Objective Structured Clinical Examination Performance Research Articles

Associations of coping and health-related behaviors with medical students’ well-being and performance during objective structured clinical examination

Objective structured clinical examination (OSCE) is a valid method to evaluate medical students’ competencies. The present cross-sectional study aimed at determining how students’ coping and health-related behaviors are associated with their psychological well-being and performance on the day of the OSCE. Fourth-year medical students answered a set of standardized questionnaires assessing their coping (BCI) and health-related behaviors before the examination (sleep PSQI, physical activity GPAQ). Immediately before the OSCE, they reported their level of instant psychological well-being on multi-dimensional visual analogue scales. OSCE performance was assessed by examiners blinded to the study. Associations were explored using multivariable linear regression models. A total of 482 students were included. Instant psychological well-being was positively associated with the level of positive thinking and of physical activity. It was negatively associated with the level of avoidance and of sleep disturbance. Furthermore, performance was negatively associated with the level of avoidance. Positive thinking, good sleep quality, and higher level of physical activity were all associated with improved well-being before the OSCE. Conversely, avoidance coping behaviors seem to be detrimental to both well-being and OSCE performance. The recommendation is to pay special attention to students who engage in avoidance and to consider implementing stress management programs.Clinical trial: The study protocol was registered on clinicaltrial.gov NCT05393206, date of registration: 11 June 2022.

Situational simulation teaching effectively improves dental students’ non-operational clinical competency and objective structured clinical examination performance

BackgroundAppropriate communication with dental patients enhances treatment outcomes and patient satisfaction. Implementing simulated patient interviews courses can improve patient-centered care and reduce conflict during clerkship training. Therefore, this study explored the relationship among student participation in a situational simulation course (SSC), academic performance, clerkship performance, and objective structured clinical examination (OSCE) performance.MethodsThis study was conducted with a sample of fifth-year dental students undergoing clerkship training. After implementing a situational simulation course to investigate the relationship among participation in SSC, academic performance, clerkship performance, and OSCE performance, a path analysis model was developed and tested.ResultsEighty-seven fifth-year dental students were eligible for the SSC, and most (n = 70, 80.46%) volunteered to participate. The path analysis model revealed that academic performance had a direct effect on OSCE performance (β = 0.281, P = 0.003) and clerkship performance (β = 0.441, P < 0.001). In addition, SSC teaching had a direct effect on OSCE performance (β = 0.356, P < 0.001).ConclusionsSSCs can enhance dental students’ non-operational clinical competency and OSCE performance effectively. Simulated patient encounters with feedback, incorporated into the dental curricula, have led to improved communication. Based on our findings, we suggest implementing SSC teaching before the OSCE to improve communication and cognitive skills.

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.

Review of Objective Structured Clinical Examination Practices Within Pharmacy Programs Throughout the United States

ObjectiveTo update the description of current objective structured clinical examination (OSCE) practices within pharmacy schools in the United States and identify barriers to OSCE implementation and expansion. MethodsA survey was deployed to all accredited Doctor of Pharmacy programs within the United States. The survey was designed to collect information regarding the curricular mapping of OSCEs, OSCE design, OSCE delivery, assessment of OSCE performance, and barriers to OSCE implementation and expansion. ResultsOf the 135 US-accredited programs identified, 109 (81%) programs completed the survey. In total, 93 (85%) programs reported using OSCEs to assess students; however, implementation throughout the curriculum and current practices varied by institution. Most programs place OSCEs within specific courses (96%), with the applied skills coursework being the most used (80%). The most common number of OSCEs that occur throughout a curriculum is 6 (18%), however, 20 (22%) programs execute 10 or more OSCEs throughout their curriculum. Forty (43%) programs use OSCEs as high-stakes assessments where poor performance could prevent a student from progressing to advanced pharmacy practice experiences. Of the responding programs, over half (56%) use teaching objective structured examinations to enhance learning. Common barriers to OSCE expansion exist and are related to resource utilization. ConclusionSignificant expansion of OSCE development and implementation has occurred over the last decade. There is substantial variability in implementation and utilization among programs. Although standards of best practice for OSCEs exist for other health professions, best practices in pharmacy education have not been widely accepted or adopted.

Perceived and actual value of Student-led Objective Structured Clinical Examinations.

