OSCE Performance Research Articles

Students’ perception on the effects of basic clinical skills training in preclinical phase to national OSCE

The aim of this study was to evaluate students’ perception on effect of BCS training in preclinical phase to national OSCE. Cross sectional study was conducted at FMHS during January and December 2013. After students finished national OSCE, they were asked to filled up questionnaire that comprised their perception on effect of BCS training in preclinical phase whether helpful to pass national OSCE. There were nine items questionnaire with Likert Scale of 1-5 (strongly disagree to strongly agree) and open question for comments. There were 50 students of total 53 students involved (response rate was 94.3%). Generally students’ perception on effect of BCS training to national OSCE was fair (3.53 ± 0.58). Students revealed that preclinical phase curriculum didn’t effect to their succeed to pass national OSCE, whilst physical examination training gained the highest score (3.38 ± 0.87 and 3.66 ± 0.74, respectively). Overall students’ perception on effect of BCS training to national OSCE was fair. In the future we have to revise our preclinical phase curriculum which integrate with BCS training curriculum and enhance students’ clinical reasoning process to improve students’ performance in national OSCE.

Influence of Marital Status on Attitude of Midwives towards OSCE and Their Performance in the Examination in Akwa Ibom and Cross River States, Nigeria

This quantitative study investigated the influence of marital status on the midwives’ attitude towards OSCE and how this affects their performance in the examination. Two hypotheses guided the study. HO 1 sort to find out if there exist a significant influence of marital status of midwives on their attitude towards OSCE as well as performance in the examination and HO 11 states: there is no significant joint influence of midwives’ attitude and marital status on their performance in OSCE. Ex-post facto design was used to carry out the study. 502 midwives from 8 institutes of midwifery education in Akwa Ibom & Cross River states were engaged in the study. Two validated instruments, OSCE stake holders’ questionnaire (OSCEQ) and Achievement test on OSCE were used to collect data for the study. Data were analyzed using linear regression analysis of variance (ANOVA). The findings show that marital status significantly influences midwives’ perception of OSCE. However, there is no significant influence of marital status on midwives’ attitude towards OSCE. The implication of these findings is, it will be useful and helpful to midwife educators in counseling of new midwifery students on OSCE.

Are the General Medical Council's Tests of Competence fair to long standing doctors? A retrospective cohort study.

BackgroundThe General Medical Council’s Fitness to Practise investigations may involve a test of competence for doctors with performance concerns. Concern has been raised about the suitability of the test format for doctors who qualified before the introduction of Single Best Answer and Objective Structured Clinical Examination assessments, both of which form the test of competence. This study explored whether the examination formats used in the tests of competence are fair to long standing doctors who have undergone fitness to practise investigation.MethodsA retrospective cohort design was used to determine an association between year of primary medical qualification and doctors’ test of competence performance. Performance of 95 general practitioners under investigation was compared with a group of 376 volunteer doctors. We analysed performance on knowledge test, OSCE overall, and three individual OSCE stations using Spearman’s correlation and regression models.ResultsDoctors under investigation performed worse on all test outcomes compared to the comparison group. Qualification year correlated positively with performance on all outcomes except for physical examination (e.g. knowledge test r = 0.48, p < 0.001 and OSCE r = 0.37, p < 0.001). Qualification year was associated with test performance in doctors under investigation even when controlling for sex, ethnicity and qualification region. Regression analyses showed that qualification year was associated with knowledge test, OSCE and communication skills performance of doctors under investigation when other variables were controlled for. Among volunteer doctors this was not the case and their performance was more strongly related to where they qualified and their ethnic background. Furthermore, volunteer doctors who qualified before the introduction of Single Best Answer and OSCE assessments, still outperformed their peers under investigation.ConclusionsEarlier graduates under fitness to practise investigation performed less well on the test of competence than their more recently qualified peers under investigation. The performance of the comparator group tended to stay consistent irrespective of year qualified. Our results suggest that the test format does not disadvantage early qualified doctors. We discuss findings in relation to the GMC’s fitness to practise procedures and suggest alternative explanations for the poorer performance of long standing doctors under investigation.

