Objective Structured Clinical Examination Session Research Articles

Self-Instruction Video Versus Face-to-Face Instruction of Pharmacy Students' Skills in Blood Pressure Measurement.

A modern approach to clinical skill education is the use of educational videos, yet there is a shortage of literature investigating the effect of self-instruction videos (SIVs) in pharmacy students. Therefore, our objective was to investigate whether an SIV is non-inferior compared to face-to-face instruction (FTFI) in acquiring blood pressure measurement skills. The participants in this randomized controlled study were pharmacy students. The control group was taught by FTFI, while the intervention group watched an SIV. Before and after the instruction, the participants’ performance was assessed by an objective structured clinical examination (OSCE). The participants completed a self-assessment survey before each OSCE session. Moreover, the participants’ perception and satisfaction were assessed using another survey. The OSCE score and self-assessment score increased significantly from pre- to post-instruction in both groups. The SIV was non-inferior compared to FTFI in terms of the OSCE score, considering a predefined non-inferiority margin of −10%. The participants’ self-assessment yielded inconclusive results for non-inferiority. Both instructional approaches were well received. Considering our findings, SIVs might be a valuable option for teaching pharmacy students’ blood pressure measurement skills. However, depending on the skill intended to be taught, a combination of an instructional video with instructor-led teaching may be necessary.

Introducing the Objective Structured Clinical Examination in Haiti.

Haiti, a nation of approximately 10.7 million people located in the western Caribbean,1 is a low-income country, with 59% of its population living below the poverty line (less than $2.41 per day), and 24% living in conditions of extreme poverty (less than $1.23 per day).2 Haiti has a history of political instability and natural disasters, and remains the country with the highest rate of poverty in the Americas.2The health care system in Haiti is regulated by the Ministry of Public Health and Population (MSPP). MSPP is under-resourced, spending only US $13 per person on health care each year. This represents a mere 6.1% of the national budget, and is significantly less than its neighboring countries of Cuba (US $781) and the Dominican Republic (US $180).3Six universities in Haiti offer degree programs in medicine. Upon graduation, medical school graduates are required to complete 1 year of social service, and then can practice medicine independently or apply for entrance into one of Haiti's 37 residency programs.Zanmi Lasante (ZL), a sister organization to Boston, Massachusetts-based Partners In Health, in partnership with MSPP, offers 1 residency program at Hospital St. Nicolas (HSN) in Saint-Marc and 5 programs at Hôpital Universitaire de Mirebalais (HUM) in Mirebalais. The programs that have been accepted are in the preapproval phase with the Accreditation Council for Graduate Medical Education International (ACGME-I).As part of its system of assessment in 2015, we introduced the objective structured clinical examination (OSCE) in the family medicine residency program at HSN, with the help of 2 Canadian fellows who volunteered in Haiti. Faculty members were trained on the new technique and were given opportunities to practice their new skills. These “pioneers” then trained other faculty at HUM. Although widely used in high-income countries, ZL was the first institution in Haiti to use the OSCE.The OSCE is a group of tests that includes a succession of stations with simulated clinical problems, involving standardized patients or mannequins, that learners need to solve in a limited time. Each station has clearly defined objectives, and a checklist for the evaluation of the candidates.4 It is considered the gold standard for evaluating clinical competencies, including the physician-patient relationship, the physical examination, and interpersonal and communication skills (box).4In 2016, the Director of Graduate Medical Education at ZL implemented an OSCE as a pre-assessment tool during the orientation month at the start of postgraduate year 1 (PGY-1). Based on this positive experience, the Graduate Medical Education Committee (GMEC) voted to implement the OSCE as part of the recruitment process for all ZL programs. In 2017, we conducted the first OSCE session during recruitment, with 90 candidates who aspired to enter 1 of the 6 ZL residency programs.Each session consisted of 4 themed stations with different objectives and a break station. The duration of each station was 10 minutes. The OSCE was scored by faculty, the training and research department director, and representatives from the school of medicine.The OSCE was a new evaluation tool for medical educators in Haiti, and implementation faced challenges. We needed to train faculty and the standardized patients (SPs). Because of a lack of funds, we used medical students and residents as SPs. The use of medical students as SPs was helpful in multiple ways, allowing the students to learn clinical portrayal and trainee performance. Candidates and student SPs were nervous at first, but by the end of the day, all said they had benefited from the experience.We are currently testing the OSCE as an evaluation tool in 2 residency programs (anesthesiology and pediatrics), and we intend to implement it in all ZL residency programs.

Qualitative content analysis experiences with objective structured clinical examination among Korean nursing students

The aim of this study was to explore the experiences of Korean nursing students with an objective structured clinical examination (OSCE) assessment regarding the 12 cranial nerves using qualitative content analysis. Qualitative content analysis was used to explore the subjective experiences of nursing baccalaureate students after taking the OSCE. Convenience sampling was used to select 64 4th year nursing students who were interested in taking the OSCE. The participants learned content about the 12 cranial nerve assessment by lectures, demonstrations, and videos before the OSCE. The OSCE consisted of examinations in each of three stations for 2 days. The participants wrote information about their experiences on sheets of paper immediately after the OSCE anonymously in an adjacent room. The submitted materials were analyzed via qualitative content analysis. The collected materials were classified into two themes and seven categories. One theme was "awareness of inner capabilities", which included three categories: "inner motivation", "inner confidence", and "creativity". The other theme was "barriers to nursing performance", which included four categories: "deficiency of knowledge", "deficiency of communication skill", "deficiency of attitude toward comfort", and "deficiency of repetitive practice". This study revealed that the participants simultaneously experienced the potential and deficiency of their nursing competency after an OSCE session on cranial nerves. OSCE also provided the opportunity for nursing students to realize nursing care in a holistic manner unlike concern that OSCE undermines holism.

Hand Hygiene Practices among Medical Students.

Background. Hand hygiene is a cost-effective method in preventing infection transmission. Hand hygiene practices have been found to be faulty in most healthcare settings. We conducted a study to evaluate the awareness, and compliance of hand hygiene among undergraduate medical students during their clinical phase in Qassim College of Medicine, Saudi Arabia. Methods. A questionnaire based on World Health Organization's concept of “Five Moments for Hand Hygiene” was used to evaluate the awareness of the indications for hand hygiene and compliance was observed during Objective Structured Clinical Examination (OSCE) sessions. Sixty students including thirty-six males (60%) and twenty-four females (40%) participated voluntarily in the study. Results. The average awareness regarding the positive indications of hand hygiene was 56%. Rest of the 44% of students were either not sure or unaware of the indications of hygiene. Only 29% of students were able to identify all the five indications for hand hygiene in the questionnaire. Compliance as assessed during OSCE sessions was only 17% with no significant difference between the genders. Conclusion. It was concluded that serious efforts are needed to improve the hand hygiene practices among medical students.