Student-led Objective Structured Clinical Examinations (OSCEs) provide formative learning opportunities prior to Faculty-led OSCEs. It is important to undertake quality assurance measurements of peer-led assessments because, if they are found to be unreliable and invalid, they may have detrimental impacts. The objectives of this study were to explore and evaluate Student-led OSCEs hosted by fifth-year medical students. Student-led OSCE results were analysed to examine reliability (Cronbach's alpha). The relationship between Student-led and Faculty-led OSCEs was evaluated using linear regression. Qualitative data were acquired by survey and semi-structured interviews and were analysed using an inductive content analysis approach. In total, 85 (94%) of 91 eligible students consented to study participation. Student-led OSCEs had a low-moderate reliability [Cronbach alpha = 0.47 (primary care) and 0.61 (human reproduction/paediatrics) (HRH)]. A statistically significant, positive relationship between Student-led and Faculty-led OSCE results was observed. Faculty-led OSCE grades increased by 0.49 (95% CI: 0.18, 0.80) to 1.09 (95% CI: 0.67, 1.52), for each percentage increase in Student-led OSCE result. Student-led OSCE participants highly valued the authentic peer-assessed experience. Reported benefits included a reduction of perceived stress and anxiety prior to Faculty-led OSCEs, recognition of learning gaps, contribution to overall clinical competency and facilitation of collaboration between peers. Student-led OSCEs are moderately reliable and can predict Faculty-led OSCE performance. This form of near-peer assessment encourages the metacognitive process of reflective practice and can be effectively implemented to direct further study. Faculties should collaborate with their student bodies to facilitate Student-led OSCEs and offer assistance to improve the quality, and benefits, of these endeavours.

Early formative objective structured clinical examinations for students in the pre-clinical years of medical education: A non-randomized controlled prospective pilot study

Background The value of formative objective structured clinical examinations (OSCEs) during the pre-clinical years of medical education remains unclear. We aimed to assess the effectiveness of a formative OSCE program for medical students in their pre-clinical years on subsequent performance in summative OSCE. Methods We conducted a non-randomized controlled prospective pilot study that included all medical students from the last year of the pre-clinical cycle of the Université Paris-Cité Medical School, France, in 2021. The intervention group received the formative OSCE program, which consisted of four OSCE sessions, followed by debriefing and feedback, whereas the control group received the standard teaching program. The main objective of this formative OSCE program was to develop skills in taking a structured medical history and communication. All participants took a final summative OSCE. The primary endpoint was the summative OSCE mark in each group. A questionnaire was also administered to the intervention-group students to collect their feedback. A qualitative analysis, using a convenience sample, was conducted by gathering data pertaining to the process through on-site participative observation of the formative OSCE program. Results Twenty students were included in the intervention group; 776 in the control group. We observed a significant improvement with each successive formative OSCE session in communication skills and in taking a structured medical history (p&lt;0.0001 for both skills). Students from the intervention group performed better in a summative OSCE that assessed the structuring of a medical history (median mark 16/20, IQR [15; 17] versus 14/20, [13; 16], respectively, p = 0.012). Adjusted analyses gave similar results. The students from the intervention group reported a feeling of improved competence and a reduced level of stress at the time of the evaluation, supported by the qualitative data showing the benefits of the formative sessions. Conclusion Our findings suggest that an early formative OSCE program is suitable for the pre-clinical years of medical education and is associated with improved student performance in domains targeted by the program.

Objective Structured Clinical Examinations (OSCEs) for High-Stakes Assessment of Certified Registered Nurse Anesthesiologists (CRNAs)

BackgroundCertified registered nurse anesthesiologists (CRNAs) undergoing high stakes assessment must demonstrate competency. Written competency is the current method of high-stakes assessment, and this paper uses Miller's Pyramid of competency to explore use of the objective structured clinical examination (OSCE) for high-stakes assessment. MethodsThe modified Delphi method was used with 10 experts to design and execute an anaphylaxis OSCE simulation scenario of 3 proficiency levels. OSCE performance assessment tools included a checklist and global rating scale (O-GRS). A system usability survey was used to assess OSCE utility. ResultsThe overall system usability survey score was below our goal of 75. Assessment tool results did not demonstrate high correlation among panelists, although mean scores for each performance showed statistically significant differences in scores (p < .001). ConclusionOur paper showed the process of OSCE design, execution, and utility. Although results did not allow us to strongly recommend use of OSCEs for high-stakes assessment of CRNAs, we are encouraged that our results will provide direction for future papers related to this topic.

