Objective Structured Clinical Examination Scores Research Articles

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

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

Can routine EPA-based assessments predict OSCE performances of undergraduate medical students?

Background Objective structured clinical examination (OSCE) is used worldwide. This study aims to explore potential alternatives to the OSCE by using entrustable professional activities (EPA)-based assessments in the workplace. Methods This study enrolled 265 six-year undergraduate medical students (UGY) from 2021 to 2023. During their rotations, students were assessed using 13 EPAs, with the grading methods modified to facilitate application. Before graduation, they participated in two mock OSCEs and a National OSCE. We used generalized estimating equations to analyze the associations between the EPA assessments and the OSCE scores, adjusting for age and sex, and developed a prediction model. EPA8 and EPA9, which represent advanced abilities that were not significant in the regression models, were removed from the prediction model. Results Most EPAs were significantly correlated with OSCE scores across the three cohorts. The prediction model for forecasting passing in the three OSCEs demonstrated fair predictive capacity (area under curve = 0.82, 0.66, and 0.71 for students graduated in 2021, 2022, and 2023, respectively all p < 0.05). Conclusions The workplace-based assessments (EPA) showed a high correlation with competency-based assessments in simulated settings (OSCE). EPAs may serve as alternative tools to formal OSCE for medical students.

Substitution of a Traditional Face-to-Face Workshop With Virtual Escape Room in Higher Education: A Cost-Effectiveness Analysis.

Online education games are gaining ground in health profession education, yet there is limited literature on its costs. This study is an economic evaluation of the substitution of a face-to-face (F2F) workshop with an online escape room game teaching the same content. A traditional F2F workshop on hepatitis management was conducted with 364 students in 2021 and was compared with a virtual self-run escape room game called Hepatitiscape™, which was used by 417 students in 2022. The outcomes were final examination and objective structured clinical examination (OSCE) scores for hepatitis stations. An incremental cost-effectiveness ratio was used to compare costs and outcomes. Student perceptions of the delivery of Hepatitiscape™ were also captured using an online questionnaire. Delivering the hepatitis case workshop via Hepatitiscape™ yielded an additional 4.77% increase in the final examination score and a 21.04% increase in the OSCE score at an additional cost of AUD $4212 in the first year compared with F2F delivery. This equated to an incremental cost-effectiveness ratio of AUD 883 per additional score of final examination and AUD 200 per additional score of OSCE for hepatitis stations. Hepatitiscape™ became cost saving from the second year onward. Student perception data revealed their recall of content was higher owing to the iterative design of the gaming elements. Hepatitiscape™ is likely to be a cost-effective strategy to deliver workshops that are routinely delivered F2F to test knowledge-based constructs. In addition, virtual gaming has a logistical advantage over F2F delivery in that it enhances student participation from remote locations and allows for better control and flexibility of content delivery with increasing or decreasing cohort sizes, and can have potential long-term sustainable savings.

Self-assessment and Teacher-Assessment During an OSCE in Undergraduate Dental Students-Application of a Visual Metaphor

Background: Reflection on both student and teacher perspectives is crucial for effective communication and professional relationships during education. Objectives: This observational cohort study aimed to compare students' self-assessment with teacher assessments, as well as with estimated self-assessment and estimated teacher-assessment, using the pictorial representation of illness and self-measure (PRISM) during an objective structured clinical examination (OSCE). Additionally, it sought to compare self-assessment and teacher-assessment with OSCE scores. Methods: Fourth-year dental students (n = 44) were included at the beginning of their clinical course. Three tasks were selected for the OSCE exams: Oral examination on a model (task 1), matrix placement (task 2), and endodontic radiograph evaluation (task 3). Objective structured clinical examination scores were rated by an independent rater. Students and one of three calibrated teachers used PRISM to evaluate their respective assessments independently and blinded from each other. The relationships between the different assessments were determined using the Pearson correlation coefficient. Results: For task 1, a moderate correlation was found between students' self-assessment and estimated self-assessment (r = 0.44, P &lt; 0.01). For task 2, moderate correlations were observed between self-assessment and teacher-assessment, estimated teacher-assessment and teacher-assessment, as well as between self-assessment and estimated self-assessment (P ≤ 0.01). For task 3, moderate correlations were found between self-assessment and teacher-assessment, and between self-assessment and estimated self-assessment (P &lt; 0.01). A moderate negative correlation between self-assessment and the OSCE score was observed only for task 2 (r = -0.41, P = 0.01). Moderate negative correlations between teacher-assessment in PRISM and the OSCE score were found for all three tasks (P &lt; 0.01). Conclusions: Self-assessment and teacher-assessment using PRISM exhibited task-dependent correlations, while results for estimated assessments varied. PRISM may serve as a promising tool for feedback and discussion in the future, as it seems capable of highlighting different views and expectations in the teaching context. Further studies are needed to confirm these findings.

