31, 19.9%). Overall, the remote OSCE experience was well-received, and students described it as applicable to their future pharmacy practice. Future work should explore the design, implementation, and outcomes of remote OSCEs.

Virtual objective structured clinical examination for family nurse practitioner students using a Zoom platform in the time of COVID-19

Objective: In response to school shut downs amid the COVID-19 pandemic, nurse educators from the University of Southern California implemented a virtual objective structured clinical examination (OSCE) using standardized patients (SPs) to assess family nurse practitioner (FNP) students’ clinical and communication skills as an alternative to the traditional in-person OSCE format. The intent of this paper is to share the nurse educators’ experiences with the transitional process and students’ feedback about their virtual OSCE experiences.Methods: Students (N = 36) enrolled in a childbearing/childrearing clinical course participated in the virtual OSCE using Zoom. The experience included briefing and debriefing sessions. Students were evaluated for their communication and clinical decision making skills based on their assessment of two adolescent patients: one acute with behavioral problems presenting for a checkup and one with headache.Results: All students who participated in the virtual OSCE experience demonstrated appropriate clinical and communication skills. Students perceived the virtual OSCE as a realistic model for telehealth but missed social interaction with faculty and peers and found their inability to conduct physical exam maneuvers challenging. The majority (79.3%) preferred interacting with patients face-to-face.Conclusions: Virtual OSCEs used as low-stakes formative assessments provide FNP students with effective and valuable learning experiences. Transitioning from in-person to virtual OSCEs using Zoom is feasible but requires extensive collaboration between nursing educators and those with access to simulation facilities, such as faculty from schools of medicine. Findings from this experience will serve as a guide for deliberate process improvements for future iterations.

Assessing the Impact of Telehealth Objective Structured Clinical Examinations in Graduate Nursing Education.

The National Organization of Nurse Practitioner Faculties supports the incorporation of telehealth in nurse practitioner (NP) education. The purpose of this article is to describe the implementation of a no-cost telehealth simulation and its impact on students in their first NP clinical course. Twenty-eight NP students participated in the telehealth objective structured clinical examination (OSCE). Students completed an online survey about the impact of telehealth OSCE simulation both before and after the simulation. The students' general understanding of the field of telehealth was significantly greater after the telehealth OSCE experience. Directed content analysis revealed 3 themes: usefulness of telehealth, benefit in role preparation, and technology. The use of telehealth simulation can be an effective strategy to assess clinical competency, provide individualized feedback, and ensure students are using evidence-based practice.

Experience Is the Teacher of All Things: Prior Participation in Anesthesiology OSCEs Enhances Communication of Treatment Options With Simulated High-Risk Patients

The objective of this study was to investigate whether previous experiences within an anesthesiology-based Objective Structured Clinical Examination (OSCE) assessing communication and professionalism skills was associated with improved performance in a subsequent anesthesiology-based OSCE scenario. This retrospective multi-center study used the performance data of 44 Post Graduate Year 4 clinical anesthesia residents from 3 US anesthesiology residency programs on an OSCE scenario that assessed the residents' effectiveness of discussing anesthesiology-specific treatment options with a high-risk patient. Residents from 2 of the programs had no prior anesthesiology-based OSCE experience. Residents from the third program had previously participated in 4 separate multi-scenario anesthesiology-based OSCE sessions in the 2 years prior to this study. Participating residents completed the same scenario at their respective institutions' simulation center. Ten performances were randomly selected for double rating to assess the interrater reliability of the assessments. Interrater reliability was good for the scenario (intraclass correlation coefficient = 0.66, 95% confidence interval = 0.12-0.90). Performance difference between groups with different OSCE experience status were examined using an independent sample t test, with a Wilcoxon-Mann-Whitney test as a sensitivity analysis. Independent sample t test found prior OSCE experience was significantly associated with higher performance scores (t = 2.53, P = .02). The Wilcoxon-Mann-Whitney test result confirmed this finding (z = 3.28, P = .001). Findings from this study provide preliminary evidence that anesthesiology-based OSCE experience is associated with improved performance in an OSCE scenario, specifically regarding discussions of treatment options with high-risk patients.

Preparation for Objective Structured Clinical Examination: A student perspective.