Cognitive load theory in action: e-learning modules improve performance in simulation-based education. A pilot study.

Learners participating in simulation-based education may experience cognitive overload with potential detrimental effects to learning and performance. Multiple strategies have been proposed to mitigate this detrimental response. However, these strategies have not fully considered the potential benefits of using online platforms, such as accessibility, cost-effectiveness, efficiency, and scalability. Addressing this gap in the literature, preparatory online modules were developed by applying concepts from cognitive load theory and simulation-based education. This study assessed whether using preparatory online modules to deliver weekly pre-briefing content could impact cognitive load and performance. The participants were first-year postgraduate medical trainees participating in a simulation-based resuscitation curriculum. Fifty-three trainees were allocated to receive preparatory online modules (online modules group, n = 27) or not (control group, n = 26) during the course component of a simulation-based resuscitation curriculum. Then, these trainees participated in a simulation-based objective structured clinical examination (OSCE). Sources of cognitive load (intrinsic, extraneous, and germane) were measured using a modified cognitive load questionnaire. Performance was assessed using the Ottawa Surgical Competency Operating Room Evaluation. Data were analyzed with descriptive statistics, and principal component analysis. During the course component, the online modules group was found to have higher intrinsic and germane cognitive load, and lower extraneous cognitive load compared to the control group. During the OSCE, the online modules group scored significantly higher in performance scores (p = 0.0077, d = 0.39, 95% confidence interval = 0.10;0.68) compared to the control group. Principal component analysis supported the results obtained with the modified cognitive load questionnaire. Trainees using preparatory online modules during the course component of a simulation-based resuscitation curriculum experienced cognitive load changes consistent with cognitive optimization. This may have contributed to their superior performance in the subsequent OSCE. Future research should explore the long-term impacts of online preparatory training and consider potential barriers to implementation in diverse healthcare environments.

Linking assessment to real life practice – comparing work based assessments and objective structured clinical examinations using mystery shopping

Objective Structured Clinical Examinations (OSCEs) and Work Based Assessments (WBAs) are the mainstays of assessing clinical competency in health professions’ education. Underpinned by the extrapolation inference in Kane’s Validity Framework, the purpose of this study is to determine whether OSCEs translate to real life performance by comparing students’ OSCE performance to their performance in real-life (as a WBA) using the same clinical scenario, and to understand factors that affect students’ performance. A sequential explanatory mixed methods approach where a grade comparison between students’ performance in their OSCE and WBA was performed. Students were third year pharmacy undergraduates on placement at a community pharmacy in 2022. The WBA was conducted by a simulated patient, unbeknownst to students and indistinguishable from a genuine patient, visiting the pharmacy asking for health advice. The simulated patient was referred to as a ‘mystery shopper’ and the process to ‘mystery shopping’ in this manuscript. Community pharmacy is an ideal setting for real-time observation and mystery shopping as staff can be accessed without appointment. The students’ provision of care and clinical knowledge was assessed by the mystery shopper using the same clinical checklist the student was assessed from in the OSCE. Students who had the WBA conducted were then invited to participate in semi-structured interviews to discuss their experiences in both settings. Overall, 92 mystery shopper (WBA) visits with students were conducted and 36 follow-up interviews were completed. The median WBA score was 41.7% [IQR 28.3] and significantly lower compared to the OSCE score 80.9% [IQR 19.0] in all participants (p < 0.001). Interviews revealed students knew they did not perform as well in the WBA compared to their OSCE, but reflected that they still need OSCEs to prepare them to manage real-life patients. Many students related their performance to how they perceived their role in OSCEs versus WBAs, and that OSCEs allowed them more autonomy to manage the patient as opposed to an unfamiliar workplace. As suggested by the activity theory, the performance of the student can be driven by their motivation which differed in the two contexts.

Efficacy of Simulator-Based Slit Lamp Training for Medical Students: A Prospective, Randomized Trial.