Internet Teaching of the Neurologic Examination and OSCE Performance in the Neurology Clerkship (s19.006)

Internet Teaching of the Neurologic Examination and OSCE Performance in the Neurology Clerkship (s19.006)

Simulation-based end-of-life care training during surgical clerkship: assessment of skills and perceptions

BackgroundAssessment of interpersonal and psychosocial competencies during end-of-life care training is essential. This study reports the relationship between simulation-based end-of-life care Objective Structured Clinical Examination ratings and communication skills, trust, and self-assessed empathy along with the perceptions of students regarding their training experiences. MethodMedical students underwent simulation-based end-of-life care OSCE training that involved standardized patients who evaluated students' communication skills and physician trust with the Kalamazoo Essential Elements Communication Checklist and the Wake Forest Physician Trust Scale. Students also completed the Jefferson Scale of Physician Empathy. Pearson correlation was used to examine the relationship between OSCE performance grades and communication, trust, and empathy scores. Student comments were analyzed using the constant comparative method of analysis to identify dominant themes. ResultsThe 389 students (mean age 26.6 ± 2.8 y; 54.5% female) had OSCE grades that were positively correlated with physician trust scores (r = 0.325, P < 0.01) and communication skills (r = 0.383, P < 0.01). However, OSCE grades and self-reported empathy were not related (r = 0.021, P = 0.68). Time of clerkship differed for OSCE grade and physician trust scores; however, there was no trend identified. No differences were noted between the time of clerkship and communication skills or empathy. Overall, students perceived simulation-based end-of-life care training to be a valuable learning experience and appreciated its placement early in clinical training. ConclusionsWe found that simulation-based OSCE training in palliative and end-of-life care can be effectively conducted during a surgery clerkship. Moreover, the standardized patient encounters combined with the formal assessment of communication skills, physician trust, and empathy provide feedback to students at an early phase of their professional life. The positive and appreciative comments of students regarding the opportunity to practice difficult patient conversations suggest that attention to these professional characteristics and skills is a valued element of clinical training and conceivably a step toward better patient outcomes and satisfaction.

2086769 Medical Student OSCE Performance with Hand-Held Ultrasound

2086769 Medical Student OSCE Performance with Hand-Held Ultrasound

The fairness, predictive validity and acceptability of multiple mini interview in an internationally diverse student population--a mixed methods study.

BackgroundInternational medical students, those attending medical school outside of their country of citizenship, account for a growing proportion of medical undergraduates worldwide. This study aimed to establish the fairness, predictive validity and acceptability of Multiple Mini Interview (MMI) in an internationally diverse student population.MethodsThis was an explanatory sequential, mixed methods study. All students in First Year Medicine, National University of Ireland Galway 2012 were eligible to sit a previously validated 10 station MMI. Quantitative data comprised: demographics, selection tool scores and First Year Assessment scores. Qualitative data comprised separate focus groups with MMI Assessors, EU and Non-EU students.Results109 students participated (45% of class). Of this 41.3% (n = 45) were Non-EU and 35.8% (n = 39) did not have English as first language. Age, gender and socioeconomic class did not impact on MMI scores. Non-EU students and those for whom English was not a first language achieved significantly lower scores on MMI than their EU and English speaking counterparts (difference in mean 11.9% and 12.2% respectively, P<0.001). MMI score was associated with English language proficiency (IELTS) (r = 0.5, P<0.01). Correlations emerged between First Year results and IELTS (r = 0.44; p = 0.006; n = 38) and EU school exit exam (r = 0.52; p<0.001; n = 56). MMI predicted EU student OSCE performance (r = 0.27; p = 0.03; n = 64). In the analysis of focus group data two overarching themes emerged: Authenticity and Cultural Awareness. MMI was considered a highly authentic assessment that offered a deeper understanding of the applicant than traditional tools, with an immediate relevance to clinical practice. Cultural specificity of some stations and English language proficiency were seen to disadvantage international students. Recommendations included cultural awareness training for MMI assessors, designing and piloting culturally neutral stations, lengthening station duration and providing high quality advance information to candidates.ConclusionMMI is a welcome addition to assessment armamentarium for selection, particularly with regard to stakeholder acceptability. Understanding the mediating and moderating influences for differences in performance of international candidates is essential to ensure that MMI complies with the metrics of good assessment practice and principles of both distributive and procedural justice for all applicants, irrespective of nationality and cultural background.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-014-0267-0) contains supplementary material, which is available to authorized users.