The aim of this study was to explore how student Operating Department Practitioners prepared for an Objective Structured Clinical Examination. A mixed methods design was used; questionnaires were used to gather data from a group of student Operating Department Practitioners on their Objective Structured Clinical Examination experience. The study found coping with anxiety and the level of information students receive are important issues in preparing for Objective Structured Clinical Examinations. Whilst preparation with the manikin is important, it may not be enough to fully prepare students for an Objective Structured Clinical Examination. Students also need to be given sufficient information so they fully understand the competencies they will be assessed against and receive support to cope with anxiety during the Objective Structured Clinical Examination. Further research is needed to identify mechanisms for coping with anxiety and stress in Objective Structured Clinical Examinations.

Use of Moulage to Evaluate Student Assessment of Skin in an Objective Structured Clinical Examination

This study investigated the physician assistant (PA) student evaluation of skin and the use of moulage in an objective structured clinical examination (OSCE). Clinical-year PA students participated in an OSCE, taking a history, completing a physical examination, and writing a focused clinical note. The standardized patient's history simulated a primary diagnosis of right-sided carpal tunnel syndrome and an incidental skin lesion consistent with melanoma, only if the student made an inquiry in this replication study. Faculty members' assessments of students' physical examinations were standardized using an agreed-upon rubric. Students completed an anonymous survey on the OSCE experience immediately following the activity. All students identified the primary diagnosis of carpal tunnel. Sixty-three percent of students verbalized examination of the skin; however, only 38% identified an atypical skin lesion in their clinical note documentation. Of those, only 33% of students referred the patient for biopsy. Most students believed that the use of moulage increased the realism of the standardized patient encounter. Sixty percent of students reported that they noticed a skin lesion but did not believe that it was part of the simulated experience. Moulage increased the realism of the OSCE. This study found that the ability of a student to verbalize the evaluation of a particular body system did not necessarily mean that they adequately or correctly assessed that system upon physical examination. Implementation of an OSCE and use of moulage provided an opportunity to explicitly assess student performance related to evaluation and assessment of skin. It provided a mechanism for meaningful, formative feedback of students' performance.

Introduction of Undergraduate Nursing Students to an Objective Structured Clinical Examination.

The Objective Structured Clinical Examination (OSCE) is used increasingly in nursing education. The purpose of this article is to report on the qualitative evaluation of the first implementation of a medication administration OSCE within an Australian school of nursing. A two-stage data gathering strategy was undertaken. The first stage was to survey participants' pre-OSCE and the second stage involved surveying the same participants' immediately post-OSCE. A constant comparison analysis method was used. The first stage data analysis (pre-OSCE) were classified into three themes: (a) Student Anxiety, (b) Student Preparedness, and (c) The Effectiveness of This Style of Assessment. The three key themes from the second stage (post-OSCE) analysis were: (a) Feelings Toward the OSCE, (b) Assessor Interaction, and (c) The OSCE Environment. Although they found it stressful, the participants valued the OSCE experience. The OSCE gave the students confidence in their capabilities of medication management. [J Nurs Educ. 2017;56(4):231-234.].

Can teaching hospitals use serial formative OSCEs to improve student performance?

BackgroundWe report on interns’ clinical competence and experiences of an objective structured clinical examination (OSCE) training program over 3 years. We aimed to determine whether repeated formative OSCEs allow teaching hospitals to improve the effectiveness of clinical training and help interns to achieve high scores in the national summative OSCE.MethodsThis study included 207 participants, among whom 82 were interns who had completed four mock OSCEs and a national OSCE at the clinical center of Cathay General Hospital (CGH). The other 125 participants were final-year medical students from Fu-Jen University who had completed the national OSCE between 2013 and 2015 at one of four teaching hospitals (including CGH). CGH interns were categorized into three groups according to the medical school attended and Fu-Jen University students were grouped according to their training hospitals. CGH held four mock OSCEs (30 stations), whereas each of the four training hospitals for Fu-Jen students each held one or two OSCEs (6–12 stations) annually. Differences in the mean OSCE scores among groups were analyzed. The medical school attended, pre-internship OSCE experience and the frequency of mock OSCEs held by training hospitals were independent factors in this study.ResultsThe cumulative mean scores for five OSCEs among three groups of students trained at CGH tended to increase from the first OSCE (OSCE1) to the fifth (OSCE5). The mean score of the students who attended Fu-Jen Medical School was higher than that of students who graduated from foreign medical schools in all five OSCEs; however, the differences were significant only for OSCE2 (P = 0.022) and OSCE3 (P = 0.027). The mean national OSCE scores of FJU students showed no statistically significant differences among the four training hospitals for 2013; however, students training at CGH had significantly higher mean scores in the 2014 (P = 0.001) and 2015 (P = 0.005) OSCEs compared with students training at the other three hospitals.ConclusionsSerial administration of formative OSCEs by teaching hospitals enhances the performance of students on the sequential summative OSCE. Such programs provide multiple opportunities for students to practice their clinical skills, and for faculty to develop their teaching, assessment and consensus building skills.