Simulation training has an important role in medical education. In ophthalmology, simulation-based training has been shown to be significantly effective for surgical and diagnostic training in direct and indirect ophthalmoscopy. In this study, we analysed the effects of simulator-based slit lamp training. In this prospective controlled trial, medical students in their eighth semester at Saarland University Medical Center (n = 24) who had attended a 1-week ophthalmological internship were randomized into two groups: The traditional group (n = 12) was examined directly after the 1-week internship; the simulator group (n = 12) was trained with the slit lamp simulator before passing an objective structured clinical examination (OSCE). A masked ophthalmological faculty trainer assessed the students' slit lamp skills (maximum total score 42 points [pts]): preparation (5 pts), clinical examination (9.5 pts), assessment of findings (9.5 pts), diagnosis (3 pts), commentary on the examination approach (8 pts), measurement of structures (2 pts) and recognition of five diagnoses (5 pts). All students completed post-assessment surveys. Examination grades and survey responses were compared between the groups. The overall performance of the slit lamp OSCE was significantly better (p < 0.001) in the simulator group than in the traditional group (29.75 [7.88] vs. 17.00 [4.75]) with significantly higher scores for the preparation and assessment of slit lamp controls (5.0 [0.0] vs. 3.0 [3.5]; p = 0.008) and localization of relevant structures (6.75 [3.13] vs. 4.0 [1.5]; p = 0.008). Consistently higher scores, but not significant, were assigned for the description of structures found (4.5 [3.38] vs. 3.25 [2.13]; p = 0.09) and the correct diagnosis (3.0 [0.0] vs. 3.0 [0.0]; p = 0.48). Surveys reflected the students' subjectively perceived knowledge gain during the simulator training for slit lamp illumination techniques (p = 0.002), recognition (p < 0.001), and assessment of the correct localization of pathologies (p < 0.001). Slit lamp examination is an important diagnostic method in ophthalmology. Simulator-based training improved students' examination techniques for localizing anatomical structures and pathological lesions. The transfer of theoretical knowledge into practice can be achieved in a stress-free atmosphere.

Examination Scores but not Clinical Performance Correlate With Duration of Preclinical Didactic Time: A Synchronous Comparison of Second- Versus Third-Year Medical Students on the Surgery Clerkship

Numerous institutions have reduced preclinical didactic time to facilitate earlier clinical exposure during the second year of medical education. However, the effects that shortened preclinical education may have on performance in the surgery clerkship are unclear. This study aims to compare the clinical and examination performance of second- (MS2) and third-year (MS3) students synchronously completing an identical surgery clerkship. All students completing the surgery clerkship (identical didactics, examinations, clinical rotations, etc.) were included. MS3s received 24 months of preclinical education, whereas MS2s received 14 months. Performance outcomes included weekly quizzes based on lectures, NBME Surgery Shelf Exam, numeric clinical evaluations, objective structured clinical examination (OSCE) scores, and overall clerkship grades. University of Miami Miller School of Medicine. All second- (MS2) and third-year (MS3) medical students completing the Surgery Clerkship over 1 year (n = 395). There were 199 MS3 (50%) and 196 MS2 (50%) students. MS3s demonstrated higher median shelf exams (77% vs 72% MS2s), weekly quiz score averages (87% vs 80% MS2s), clinical evaluations (96% vs 95% MS2s), and overall clerkship grades (89% vs 87% MS2s), all p < 0.020. There was no difference in median OSCE performance (both 92%; p = 0.499). A greater proportion of MS3 students performed in the highest 50% of weekly quiz scores (57% vs 43% MS2), NBME shelf exams (59% vs 39% MS2), and overall clerkship grades (45% vs 37% MS2), all p < 0.010. No significant difference in the proportion of students placing in the top 50% of clinical parameters including the OSCE (48% MS3 vs 46% MS2; p = 0.106) and clinical evaluations (45% MS3 vs 38%; p = 0.185) was observed. Although the duration of preclerkship education may correspond to examination scores, MS2s and MS3s perform similarly on clinical metrics. Future strategies to enhance available preclinical didactic time and preparation for examinations are needed.