Exploring the viability of Virtual Reality as a teaching method for knee aspiration

Knee arthrocentesis is a simple procedure commonly performed by general practitioners and junior doctors. As such, doctors should be competent and comfortable in performing the technique by themselves; however, they need to be adequately trained. The best method to ensure practitioner proficiency is by optimizing teaching at an institutional level, thus, educating all future doctors in the procedure. However, the Coronavirus Disease 19 (COVID-19) pandemic caused significant disruption to hospital teaching for medical students which necessitated investigating the effectiveness of virtual reality (VR) as a platform to emulate hospital teaching of knee arthrocentesis. A workshop was conducted with 100 fourth year medical students divided into three Groups: A, B and C, each receiving a pre-reading online lecture. Group A was placed in an Objective Structured Clinical Examination (OSCE) station where they were assessed by a blinded orthopaedic surgeon using the OSCE assessment rubric. Group B undertook a hands-on practice station prior to assessment, while Group C received a VR video (courtesy of the University of Adelaide’s Health Simulation) in the form of VR headset or 360° surround immersion room and hands-on station followed by the OSCE. Upon completion of the workshop, students completed a questionnaire on their confidence with the procedure and the practicality of the VR station. OSCE scores were compared between Groups B and C to investigate the educational value of VR teaching. On average, students with VR headsets reported higher confidence with the procedure and were more inclined to undertake it on their own. Students in Group C who used the VR station prior to assessment scored higher than the non-VR Groups (Group A, 56%; Group B, 67%; Group C 83%). Students in Group A had statistically significant results on average compared to those in Group B (t(69) = 3.003, p = 0.003), as do students in Group B compared to Group C (t(62) = 5.400, p < 0.001). Within Group C students who were given VR headsets scored higher than immersion room students. The VR headset was beneficial in providing students with a representation of how knee arthrocentesis may be conducted in the hospital setting. While VR will not replace conventional in-hospital teaching, given current technological limitations, it serves as an effective teaching aid for arthrocentesis and has many other potential applications for a wide scope of medicine and surgical training.

The application of blended teaching in medical practical course of clinical skills training

BackgroundBlended teaching is an effective approach that combines online and offline teaching methods, leading to improved outcomes in medical education compared to traditional offline teaching. In this study, we examined the impact of blended teaching in clinical skills training, a medical practice course.MethodsThis study involved forty-eight undergraduate students studying clinical medicine in the fifth semester at Wuhan University of Science and Technology. The students were divided into two groups: the control group, which received traditional offline teaching, and the experimental group, which received hybrid teaching. Following the completion of the 4-month course, both groups underwent the Objective Structured Clinical Examination (OSCE) to evaluate their proficiency in clinical skills. Furthermore, the experimental group was given a separate questionnaire to gauge their feedback on the Blended Teaching approach.ResultsBased on the OSCE scores, the experimental group outperformed the control group significantly (P<0.05). The questionnaire results indicated that a majority of students (54.2%, 3.71 ± 1.06) believed that blended teaching is superior to traditional offline teaching, and a significant number of students (58.3%, 3.79 ± 1.15) expressed their willingness to adopt blended teaching in other courses. Furthermore, students in the experimental group displayed varying levels of interest in different teaching contents, with emergency medicine (79.2%), internal medicine (70.8%), and surgery (66.7%) being the most popular among them.ConclusionsThis research demonstrates for the first time that blended teaching can achieve a good pedagogical effectiveness in the medical practice course, clinical skills training and practice. Moreover, in different teaching contents, the teaching effects are different. In the content of Emergency Medicine and Surgery, which is more attractive to students, the application of blended teaching could result in a better pedagogical outcome than other contents.

What do we know about Objective Structured Clinical Examination in Sport and Exercise Medicine? A scoping review.