Attitudes of Nursing Faculty Members and Graduates towards the Objective Structured Clinical Examination (OSCE)

The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessment in nursing ten years after its inception. Core nursing courses are based on instructional teaching methods and “hands-on” approach to impact cognitive, psychomotor skills and clinical judgments. Different clinical competency assessment methods are used globally; however, most of them are subjective. A descriptive survey using 16-item five-point likert scale questionnaire was conducted. The study sample consisted of 140 participants: 20 faculty members, 27 graduates of the Bachelor of Science in Nursing (BSN) Degree and 93 graduates of the Associate Degree of Nursing (ADN) programs with OSCE experience during their training. Data collection was carried out between October and November 2015. Eighty percent of faculty members, 74% of BSN and 62.3% of ADN graduates agreed that OSCE represented an objective evaluation method for psychomotor skills. Majority of the graduates perceived their OSCE experience positively although stressful. However, they have suggested the introduction of trial/mock OSCE prior to each exam to minimize the stress associated with it. In conclusion, there appears to be no single “gold-standard” assessment tool for clinical competency. OSCE assesses student nurses’ psychomotor skills in a non-clinical environment, therefore without risks to real patients. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experiences gave new nursing graduates confidence to work as registered nurses in health care settings.

Reflection and feedback during my OSCE: what have I learnt?

Background: An Objective Structured Clinical Examination (OSCE) is a type of examination frequently used in physiotherapy to assess awidevariety of physiotherapy skills. OSCEs are designed to assess clinical skill performance in physiotherapy including assessment and treatment methods. They are an integral part of physiotherapy preclinical assessment to prepare students for clinical placements. Purpose:This projectwas undertaken to analyse student’s perception of their OSCE experience in year one semester 2 Doctor of Physiotherapy (DPT) program for the years 2012–2013. Methods: Physiotherapy students completed two fifteen minute OSCEs for the subject Physiotherapy Theory and Practice 2 (PTP2), a second semester, year one subject. One OSCE was dedicated to electrotherapy examination whilst the second OSCE examines physiotherapy skills, which include exercise prescription and/or joint mobilisation/treatment techniques. Examiners have amarking scheme to keep the assessment of clinical skills objective, rather than subjective. The OSCEs are carefully structured with a vignette to include parts from all elements of the curriculum as well as a wide range of skills. Instructions are carefully written to ensure that the student is given a specific task to complete. At the completion of each OSCE section, students were asked to reflect on their performance and would they have any done anything differently if they were to have this vignette again. Students are then given immediate constructive feedback by the examiner about their performance, but no marks are given to the student at this time. Students then proceed to complete a further two OSCEs in another subject. Students are then asked to complete a questionnaire at the completion of their OSCE assessment regarding their understanding of their performance. The questionnaire comprises offifteen questions that are linked to learning outcomes for the physiotherapy subject. The questionnaire used a five point Likert scale ranging from strongly agree to strongly disagree. Data from PTP 2 was analysed for this presentation (2012–13). Results: The majority of students reported they were able to demonstrate their level of skill to the examiners, their performance was an accurate reflection of their skills and student’s reflection on their performance was useful to their learning. They also reported theyweremore confident in their preparation for clinical placements and identified the need to further practice their physiotherapy skills prior to their clinical placement the following year. In addition, the majority of students reported the OSCEs were a valid assessment for judging student’s level of knowledge and skill. Conclusion(s): OSCE assessment in physiotherapy is an acceptable form of assessing physiotherapy skills in year one DPT students. Reflection and feedback is an integral part of the student’s skills development in further physiotherapy skills in the preclinical program. Implications: OSCE assessment can be used in a variety of physiotherapy areas for assessment purposes. By integrating reflection and feedback within the OSCE process, student’s learning can be facilitated in a positive manner by this immediate feedback from the examiner.

