scholarly journals Training in Neurology: Implementation and Evaluation of an Objective Structured Clinical Examination Tool for Neurology Post-graduate Trainees in Lusaka, Zambia

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012134
Author(s):  
Rebecca Marie DiBiase ◽  
Rachel Marie E. Salas ◽  
Charlene E. Gamaldo ◽  
Aparna Nutakki ◽  
Isabel Elicer ◽  
...  

Introduction:We established Zambia’s first neurology residency program at the University of Zambia School of Medicine and the University Teaching Hospital in Lusaka. We evaluated the feasibility and effectiveness of a modified Objective Structured Clinical Examination (OSCE) to assess clinical skills.Program Description:The neurology training program’s three participants completed the OSCE exercise in February 2019. We used smartphones to videotape trainees performing a physical examination and oral presentation in the neurology clinic. Trainees and faculty reviewed the videos independently using a standardized rubric and then met for in-person feedback.Assessment & Outcomes:Three trainees completed pre- and post-OSCE surveys rating their confidence in elements of the history and examination. Trainees’ average self-confidence scores improved from the pre- to post-OSCE survey in every category (pre-OSCE: mean score 6.84, range 4.8-7.8, SD 0.92; post-OSCE: mean score 7.9, range 5.67-9.33, SD 0.86). Qualitative feedback showed trainees found the OSCE helpful, routinely applied feedback, and would appreciate repeating OSCEs.Lessons Learned:OSCEs improve trainees’ self-confidence and can be modified and successfully implemented in a resource-limited neurology post-graduate training program. Important OSCE modifications involved using smartphones for videotaping and a real patient encounter rather than a standardized patient. Additionally, embedding the experience within a busy clinic day was practical, applicable, and efficient.Future Directions:Future work should expand use of OSCEs both within the Zambian neurology residency program and non-neurology training programs. Including additional video reviewers could add to the validity of clinical skills assessment. Videos could also be used for remote mentorship and teaching purposes.

2017 ◽  
Vol 8 (2) ◽  
Author(s):  
Kimberly A.B. Cauthon ◽  
Rebecca L. Attridge ◽  
Elizabeth M. Urteaga ◽  
Amy P. Witte

Objective: The objective was to utilize an Objective Structured Clinical Examination (OSCE) for assessment of pharmacy residents. Innovation: Post-graduate year 1 (PGY1) and post-graduate year 2 (PGY2) pharmacy residents completing multiple, local residency programs were invited to participate in an OSCE. A total of eight PGY1 residents and one PGY2 resident completed the OSCE. American Society of Health-System Pharmacists (ASHP) residency program goals were aligned for each case, which were originally developed for a fourth-year pharmacy student OSCE. Station design included outpatient and inpatient settings with patient and physician interactions. Median communication and clinical skills scores were evaluated. Critical Analysis: The OSCE allows for assessment of all residents on common scenarios. Pharmacy residents met competency requirements and demonstrated excellent communication skills. The OSCE was able to evaluate both physician-pharmacist communication and patient-pharmacist communication. Baseline performance related to the ASHP goals and objectives was not completed; however, the OSCE could highlight resident strengths and weaknesses in communication and clinical skills. The OSCE could simulate independent practice, may reduce bias, and could provide an evaluation of the resident by a patient. However, the OSCE incurs higher resource utilization, specifically monetary and time, than other assessment methods. Next Steps: The pilot study results provide a beginning for further study of OSCEs for pharmacy residents. Further study should include surveying the residency directors about use of the OSCE, a comparison of performance between the OSCE and preceptor evaluations of residents on ASHP goals and objectives, and an evaluation of OSCE implementation at different time points within the residency. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Note


Author(s):  
Jonathan Zachary Felthun ◽  
Silas Taylor ◽  
Boaz Shulruf ◽  
Digby Wigram Allen

Purpose: It aimed to compare the use of the tele objective structured clinical examination (teleOSCE) with in-person assessment in high-stakes clinical examination so as to determine the impact of the teleOSCE on the assessment undertaken. Discussion follows regarding what skills and domains can effectively be assessed in a teleOSCE. Methods: This study is a retrospective observational analysis. It compares the results achieved by final year medical students in their clinical examination, assessed using the teleOSCE in 2020 (n=285), with those who were examined using the traditional in-person format in 2019 (n=280). The study was undertaken at the University of New South Wales, Australia.Results: In the domain of physical examination, students in 2020 scored 0.277 points higher than those in 2019 (mean difference –0.277, P<0.001, effect size 0.332). Across all other domains, there was no significant difference in mean scores between 2019 and 2020.Conclusion: The teleOSCE does not negatively impact assessment in clinical examination in all domains except physical examination. If the teleOSCE is the future of clinical skills examination, assessment of physical examination will require concomitant workplace-based assessment.