Medical school handoff education improves postgraduate trainee performance and confidence

Objectives: Determine postgraduate first-year (PGY-1) trainees ability to perform patient care handoffs and associated medical school training.Methods: About 173 incoming PGY-1 trainees completed an OSCE handoff station and a survey eliciting their training and confidence in conducting handoffs. Independent t-tests compared OSCE performance of trainees who reported receiving handoff training to those who had not. Analysis of variance examined differences in performance based on prior handoff instruction and across levels of self-assessed abilities, with significance set at p < 0.05.Results: About 35% of trainees reported receiving instruction and 51% reported receiving feedback about their handoff performance in medical school. Mean handoff performance score was 69.5%. Trainees who received instruction or feedback during medical school had higher total and component handoff performance scores (p < 0.05); they were also more confident in their handoff abilities (p < 0.001). Trainees with higher self-assessed skills and preparedness performed better on the OSCE (p < 0.05).Conclusions: This study provides evidence that incoming trainees are not well prepared to perform handoffs. However, those who received instruction during medical school perform better and are more confident on standardized performance assessments. Given communication failures lead to uncertainty in patient care and increases in medical errors, medical schools should incorporate handoff training as required instruction.

Comparison of Teacher's and Students' Evaluations on OSCE Performance among College Nursing Students

Purpose: This study was aimed to compare and contrast the evaluation scores on students OSCE performance between the instructors and students according to the Bloom's taxonomy. Methods: A total of sixty six students in a nursing college in Seoul, Korea and four instructors were recruited in the study. The 28 sophomore students were assigned to an OSCE on intravenous injection, whereas 38 junior students on tracheostomy care. Knowledge levels were measured by the students using the researcher developed knowledge questionnaires, and the attitudes and skills by the students and instructors by the modified clinical performance checklists. The data were analyzed by SPSS 22.0 program. Results: For knowledge, the higher GPA of the previous semester was only significant factor of higher knowledge scores. There were statistically significant differences in scores of total (t=-2.740, p=.008) and skill (t=-2.528, p=0.014), but not in attitude between the instructors and students' evaluations. The students evaluated their skill scores significantly higher than those of the instructors. For knowledge, the higher GPA of the previous semester was the only significant factor of higher knowledge scores. In attitude scores, the students in higher grade significantly overestimated themselves (t=3.076, p=.003). Conclusion: Clinical performance assessment requires methodological validity and reliability for student to attain necessary clinical skills properly and efficiently. The findings of this study mandate various assessment methods for nursing simulation evaluations to be valid.

The Multiple Mini-Interview (MMI) for student selection in health professions training – A systematic review

Background: The Multiple Mini-Interview (MMI) has been used increasingly for selection of students to health professions programmes.Objectives: This paper reports on the evidence base for the feasibility, acceptability, reliability and validity of the MMI.Data sources: CINAHL and MEDLINEStudy eligibility criteria: All studies testing the MMI on applicants to health professions training.Study appraisal and synthesis methods: Each paper was appraised by two reviewers. Narrative summary findings on feasibility, acceptability, reliability and validity are presented.Results: Of the 64 citations identified, 30 were selected for review. The modal MMI consisted of 10 stations, each lasting eight minutes and assessed by one interviewer. The MMI was feasible, i.e. did not require more examiners, did not cost more, and interviews were completed over a short period of time. It was acceptable, i.e. fair, transparent, free from gender, cultural and socio-economic bias, and did not favour applicants with previous coaching. Its reliability was reported to be moderate to high, with Cronbach's alpha = 0.69–0.98 and G = 0.55–0.72. MMI scores did not correlate to traditional admission tools scores, were not associated with pre-entry academic qualifications, were the best predictor for OSCE performance and statistically predictive of subsequent performance at medical council examinations.Conclusions: The MMI is reliable, acceptable and feasible. The evidence base for its validity against future medical council exams is growing with reports from longitudinal investigations. However, further research is needed for its acceptability in different cultural context and validity against future clinical behaviours.