The Relationship between Kolb Learning Style and Academic Performances in Orthopedic Residents

Objective: The assimilating and converging Kolb learning style were reported to have positive correlation with critical thinking ability in Orthopedic resident. However, the relationship between Kolb learning styles and academic performance remained controversy. The objective of this study is to report the relationship between Kolb learning style and academic performance in Orthopedic residents. Materials and Methods: The causal comparative cross-sectional study on 48 Orthopedic residents of academic year 2020 was conducted. The demographic characteristics of the participants were reviewed. The scores from the multiple choices question (MCQ) in-training examination, the objective structured clinical examination (OSCE) and the global performance rating scale were collected to represent academic performances of each Miller’s pyramid of assessment level. The Kolb learning style inventory were allocated. The statistical analysis was performed and p &lt; 0.05 was considered statistically significant difference. Results: The response rate was 100%. There was no statistically significant difference of MCQ in-training examination, OSCE and global performance rating scale among each learning style as p=0.789, 0.493 and 0.407, respectively. The assimilating and converging styles were the 2 learning styles which had the academic performance scores above the average scores in all assessments. Conclusion: This study could not demonstrate the significant difference of academic performances among Kolb learning style in Orthopedic residents. However, the assimilating and converging style had the consistent scores above average scores in all domains. The Orthopedic learning experience should focus on the development of reflective observation, abstract conceptualization and active experimentation to facilitate effective improvement in academic performance of the residents.

PERCEPTION OF MEDICAL STUDENTS AND EXAMINERS TOWARDS OBJECTIVE STRUCTURED CLINICAL EXAMINATION: A FEEDBACK FOR IMPROVEMENT

Background &#x0D; Objective Structured Clinical Examination (OSCE) is globally used in the assessment of the clinical competency of medical students. Nevertheless, OSCE has to be carefully designed and organised to be fair and reliable.&#x0D; Objectives &#x0D; The study aimed to observe the perception of medical students and their examiners towards OSCE.&#x0D; Materials and Methods&#x0D; The survey is a cross-sectional study in which a self-administrative questionnaire was designed and filled by 286 third-year students and 64 examiners of the College of Medicine /University of Sulaimani after the end of phase-1 assessment OSCE of 2020-2021. Ethical approval has been obtained from the university. The study data were collected and analysed by SPSS (23.0).&#x0D; Results&#x0D; The response rate was high among the students and examiners; 95.6% (286/299) and 80% (64/80), respectively. The OSCE reliability test was acceptable (Cronbach’s alpha = 0.78-0.81). The proportions of agreed students to the OSCE fairness, tested skills, and minimising the chance of failing were 42.7%, 51.4%, and 33%, respectively; however, 65.8% found the OSCE very stressful. Although 45% of the students felt dissatisfied with the OSCE instructions, 42-58% and 33-39% agreed with the OSCE organisation and performance, respectively. Among the examiners, the majority perceived that the OSCE was fair, well-organised, and timed. Compared to the conventional method, 79.7% of the examiners thought that OSCE was better in various domain assessments, whereas 60.9% found it exhausting. &#x0D; Conclusion&#x0D; Overall, students’ perception of the OSCE was similarly spread to agree, neutral, and disagree, which was lower than the examiner’s great satisfaction. These results highlighted the necessity of further improvement in future OSCEs.

Medication therapy problems assessment within medication history objective structured clinical examinations using standardized patients versus peer actors

AbstractIntroductionStandardized patients (SPs) are actors who role‐play patients in objective structured clinical examinations (OSCEs). Potential benefits of using SPs may include standardized learning experiences and realistic emulations. Use of SPs on academic performance remains unreported.ObjectiveTo compare students' identification of medication therapy problems (MTPs) in medication history OSCEs utilizing SPs versus those utilizing student peer actors.MethodsThis single‐center historical cohort study included two cohorts of third‐year student pharmacists in a capstone course in spring 2019 and 2021. One cohort had peers acting as patients and another interacted with SPs. Students completed two OSCEs and were assessed by faculty using a performance‐based rubric. Outcomes included students' identification of MTPs defined per Pharmacy Quality Alliance Frameworks, OSCE performance, levels of MTP management, and questionnaire item responses.ResultsOne‐hundred forty‐three subjects were enrolled: 86 in the peer and 57 in the SP cohorts. Baseline characteristics between cohorts were similar across age, overall grade point average, and composite Pharmacy College Admission Test score. Fewer students in the SP cohort identified MTPs versus the peer actor cohort on both OSCEs (52.6% vs. 89.7%, p &lt; 0.001, and 64.9% vs. 88.2%, p = 0.001), and OSCE grades were significantly lower in the SP cohort (76.0% vs. 81.5%, p = 0.01, and 76.5% vs. 89.0%, p &lt; 0.001). Medication therapy problem management was significantly different between the cohorts across both OSCEs (p &lt; 0.05). Students responded to questionnaire items by agreeing SPs were effective and improved the OSCEs.ConclusionUse of SPs in medication history OSCEs was associated with significant decreases in students' identification of MTPs and lower OSCE grades. Continued research is warranted to assess factors associated with differences in performance and to provide recommendations optimizing SP and peer actor roles.