Despite the importance of the Objective Structured Clinical Examination (OSCE) in Sport and Exercise Medicine, the literature on the topic is fragmented and has been poorly developed. The goal of this review was to map current knowledge about how the OSCE is used in Sport and Exercise Medicine, and to identify knowledge gaps for future research. The authors conducted a scoping review. They searched PubMed and Scopus for articles using key terms related to 'OSCE' and 'sport medicine' with no limit on search start date and up to July 2022. Retrieved records were imported, abstracts were screened, and full-text articles were reviewed. A forward and backward citation tracking was conducted. Data was extracted and a qualitative meta-summary of the studies was conducted. A total of 469 records were screened, and 22 studies were included. The objectives of the studies included using OSCEs to assess knowledge/skills after a training program (n = 11), to assess an intervention (n = 8), and to assess and improve the OSCE itself (n = 3). Thirteen studies reported validity and/or reliability of the OSCE. Despite the widespread use of OSCEs in the examination of Sport and Exercise Medicine trainees, only a handful of scholarly works have been published. More research is needed to support the use of OSCE in Sport and Exercise Medicine for its initial purpose. We highlight avenues for future research such as assessing the need for a deeper exploration of the relationship between candidate characteristics and OSCE scores.

Immunization Simulation Using Actual-Size Infant Manikins for Medical Students in Indonesia

Introduction Manikins are tools used in simulation training for medical students to develop important skills, one of which is immunization. However, conventional manikins often do not resemble the actual size of an infant's arm or leg. This study aimed to determine the impact of using actual-size manikins on students' knowledge and practical skills, evaluate their confidence in immunization practice, and assess students' responses and feedback regarding the practice using actual-size manikins. Methods This was a quasi-experimental study involving medical students at the Faculty of Medicine, Universitas Indonesia, from October 2020 to April 2021. Students in the intervention group used newly developed actual-size infant arm and leg manikins, while the control group used conventional manikins. All students underwent the objective structured clinical examination (OSCE) and the scores were compared between the 2 groups. Within the intervention group, data on pretest and posttest scores, feedback questionnaires, and self-confidence assessments were also obtained and analyzed. Results A total of 205 students were included. Statistically significant difference was found in the OSCE scores between the intervention and control groups (P &lt; 0.01). Students in the intervention group (n = 108) showed significant improvement in knowledge scores after the workshop (P &lt; 0.01). Most students (81.7%) expressed confidence in administering vaccines to live patients after practicing with manikins. In addition, 98.2% of students (n = 107) acknowledged the benefits of practicing with actual-size manikins in accurately determining the injection sites. Conclusions Simulation with the actual-size manikins significantly improved students' knowledge and practical immunization skills, leading to increased confidence and competence in their immunization skills.

Using Group History-Taking and Individual Reasoning to Identify Shortcomings in Clinical Reasoning for Medical Students.

It is crucial that teaching faculties determine and remain informed of medical school learners' clinical reasoning competence. We created an innovative assessment method for fourth-year medical students to identify deficiencies in various components of their clinical reasoning ability. This was a cross-sectional observational study of fourth-year medical students' reasoning assessments from 2019 to 2022. Teams of four-five trainees questioned standardized patients in clinical scenarios, including fever, abdominal pain, and weight loss. They then individually documented key information to reflect comprehension of patient problems. Trainees were tasked with differentiating diagnoses and associated statuses and reaching the most likely diagnosis along with two tentative diagnoses. The correlations observed between 2020 and 2022 for abdominal pain were analyzed using student t-tests. A total of 177 students participated in this study. Across the scenarios, there was no significant difference in key information representation scores (56%-58%). Reasoning ability scores were 49% for fever, 57% for abdominal pain, and 61% for weight loss. A comparison between 2020 and 2022 revealed a significant improvement in the objective structured clinical examination scores and differential diagnoses (P < .01). Shortcomings included brief chief complaint duration, lack of detailed presentation, and insufficient description of negative information. Differential diagnosis and diagnostic justification were inadequate for acute and chronic conditions, and disease location clarity within the organ system was lacking. On average, students presented two correct diagnoses. Fourth-year medical students exhibited inadequate reasoning abilities, particularly in fever and abdominal pain scenarios, with deficiencies in hypothesis generation and differential diagnosis. Group history-taking with individual reasoning assessment identified students' shortcomings and provided faculty feedback to improve their teaching strategies.

Developing an Educational Program for Ultrasound Hip Screening during Newborn and Infant Home Visits: A Protocol Paper.