Impact of Self-Efficacy Beliefs on Short- and Long-Term Academic Improvements for Underperforming Medical Students

This study investigated the effectiveness of an innovative remediation program, based on promoting self-efficacy, a construct of self-regulation theory, which was developed to provide sustainable improvements in academic and clinical performance of underperforming medical students. Eighteen medical (eight 4th and ten 5th year) students participated in the remediation program. Interventions were multi-faceted and composed of a wide range of group activities. The efficacy of the intervention was evaluated using mixed-method approach consisting of interviews, questionnaire and quantitative analysis of OSCE outcomes (pre and post intervention). The in-depth interviews were used to explore the short- and long-term causal effects of the remediation program on improved performance. Students demonstrated significant improvements across 3 of the 5 domains measured in OSCE performance (management, diagnosis and communication). There was a 44% improvement in number of stations passed by participants post-remediation (95% CI = -52.25 to -35.64; r = 0.82). Large effect sizes were obtained, indicating the substantive significance of the results. Self-efficacy beliefs were markedly increased post-intervention with the total score increasing from 33.52 (SD=4.9) points pre-remediation to 45.71 (SD=5.1) points post-remediation (95% CI = -14.52 to -9.83; p<0.001; r = 0.77). Subsequent qualitative data suggested that beyond summative exam results, gains were translated to the clinical context with enhanced confidence and self–belief, enabling perceived improved performance in the workplace. Multi-dimensional, group orientated remediation, which emphasises self-efficacy beliefs, may enhance outcomes for students in both high stakes assessment and in the clinical context, thus allowing translational and longitudinal benefits.

Metacognition, OSCE performance anxiety and OSCE performance

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Plasmon Resonance Enhanced Optical Absorption in Inverted Polymer/Fullerene Solar Cells with Metal Nanoparticle-Doped Solution-Processable TiO2 Layer

This paper investigates the effects of localized surface plasmon resonance (LSPR) in an inverted polymer/fullerene solar cell by incorporating Au and/or Ag nanoparticles (NPs) into the TiO2 buffer layer. Enhanced light harvesting via plasmonic resonance of metal NPs has been observed. It results in improved short-circuit current density (Jsc) while the corresponding open-circuit voltage (Voc) is maintained. A maximum power conversion efficiency of 7.52% is obtained in the case of introducing 30% Ag NPs into the TiO2, corresponding to a 20.7% enhancement compared with the reference device without the metal NPs. The device photovoltaic characteristics, photocurrent properties, steady-state and dynamic photoluminescences of active layer on metal NP-doped TiO2, and electric field profile in metal NP-doped TiO2 layers are systematically investigated to explore how the plasmonic effects of Au and/or Ag NPs influence the OSC performance.

Can narrative medicine training improve OSCE performance?

Medical EducationVolume 46, Issue 11 p. 1112-1113 really good stuff Can narrative medicine training improve OSCE performance? Shih-Li Tsai, Shih-Li TsaiSearch for more papers by this authorMing-Jung Ho, Ming-Jung HoSearch for more papers by this author Shih-Li Tsai, Shih-Li TsaiSearch for more papers by this authorMing-Jung Ho, Ming-Jung HoSearch for more papers by this author First published: 18 October 2012 https://doi.org/10.1111/medu.12029Citations: 11 Dr Ming-Jung Ho, Department of Social Medicine, National Taiwan University College of Medicine, No. 1 Ren-Ai Road, Section 1, Taipei 106, Taiwan. Tel: 00 886 910 188399; Fax: 00 886 2 393 5254; E-mail: mjho@ntu.edu.tw Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume46, Issue11November 2012Pages 1112-1113 RelatedInformation

Educational Outcomes of the Harvard Medical School–Cambridge Integrated Clerkship

The authors report data from the Harvard Medical School-Cambridge Integrated Clerkship (CIC), a model of medical education in which students' entire third year consists of a longitudinal, integrated curriculum. The authors compare the knowledge, skills, and attitudes of students completing the CIC with those of students completing traditional third-year clerkships. The authors compared 27 students completing the first three years of the CIC (2004-2007) with 45 students completing clerkships at other Harvard teaching hospitals during the same period. At baseline, no significant between-group differences existed (Medical College Admission Test and Step 1 scores, second-year objective structured clinical examination [OSCE] performance, attitudes toward patient-centered care, and plans for future practice) in any year. The authors compared students' National Board of Medical Examiners Subject and Step 2 Clinical Knowledge scores, OSCE performance, perceptions of the learning environment, and attitudes toward patient-centeredness. CIC students performed as well as or better than their traditionally trained peers on measures of content knowledge and clinical skills. CIC students expressed higher satisfaction with the learning environment, more confidence in dealing with numerous domains of patient care, and a stronger sense of patient-centeredness. CIC students are at least as well as and in several ways better prepared than their peers. CIC students also demonstrate richer perspectives on the course of illness, more insight into social determinants of illness and recovery, and increased commitment to patients. These data suggest that longitudinal integrated clerkships offer students important intellectual, professional, and personal benefits.

