Benefits of semiology taught using near-peer tutoring are sustainable

Background Near-peer tutoring appears to be an efficient approach for teaching clinical skills. However, the clinical experience gained in the form of student medical internships may offset any interest in such tutoring programme. We then investigated the long-term benefits of this programme. Methods This study was conducted in a medical school that experimented in near-peer tutoring for semiology intended for undergraduate medical students. Objective Structured Clinical Examinations and a written semiology test were used to assess students’ clinical skills immediately on its conclusion and repeated one and 2 years after the tutoring was completed. Results 116 students were evaluated initially (80 tutored and 36 untutored), 38 at 1 year (16 tutored and 22 untutored), 42 at 2 years (21 tutored and 21 untutored). In the global score for Objective Structured Clinical Examinations: at 1 year, the tutored group scored 14.0 ± 1.05 and the untutored group scored 11.3 ± 2.3 (p < 0.001), at 2 years, the tutored group scored 15.1 ± 1.5 and the untutored group scored 12.4 ± 2.2 (p < 0.001). We found a similar but smaller difference for the written semiology test. The difference for Objective Structured Clinical Examinations between tutored and untutored students vanished over time for cross-cutting skills. Conclusions Near-peer tutoring in semiology for undergraduate medical students led to better results that remained with the passing of time. Though internships do allow an improvement in the clinical skills of untutored students, they did not reach the level of tutored students.

Evaluation of faculty inter-variability OSCE grade scoring on overall student performance in a laboratory course

Introduction: Objective structured clinical examinations (OSCEs) are considered the gold standard for evaluating pharmacy students’ clinical skills due to their reliability and validity. Aim: The purpose of this study was to determine whether faculty inter-variability in OSCE grading had a significant impact on a student’s overall performance. Methods: A retrospective analysis was conducted using data from two cohorts of third-year pharmacy students. Descriptive statistics, simple linear regression, and multivariate linear regression analyses were conducted. Results: There were 120 students that participated in the OSCE with a mean score of 66.7%. Higher scores in the Integrated Therapeutics (IT) 2 lecture series and the IT 2 lab course corresponded to better OSCE scores. Out of 17 evaluators, six were found to rate students significantly lower and one was found to rate students significantly higher in comparison to a reference evaluator who evaluated students closest to the overall mean. Conclusion: It is likely that standardised grading, and possibly additional training, may be needed to ensure a fair and appropriate evaluation of OSCE performance.

OSCE rater cognition – an international multi-centre qualitative study

Introduction This study aimed to explore the decision-making processes of raters during objective structured clinical examinations (OSCEs), in particular to explore the tacit assumptions and beliefs of raters as well as rater idiosyncrasies. Methods Thinking aloud protocol interviews were used to gather data on the thoughts of examiners during their decision-making, while watching trigger OSCE videos and rating candidates. A purposeful recruiting strategy was taken, with a view to interviewing both examiners with many years of experience (greater than six years) and those with less experience examining at final medical examination level. Results Thirty-one interviews were conducted in three centres in three different countries. Three themes were identified during data analysis, entitled ‘OSCEs are inauthentic’, ‘looking for glimpses of truth’ and ‘evolution with experience’. Conclusion Raters perceive that the shortcomings of OSCEs can have unwanted effects on student behaviour. Some examiners, more likely the more experienced group, may deviate from an organisations directions due to perceived shortcomings of the assessment. No method of assessment is without flaw, and it is important to be aware of the limitations and shortcomings of assessment methods on student performance and examiner perception. Further study of assessor and student perception of OSCE performance would be helpful.

Evaluation of Nursing Students’ Perspectives toward Objective Structured Clinical Examination

Nurses need to master the core nursing competencies to perform their professional duties effectively. The Objective Structured Clinical Examinations (OSCEs) have been integrated as an innovative method of evaluating clinical skills in the nursing curriculum over the years. The study that directed this article aimed to assess nursing students’ perception toward OSCEs. A cross-sectional descriptive design was used. A convenient sample of 429 undergraduate nursing students was enrolled. In addition to demographic data, the OSCEs’ evaluation questionnaire was used to gather data. The questionnaire assessed nursing students’ evaluation of the OSCEs’ attributes, the quality of OSCEs’ performance, and OSCEs’ scoring and objectivity. Seven questions about the evaluation of the OSCEs’ organisation were added. About two-thirds of the students were female (69.2%) and belonged to the age category of younger than 24 years (59.9%). The OSCEs were rated the most preferred assessment method for clinical competencies and fit for all student levels. Nursing students showed positive perspectives toward OSCEs’ attributes, quality of performance, scoring and objectivity, and organisation. OSCEs have been used as an innovative method of evaluating clinical nursing skills. OSCEs are accepted well by nursing students. The study recommends that academic institutions have to design OCSEs well in terms of preparation, planning, equipping labs, organisation, implementation, follow-up, and monitoring, and they should consider faculty and students’ feedback to make it more effective and valuable.

Peer led practice improves medical student confidence in subsequent Objective Structured Clinical Examinations (Preprint)

BACKGROUND Diabetic ketoacidosis (DKA) teaching is often inadequate leading to confusion amongst medical students and junior doctors. Active learning approaches such as simulation improves retention of learning. A peer led simulated OSCE programme improved medical students’ knowledge and confidence in recognising and managing DKA. OBJECTIVE To design a protocol to improve medical education on the topic of DKA. METHODS A combination of Objective Structured Clinical Examination (OSCE) and medical simulation was devised utilising a SMART simulator mannequin and a peer taking the role of simulated patient. Students received two debriefs, individual feedback and group discussion. Students were assessed through objective assessment results from a questionmark assessment. RESULTS Objective scores on assessment were improved from 5.2/10 (SD, 1.0) to 10/10 (SD, 2.1) on the questionmark. The difference in scores was statistically significant (p<0.05). CONCLUSIONS Medical students benefit from and enjoy OSCE style simulation education on DKA. This programme could be expanded to other topics in acute medicine and extended to other students in healthcare professions.