Ultrasound hip screening is suitable for the early identification of developmental dysplasia of the hip (DDH). Newborn and infant home visits are good opportunities for hip screening in the community, but studies focusing on nurse-led screenings are lacking. Based on a pre-post design, this study aims to develop and evaluate an ultrasound training program to improve nurses' assessment skills in detecting DDH cases during newborn and infant home visits. Said educational program will include e-learning, hands-on seminars, and clinical training. The primary outcome will be the success rate of imaging standard planes (standardized images for hip assessment) in clinical training. The secondary outcomes will include knowledge test results, objective structured clinical examination scores, time required for imaging, and inter-rater reliability between nurses and physicians. The educational program will address the issue of missed and late detection of DDH cases in resource-limited communities. This study will demonstrate the feasibility of procedures and the effectiveness of the educational program in 2024. The protocol was registered in the University Hospital Medical Information Network Clinical Trial Registry before starting the study (no. UMIN000051929, 16 August 2023).

Telepharmacy versus Face-to-Face Approach in Providing Inhaler Technique Training Service: A Non-Inferiority Assessment Among German Pharmacy Students.

The use of telepharmacy in delivering pharmaceutical care services has grown in the past few years; however, there are perceptions of its inappropriateness for providing medical device training among pharmacy students and practicing pharmacists. The primary objective of this study was to determine if the telepharmacy approach for providing inhaler technique training service was non-inferior to the face-to-face approach regarding pharmacy students' performance in simulated patient encounters. Secondary objectives were to determine students' self-assessment of their ability to demonstrate and practice inhaler technique between the two modes of communication and their perceptions of telepharmacy. A randomized crossover non-inferiority trial was conducted among undergraduate pharmacy students. Outcomes were measured by comparing Objective Structured Clinical Examination (OSCE) scores of participants' performance between two modes of communication while providing inhaler technique training service. Moreover, the participants also completed self-assessment and perception questionnaires. The telepharmacy approach was non-inferior to the face-to-face approach for demonstrating and practicing the correct inhaler technique based on OSCE scores and a predefined non-inferiority margin of -10%. The results also revealed no significant differences in student self-confidence between the two modes of communication. Moreover, participants had a largely positive perception of telepharmacy and its use in providing inhaler technique training service. Considering our findings, telepharmacy is a viable alternative to traditional face-to-face consultations for providing inhaler technique training service. However, to address perceived difficulties and differences between virtual and face-to-face consultations, the pharmacy curriculum should include more telepharmacy-related didactic content with experiential learning and simulations.

Exam prediction and the general Practice Registrar Competency Assessment Grid (GPR-CAG)

ABSTRACT Background In GP training, identifying early predictors of poor summative examination performance can be challenging. We aimed to establish whether external clinical teaching visit (ECTV) performance, measured using a validated instrument (GP Registrar Competency Assessment Grid, GPR-CAG) is predictive of Royal Australian College of General Practitioners (RACGP) Fellowship examination performance. Methods A retrospective cohort study including GP registrars in New South Wales/Australian Capital Territory with ECTV data recorded during their first training term (GPT1), between 2014 and 2018, who attempted at least one Fellowship examination. Independent variables of interest included the four GPR-CAG factors assessed in GPT1 (‘patient-centredness/caring’, ‘formulating hypotheses/management plans’, ‘professional responsibilities’, ‘physical examination skills’). Outcomes of interest included individual scores of the three summative examinations (Applied Knowledge Test (AKT); Key Feature Problem (KFP); and the Objective Structured Clinical Examination (OSCE)) and overall Pass/Fail status. Univariable and multivariable regression analyses were performed. Results Univariably, there were statistically significant associations (p < 0.01) between all four GPR-CAG factors and all four summative examination outcomes, except for ‘formulating hypotheses/management plans’ and OSCE score (p = 0.07). On multivariable analysis, each factor was significantly associated (p < 0.05) with at least one exam outcome, and ‘physical examination skills’ was significantly associated (p < 0.05) with all four exam outcomes. Discussion ECTV performance, via GPR-CAG scores, is predictive of RACGP Fellowship exam performance. The univariable findings highlight the pragmatic utility of ECTVs in flagging registrars who are at-risk of poor exam performance, facilitating early intervention. The multivariable associations of GPR-CAG scores and examination performance suggest that these scores provide predictive ability beyond that of other known predictors.

Virtual Clinical Simulation for Training Amongst Undergraduate Medical Students: A Pilot Randomised Trial (VIRTUE-Pilot).