The weak relationship between anatomy competence and clinical skills in junior medical students

In modern curricula, the early integration of anatomy and clinical skills education at undergraduate level is seen as important. However, the direct relationship between medical students' competence in anatomy, and their clinical proficiency during early undergraduate years, has scarcely been studied. In this study, the marks for anatomy and clinical skills of three consecutive cohorts of medical students (n = 538 in total) during their first two years were correlated. The anatomy competence was measured using a new marker, the Anatomy Competence Score (ACS) which was calculated with equal contributions from theory knowledge and its practical and clinical application. Proficiency in clinical skills was determined by OSCE performance marks for stations which examined physical examination and practical procedural skills. The possible compounding effect of students' general academic ability was investigated by using the overall performance mark for each student based on their performance in all subjects over the first two years of the medical curriculum. We found that the correlation between anatomy and clinical skills marks was weak to moderate. However, this correlation was virtually nullified once the effect of academic ability was accounted for. Although these findings suggest that anatomy education does not compliment early clinical education, the lack of complexity of clinical problems used in clinical skills assessments (OSCEs) during the early stages may well be the primary contributing factor to this finding.

Hafnium metallocene compounds used as cathode interfacial layers for enhanced electron transfer in organic solar cells

We have used hafnium metallocene compounds as cathode interfacial layers for organic solar cells [OSCs]. A metallocene compound consists of a transition metal and two cyclopentadienyl ligands coordinated in a sandwich structure. For the fabrication of the OSCs, poly[3,4-ethylenedioxythiophene]:poly(styrene sulfonate), poly(3-hexylthiophene-2,5-diyl) + [6,6]-phenyl C61 butyric acid methyl ester, bis-(ethylcyclopentadienyl)hafnium(IV) dichloride, and aluminum were deposited as a hole transport layer, an active layer, a cathode interfacial layer, and a cathode, respectively. The hafnium metallocene compound cathode interfacial layer improved the performance of OSCs compared to that of OSCs without the interfacial layer. The current density-voltage characteristics of OSCs with an interfacial layer thickness of 0.7 nm and of those without an interfacial layer showed power conversion efficiency [PCE] values of 2.96% and 2.34%, respectively, under an illumination condition of 100 mW/cm2 (AM 1.5). It is thought that a cathode interfacial layer of an appropriate thickness enhances the electron transfer between the active layer and the cathode, and thus increases the PCE of the OSCs.

Michael G. DeGroote School of Medicine Faculty of Health Sciences, McMaster University

Michael G. DeGroote School of Medicine Faculty of Health Sciences, McMaster University

Clinical observed performance evaluation: a prospective study in final year students of surgery

We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series of assessments in a 25-week teaching programme. Over time, several clinicians from a pool of 16 surgical consultants and registrars evaluated each student by direct observation. A structured rating form was used for assessment data. Variance component analysis (VCA), internal consistency and inter-rater agreement were used to estimate reliability. The predictive and convergent validity of COPE in relation to summative OSCE, long case, and overall final examination was estimated. Median number of COPE assessments per student was 7. Generalisability of a mean score over 7 COPE assessments was 0.66, equal to that of an 8 × 7.5 min station final OSCE. Internal consistency was 0.88-0.97 and inter-rater agreement 0.82. Significant correlations were observed with OSCE performance (R = 0.55 disattenuated) and long case (R = 0.47 disattenuated). Convergent validity was 0.81 by VCA. Overall final examination performance was linearly related to mean COPE score with standard error 3.7%. COPE permitted efficient serial assessment of a large cohort of final year students in a real world setting. Its psychometric quality compared well with conventional assessments and with other direct observation instruments as reported in the literature. Effect on learning, and translation to clinical care, are directions for future research.

Designs and Architectures for the Next Generation of Organic Solar Cells

Organic solar cells show great promise as an economically and environmentally friendly technology to utilize solar energy because of their simple fabrication processes and minimal material usage. However, new innovations and breakthroughs are needed for organic solar cell technology to become competitive in the future. This article reviews research efforts and accomplishments focusing on three issues: power conversion efficiency, device stability and processability for mass production, followed by an outlook for optimizing OSC performance through device engineering and new architecture designs to realize next generation organic solar cells.