Using tele-ultrasound to teach medical students: A randomised control equivalence study.

Undergraduate ultrasound education is becoming increasingly important, but its expansion is limited by time, space and the availability of trained faculty. In order to validate an alternative and more accessible teaching model, our aim was to assess whether combining teleguidance and peer-assisted learning to teach ultrasound is as effective as traditional in-person methods. Peer instructors taught 47 second-year medical students ocular ultrasound via either teleguidance or traditional in-person methods. Proficiency was assessed using a multiple-choice knowledge test and objective structured clinical examination (OSCE). Confidence, overall experience, and experience with a peer instructor were measured using a 5-point Likert scale. Two one-sided t-tests were used to measure equivalency between the two groups. The null hypothesis that the two groups were not different was rejected when P < 0.05. The teleguidance group performed as well as the traditional in-person group in terms of knowledge change, confidence change, OSCE time and OSCE score (p=0.011, p=0.006, p=0.005 and =0.004, respectively, indicating the two groups are statistically equivalent). The teleguidance group rated the experience highly overall (4.06/5), but less than the traditional group (4.47/5; P=0.448, indicating statistical difference). Peer instruction was rated 4.35/5 overall. Peer-instructed teleguidance was equivalent to in-person instruction with respect to knowledge change, confidence gain and OSCE performance in basic ocular ultrasound.

The Effectiveness of Online Experiential Learning in a Psychiatry Clerkship.

The Uniformed Services University of the Health Sciences 5-week psychiatry clerkship educates about 180 students a year at sites around the USA. In 2017, weekly in-person experiential learning sessions were implemented for local students and resulted in improved performance in several end-of-clerkship Objective Structured Clinical Examination (OSCE) skills as compared to distant learners who did not receive these sessions. The difference in performance (~ 10%) highlighted a need to provide comparable training for distant learners. Providing in-person, repeated simulated experiential training at multiple distant sites was not practical, requiring development of a novel online approach. Students at all four distant sites over 2years (n = 180) participated in five weekly synchronous online experiential learning sessions, while local students (n = 180) received five weekly in-person experiential learning sessions. Tele-simulation used the same curriculum, centralized faculty, and standardized patients as the in-person iterations. Overall end-of-clerkship OSCE performance was compared for learners receiving online versus in-person experiential learning for non-inferiority. Specific skills were compared to receiving no experiential learning. Overall OSCE performance was non-inferior for students who received synchronous online as compared to in-person experiential learning. Performance on each skill other than communication improved significantly when comparing students who received online versus no experiential learning (p < 0.05). The use of weekly online experiential learning to enhance clinical skills is comparable to in-person efforts. Virtual, simulated, synchronous experiential learning provides a feasible and scalable platform for training complex clinical skills to clerkship students, a critical capability given the impact the pandemic has had on clinical training.

Difference in Physiotherapy Students' Training and Objective Structured Clinical Exam Performance Before and During COVID-19.

The Objective Structured Clinical Examination (OSCE) and station examinations, in general, have been widely utilized in health professional programmes to evaluate students' clinical performance prior to advancing to a clinical placement. The COVID-19 pandemic impacted student preparation and implementation of our programme's OSCEs. The impact on changes in student OSCE performance due COVID-19 has not been well studied. This non-concurrent cohort study evaluated the difference before and during COVID-19 pandemic on Year 1 physiotherapy students' performances on an in-person OSCE by estimating the mean difference in cohort OSCE scores and safety occurrences. Two cohorts of MSc (PT) students were compared: Cohort A (not impacted by COVID-19) and Cohort B (impacted by COVID-19). Cohort scores were summarized as means and 95% CIs. Overall OSCE scores for Cohort A and B were 77.9 and 81.9, respectively ( = 4.0, 95% CI: 2.1, 5.8). Cohort B students were approximately 4 times more likely to demonstrate safety occurrences. The impact of COVID-19 did not adversely affect total OSCE scores; however, it did increase safety infractions.