Clinical virtual simulators are promising new technologies that might facilitate teaching clinical skills. This study aimed to assess whether a virtual reality simulator might facilitate learning and improve adherence to current clinical guidelines. A double-masked randomised trial was undertaken among fourth-year medical students at Universidad Andres Bello, Chile. Participants were randomised to a clinical virtual simulator (Body Interact®, Body Interact Inc., Austin, TX) or a small-group discussion session on the management of myocardial infarction. Main outcomes included performance in an objective structured clinical examination (OSCE) and adherence to clinical recommendations. Analyses were undertaken under the intention to treat principle by an independent statistician. Fifty students volunteered to participate. Most were female (30 students, 58.8%) and had a mean age of 23.0±2.7 years. Thirty-two participants (62.8%) had used virtual reality platforms before. Students allocated to the simulator showed better OSCE scores (mean difference: 2.8 points; 95% confidence interval (CI): -3.2 to +8.7 points, p=0.14) and were faster to implement diagnostic and therapeutic interventions, but not in a statistically significant way. Academic performance was slightly improved by the use the simulator, although the overall effect was smaller than expected. This study examined the influence of a clinical virtual simulator on the academic performance and guideline adherence of undergraduate medical students, with small group discussions as a point of comparison. The findings revealed that there were no statistically significant distinctions between the two methods, potentially attributed to the selection of the comparator and the relatively brief intervention period.

The Impact of Online vs Blended Clinical Skill Laboratory Learning on Student Academic Performance: A Case Study in Indonesia

ObjectiveOnline and blended learning methods have experienced rapid growth in higher education due to the COVID-19 pandemic. Our study aimed to compare students’ academic performance between online and blended Clinical Skill Laboratories (CSL) learning in undergraduate medical students. MethodsA total of 101 undergraduate medical students at Maulana Malik Ibrahim State Islamic University, Malang, Indonesia, were enrolled (50 students from the academic year 2020 [group 1: online CSL]; 51 students from the academic year 2020 [group 2: blended CSL]). The main outcome was students’ academic performance collected from the Objective Structured Clinical Examination (OSCE) score. Additionally, students also completed an evaluation questionnaire to assess the quality of the learning scheme. ResultsBoth groups agreed that CSL is an important subject and clinical video demonstration is useful for their OSCE preparation. However, students who received online learning felt that online CSL was ineffective and scored lower in the OSCE compared to the blended CSL. Qualitative data also supported these findings. ConclusionBlended learning provides more value than online learning in terms of teaching clinical skills for undergraduate medical students. Additionally, online CSL may not be sufficient for medical students to attain critical skills.

Comparison of pharmacy student, evaluator, and standardised patient assessment of Objective Structured Clinical Examination (OSCE) performance

Objective: The study aimed to (1) determine if standardised patient (SP) assessment of student communication differs from faculty assessment and (2) identify factors that may affect their assessment scoring since differences between evaluator scoring could impact students’ learning and feedback. Methods: Students completed four OSCEs in spring 2022. Communication skills were scored using a global assessment rubric completed by a faculty evaluator, SP, and student. SPs and students rated their confidence in student recommendations on a scale of 1-5 (1=lowest; 5=highest). Spearman correlation and Wilcoxon matched-pairs signed rank tests were used for analysis. Results: SP global assessment scores were statistically significantly higher than faculty scores. SP global assessment and confidence scores were strongly correlated. Conclusion: Differences in OSCE scoring among evaluator types and factors that may impact scoring are important to explore. SP scores were consistently higher than faculty scores, which should be considered when using OSCEs as assessments.

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.

Cross-sectional study in Madagascar demonstrates efficacy of virtual mentoring and flipped classroom modifications of neonatal resuscitation programme Helping Babies Breathe.

The Covid-19 pandemic necessitated virtual adaptation of the neonatal resuscitation programme Helping Babies Breathe (HBB). This study assessed one such virtually mentored and flipped classroom modification in Madagascar. A cross-sectional study was performed in September 2021 and May 2022. Healthcare providers were identified by local collaborating organisations. United States-based master trainers collaborated with local trainers on virtually mentored trainings followed by independent trainings. Master trainers were available for consultation via Zoom during the virtual training. A flipped classroom modification and traditional didactic method were compared. Primary outcomes were knowledge and skill acquisition, evaluated by written assessments and objective structured clinical examinations. Overall, 97 providers completed the curriculum. Written assessment scores improved in both training models (traditional-74.8% vs 91.5%, p < 0.001; flipped classroom-89.7% vs 93.6%, p < 0.05). There was no significant difference among written assessment scores (92.8% vs 91.5%, p = 0.62) and significantly higher objective structured clinical examination scores (97.3% vs 89.5%, p < 0.001) for the independent training compared to the virtually mentored training. The virtually mentored HBB training was followed by a successful independent training as measured by participant knowledge and skill acquisition, supporting the efficacy of virtual dissemination.