2010 ◽  
Vol 2 (3) ◽  
pp. 354-359 ◽  
Author(s):  
Monica L. Lypson ◽  
Paula T. Ross ◽  
Stanley J. Hamstra ◽  
Hilary M. Haftel ◽  
Larry D. Gruppen ◽  
...  

Abstract Objective Some have commented that the limited number of underrepresented minorities (URMs) in United States' residency programs is due to a lack of qualified candidates. At the University of Michigan, an objective structured clinical examination is administered to incoming residents at the beginning of training to determine baseline competence. In this study we wanted to determine if competence differed for underrepresented minorities when compared to non-URM residents. Method The postgraduate orientation assessment, a 10-station examination, was developed that focused specifically on the knowledge and skills needed in the first 6 to 18 weeks of training. Stations assessed competence in informed consent, aseptic technique, evidence-based medicine, diagnostic images, critical laboratory values, cross-cultural communication, and Joint Commission requirements such as surgical fire safety, pain assessment, and management. We used various assessment measures including standardized patients, computer-based testing, and multiple-choice questions. Results Our study found no significant differences in overall mean scores between URM residents and all other residents for the 5 years during which we administered the examination, except for 2002. This stands in contrast to the consistently worse performances of URM students on USMLE Step 1 and Step 2 Clinical Knowledge. Also, URM residents did not perform better or worse than their non-URM colleagues on standardized patient stations during the course of 5 years during which the examination was administered. Conclusions The postgraduate orientation assessment provides residency program directors with a standard format to measure initial clinical skills. When compared to incoming non-URM residents from a variety of medical schools, URM residents perform as well as other trainees. Our results may aid in the recruitment efforts of URM medical students into academic residency programs such as those at the University of Michigan.


Curationis ◽  
1982 ◽  
Vol 5 (1) ◽  
Author(s):  
J.G.P. Van Niekerk ◽  
S.A. Lombard

The newly-established Department of Nursing Science at MEDUNSA had provisionally decided to use the conventional approach to the clinical examination of the ten pre-registration students on the B.Cur. course. During October 1981 Professor R. M. Harden, Professor in Medical Education, University of Dundee, Scotland, paid a lecture visit to MEDUNSA. In one lecture Professor Harden described a method used for examining clinical skills of medical students in the University of Dundee. It is called the Objective Structured Clinical Examination (OSCE). It consists of an examination in which a wide range of skills are evaluated through practical, written and oral methods of assessment.


2020 ◽  
Vol 5 (2) ◽  
pp. 28-35
Author(s):  
Jenny Novina Sitepu

Backgroud: Clinical skills is one of competency as a doctor. Objective Structured Clinical Examination (OSCE) is an ideal way to assess clinical skills for undergraduated, graduated, and postdraduated clinical students. The low score in some OSCE station can be an input for teaching and curriculum improvement. This study aim to analyzed student competency achievement in first term in 2017/2018 academic year in  Fakultas Kedokteran Universitas HKBP Nommensen. Methods: This study was qualitative study with descriptive design. The sample was OSCE score in first term in 2017/2018 academic year. Student achievement was the mean score of every student in all station in OSCE. Competency achievement was the mean of students score for every competency in OSCE. Next, the stations was categorized in practice/ procedure skills station and clinical reasoning skills station. Skills achievement was got form the mean of score (in percent) of procedure skills and clinical reasoning station. Indept interview with students and lectures was held to knowed their perception about OSCE. Results: Students’ achievement in OSCE of first term academic year 2017/2018 was 62.4% for 2015’s students, and 64.6% for 2016’ students. The lowest competency achievement of 2015’s students was diagnosis and differential diagnosis. For the 2016’s students, it was farmacology treatment. Practice/ procedure skills achievement in OSCE of first term academic year 2017/2018 was 61.34% (2015’s students) and 74.4% (2016’s students). The clinical reasoning skills achievement was 62.80% (2015’s students), and 58.77% (2016’s students). Based on indept interview, the things that make student’s achievement low were the clinical reasoning ability of students was still low, the standard patient that involved in OSCE didn’t acted properly, the students’ knowledge about medicine and prescription was poor, and there were lot of learning schedules and learning subjects that students must did and learned. Conclusions:  Students’ achievement in OSCE of first term academic year 2017/2018 is need to  be improved.