Experience of OSCE in faculty of medicine, Alzaeim Alazhari University, Sudan

Background: The traditional classical clinical exam (CCE) has limitations in terms of validity and reliability. Nowadays the Objective Structured Clinical Examination (OSCE) is widely used to assess the clinical pe rformance of medical students. Objective : To reflect and share the experience of OSCE exams in clinical departments in the Faculty of Medicine, Alzaeim Alazhari University (AAU) and to encourage more modifications to improve its quality. Material and Methodology: Data regarding clinical assessment; OSCEs versus cl assical clinical examinations was collected from faculty records. Th e collected data was entered computer and managed statistically using SPSS version 21. Results: Overall in the group of students examined by OSCE 67.7% rewarded grade B and above, whereas in the contrary 60.5% of students in CCE rewarded grade C+ and below, this difference was statistically significant (p=0.002). Conclusion: OSCE is an excellent tool, and fair to the students , as all examiners use the same check lists provided by the department . Students tend to do better in the clinical part of the examination when this type of assessment is used.

Assessment of Clinical Competence of Medical Students Using the Objective Structured Clinical Examination: First 2 Years' Experience in Taipei Veterans General Hospital

Competence-oriented education is currently the mainstream method of teaching clinical medical education. The objective structured clinical examination (OSCE) is a widely employed and accepted tool to measure the clinical competence of medical students. We describe the first 2 years' experience of OSCE in Taipei Veterans General Hospital. At Taipei Veterans General Hospital, every 7(th)-year medical student has taken the OSCE since 2006. There were 15 stations in the first 2 years' OSCEs. In years 1 and 2, 133 and 132 students were assessed by the OSCE, respectively. The content of the OSCE included internal medicine, surgery, pediatrics, obstetrics and gynecology, communication, and emergency training. All categories and results of examinees' evaluation at each station were recorded inclusively and compared statistically. The average scores of students from the 15 stations ranged from 47.7 ± 16.4 to 93.7 ± 8.5 in 2007. The score for communication skills was the lowest, whereas the score for Micro-Sim was the highest. Communication skills and electrocardiography interpretation were the 2 categories in which most of the students failed. A reliability analysis was conducted of the 2007 OSCE questions. The overall score and reliability (Cronbach's reliability) was 0.641. The difference between the impacts on reliability after deleting a test item ranged from 0.59 to 0.65 for all stations. This meant that every station had a similar impact on reliability after being deleted. The squared multiple correlation, R(2), of the reliability of each item was between 0.12 and 0.49, with chest X-ray interpretation being the lowest. The item-total correlation was between 0.10 and 0.41, with interactive case being the lowest. The OSCE is an effective method for assessing the clinical competence of medical students. The OSCE could be improved further by modifying the examination questions and promoting effective training for standardized patients and examiners.

OSCEs in Japanese postgraduate clinical training Hiroshima experience 2000-2009

Hiroshima University Hospital used the Objective Structured Clinical Examination (OSCE) as a formative and summative assessment tool to evaluate trainees' competence. To reflect on Hiroshima University Hospital experience of OSCEs in postgraduate training in terms of OSCE structure and trainees' perception of the OSCE they attended. A total 27 OSCEs implemented in Hiroshima University Hospital from 2000 to 2009 were examined. The OSCE in postgraduate training, Hiroshima University Hospital, was influenced by many factors from organisational and pedagogical perspectives, and changed to meet social and curriculum needs. At each OSCE, all examinees were required to answer an anonymous questionnaire, which consisted of ten checklists, just after their experience of OSCE. Five hundred and forty trainees who attended each OSCE were required to answer a questionnaire and 510 were returned (94.4%). In the comparison between formative and summative OSCEs, the number of trainees who answered "the OSCE is meaningful" in formative OSCE was significantly higher than that in summative OSCE (P < 0.001). In the comparison between before and after the 2006/2007 academic year, trainees who indicated that OSCEs were meaningful increased after 2006/2007 (P < 0.05), and trainees who felt they were evaluated appropriately by these OSCEs increased after 2006/2007 (P < 0.01). Trainees viewed OSCEs positively and appreciated their effectiveness from a pedagogical perspective, and OSCE positively affected the trainees' approach to learning. A ten-year process of OSCE change has helped with educational reforms because of its adaptability. Flexible attitudes to change are necessary for stakeholders to achieve the desired reforms.