Student experiences of simulation-based learning and its impact on their performance in Objective Structured Clinical Examination in Pediatrics - A mixed method study.

This study aims to assess the effectiveness of integrating simulation for teaching pediatric clinical examination skills to undergraduate, MBBS Year-IV medical students at The Aga Khan University, Karachi, Pakistan. In this mixed method study, the Objective Structured Clinical Examination (OSCE) scores of the students who were taught using simulation (batch 2017-2018) were compared with the batch of the academic year 2016 -2017 (taught via traditional methods). In order to explore the experiences of the intervention group, a questionnaire with four open-ended questions was administered at the end of the clerkship. Students who were taught by simulation, scored significantly higher on the clinical skills stations in Objective Structured Clinical Examination, than in the pre-intervention group (p-value <0.01). The students quoted safety of the learning environment, opportunities for deliberate practice, debriefing and facilitation skills maximized quoted that their experience of learning through simulation, however, some challenges were identified for future improvement. The result of the study suggested simulation as a useful instructional strategy for teaching examination skills to students in their early years. The student gained confidence through deliberate practice and feedback without compromising patient safety, which translated into improved performance in the high-stakes OSCE examination at the end of the clerkship.

Assessment of Saudi MEDs framework competence in performing clinical and practical skills by final-year medical students

Clinical examinations and practical clinical skills are essential to guide diagnosis and treatment. Competency-based medical education (CBME) is high on today’s medical education agenda, and competence has become the unit of medical education planning in many countries. With the rise of medical education in Saudi Arabia, The Saudi MEDs initiative began as a means of achieving national consensus and developing necessary learning outcomes for medical schools. The aim of this study is to evaluate the final-year medical students’ core clinical competencies and identify the gaps between clinical skills in the Saudi MEDs framework and students’ actual achievement. Online data collection from all fifth-year medical students, to assess their clinical and procedural skills by using Objective Structured Clinical Examination (OSCE) scores and using a self-administered questionnaire that has been developed based on the Saudi MEDs framework. Eight clinical competencies were chosen out of the 17 after consulting the experts in this field. OSCE scores were checked for correlation with their self-assessment scores. The total OSCE scores of 323 students were evaluated which showed 93% of students have passed all eight competencies. Also, 304 students responded to the self-administered questionnaire in the current Saudi MEDs competencies 323 (response rate=94.11). The students were confident in the majority of the eight clinical competencies of the Saudi MEDs framework. Saudi MEDs framework has ensured that Saudi medical or health care education adapted to changing demands, critical competencies are not overlooked, teaching and learning, and evaluation are appropriate at medical schools by implementing the competency framework.

Comparability of Objective Structured Clinical Examinations (OSCEs) and Written Tests for Assessing Medical School Students' Competencies: A Scoping Review.

Objective Structured Clinical Examinations (OSCEs) and written tests are commonly used to assess health professional students, but it remains unclear whether the additional human resources and expenses required for OSCEs, both in-person and online, are worthwhile for assessing competencies. This scoping review summarized literature identified by searching MEDLINE and EMBASE comparing 1) OSCEs and written tests and 2) in-person and online OSCEs, for assessing health professional trainees' competencies. For Q1, 21 studies satisfied inclusion criteria. The most examined health profession was medical trainees (19, 90.5%), the comparison was most frequently OSCEs versus multiple-choice questions (MCQs) (18, 85.7%), and 18 (87.5%) examined the same competency domain. Most (77.5%) total score correlation coefficients between testing methods were weak (r < 0.40). For Q2, 13 articles were included. In-person and online OSCEs were most used for medical trainees (9, 69.2%), checklists were the most prevalent evaluation scheme (7, 63.6%), and 14/17 overall score comparisons were not statistically significantly different. Generally low correlations exist between MCQ and OSCE scores, providing insufficient evidence as to whether OSCEs provide sufficient value to be worth their additional cost. Online OSCEs may be a viable alternative to in-person OSCEs for certain competencies where technical challenges can be met.