Effects of Recorded versus Live Teleconference Didactic Lectures on Medical Student Performance in the Surgery Clerkship

OBJECTIVEDue to the COVID-19 pandemic, numerous institutions converted medical education didactics to electronic formats including both live teleconference didactics and recorded faculty lectures. This study aims to compare the effect of recorded versus live teleconference didactic lectures on medical student examination scores during the surgery clerkship.DESIGNMedical students completing the Surgery Clerkship received a weekly series of didactic lectures taught by faculty via a teleconference (2020-2021 academic year) or recorded format (2021-2022 academic year). Performance outcomes included weekly quizzes, National Board of Medical Examiners (NBME) Surgery Shelf Exam, and clerkship Objective Structured Clinical Examination (OSCE) scores.SETTINGUniversity of Miami Miller School of Medicine.PARTICIPANTSAll second- (MS2) and third-year (MS3) medical students completing the Surgery Clerkship over two academic years (n = 312).RESULTSStudents who received live teleconference lectures (n = 156) demonstrated higher average scores on weekly quizzes (89%) and the NBME shelf exam (76%) compared to those receiving recorded lectures (n = 156; 71% quiz, 70% shelf exam), both p < 0.001. There was a significant association with performance in the highest quartile (Q1) of weekly quiz scores and receiving live lectures (40% vs. recorded lectures 1%, p < 0.001). Comparing only MS3 students, mean weekly quiz scores and Q1 achievement were significantly higher (both p < 0.001) in the teleconference cohort with no significant difference in NBME shelf exam performance (p = 0.971). No difference in OSCE performance was observed between groups.CONCLUSIONThese results suggest that synchronous teleconferences may be more effective than recorded lectures for achieving institutional learning objectives on the surgery clerkship without any negative impact on NBME shelf exam or clinical evaluation parameters. This information should be used to inform future institutional clerkship design and educational initiatives.

Medical school grades may predict future clinical competence.

In real-world medical education, there is a lack of reliable predictors of future clinical competencies. Hence, we aim to identify the factors associated with clinical competencies and construct a prediction model to identify "improvement required" trainees. We analyzed data from medical students who graduated from National Yang-Ming University with clerkship training and participated in the postgraduate year (PGY) interview at Taipei Veterans General Hospital. Clinical competencies were evaluated using grades of national objective structured clinical examination (OSCEs). This study used data from medical students who graduated in July 2018 as the derivation cohort (N = 50) and those who graduated in July 2020 (n = 56) for validation. Medical school grades were associated with the performance of national OSCEs (Pearson r = 0.34, p = 0.017), but the grades of the structured PGY interviews were marginally associated with the national OSCE (Pearson r = 0.268, p = 0.06). A prediction model was constructed to identify "improvement required" trainees, defined: trainees with the lowest 25% of scores in the national OSCEs. According to this model, trainees with the lowest 25% medical school grades predicted a higher risk of the "improvement required" clinical performance (Q1-Q3 vs Q4 = 15% vs 60%, odds ratio = 8.5 [95% confidence interval = 1.8-39.4], p = 0.029). In the validation cohort, our prediction model could accurately classify 76.7% "improvement required" and "nonimprovement required" students. Our study suggests that interventions for students with unsatisfactory medical school grades are warranted to improve their clinical competencies.

Impact of high-fidelity simulation exposure of nursing students with their objective structured clinical examination: A quasi-experimental study.

The study aimed to establish the impact of high-fidelity simulation (HFS) in the objective structured clinical examination (OSCE) of nursing students enrolled in four undergraduate courses (medical-surgical, critical-care, maternal-health and paediatric nursing). This quasi-experimental research study was performed during the midterm and final OSCEs of nursing students at the institution, and their OSCE performance was assessed. The students were divided into two: those who were exposed to HFS in addition to their clinical training and the other group who underwent clinical training without HFS exposure. The combined mean midterm and final OSCE results of the group of nursing students with HFS exposure and those without HFS exposure were 92.58 and 82.66, respectively, with a mean between-group difference of 9.92% (p < .01). Our findings reveal that the HFS exposure in addition to clinical training enhanced the students' OSCE performance.