2019 ◽  
Vol 32 ◽  
Author(s):  
Aline Moreira Ribeiro ◽  
Alcindo Antônio Ferla ◽  
Juleimar Soares Coelho de Amorim

Abstract Introduction: Problems related to the clinical abilities of physiotherapy students are not always identified throughout the educational process and might only be observed when these future professionals have to treat patients. The Objective Structured Clinical Examination (OSCE) includes a problematization approach and can be used in Health Sciences teaching to help this identification before internship practices. However, there are few studies on its use in Physiotherapy. Objective: To gather evidence of the OSCE use to evaluate clinical abilities in Physiotherapy teaching. Method: Articles published from 2000 to 2016 were surveyed in the Biblioteca Virtual em Saúde (BVS) (Virtual Health Library), Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME) (Latin-American and Caribbean Health Sciences Information Center), PubMed, Scielo and Web of Science, using the descriptors “educational assessment”, “assessment methods”, “objective structured clinical examination”, “clinical competence”, “professional competence”, “clinical skills”, “student competence”, “student skills”, “physiotherapy” and the Booleans “OR” and “AND”. Results: The initial number of identified publications was 3,242. From these, seven were included in this review. Two studies were developed in Brazil, four in Australia and one in Canada. The studies were scored 7 to 12 regarding methodologic quality, and 1B and 2B regarding scientific evidence. Conclusion: Students’ clinical abilities were grouped into three classes: cognitive, psychomotor and affective, and four studies described their use. There is very little evidence of the use of OSCE, but the instrument can be applied to evaluate skills and competences in Physiotherapy teaching.


2020 ◽  
Vol 2 (1) ◽  
pp. 11
Author(s):  
Khadiga M. Said ◽  
Safaa F. Draz

Context: The Objective Structured Clinical Examination (OSCE) method is an effective tool for evaluating the clinical nursing skills of nursing students. OSCE is an assessment technique in which the student demonstrates their competence under a variety of simulated conditions Aim: This study aimed to compare objective structured clinical examinations versus traditional clinical examination on pediatric nursing students' performance. Methods: A quasi-experimental research design (study and control group) was used to conduct this study. The study was conducted in the laboratory of pediatric nursing skills at the faculty of nursing, Benha University. All male and female pediatric nursing students in the 3rd year (n. =228), who were studying in the academic year 2018-2019, first semester, faculty of nursing, Benha University, was recruited. A simple random sample chose to achieve the aim of this study. The odd number was for the OSCE group and the even number for the traditional clinical examination (TCE) group. Four tools were utilized to collect data for the current study. A Structured Questionnaire Sheet, A modified Self-administered Questionnaire, Pediatric Nursing Students' Practice Observational Checklists, and Clinical Scenarios were designed to assess the pediatric nursing student OSCE exam and compare between the traditional method and OSCE method of exams. Results: The current study discovered statistically significant differences were found with a high percentage of agreement responses among pediatric nursing students for related items of OSCE method compared to those in TCE. Additionally, the results clarify a highly statistically significant difference between the studied pediatric nursing students' in TCE and OSCE total performance scores. Conclusion: Objective Structured Clinical Examination (OSCE) was opinioned as a tool for clinical evaluation. This finding appeared in pediatric nursing students' responses, which confirmed their acceptance of OSCE. The OSCE subsequently remains a more objective method of assessment than the traditional clinical forms of the exam that was previously used. OSCE can be used most effectively in undergraduate nursing curricula to assess fair practice. This type of exam provided an accurate measure of clinical skill competencies. Therefore, OSCE should be adopted as a strategy for examining clinical skills for students in all academic years. The current study recommended that Objective Structured Clinical Examination can be used as effective and meaningful assistance to fitness for practice, and OSCE should be adopted as a strategy for examining clinical skills for students in all academic years.


Sign in / Sign up

Export Citation Format

Share Document