Effect of Clinical Skills Evaluation by Direct Observation of Procedural Skills (DOPS) Method on Clinical Performance of Operating Room Students

Background: Evaluation is an essential and integral part of medical education. Based on the evidence, the current common methods are less effective due to the lack of accurate assessment of students' clinical skills. Clinical evaluation of students in the form of direct observation in practical situations will increase their ability to deal with clinical events in specific patient situations. Objectives: In this study, the effectiveness of the direct observation of procedural skills (DOPS) method was compared with the common method in the clinical performance of operating room students. Methods: This quasi-experimental study was performed on 30 final-year operating room students in 2019 who had an internship course. Students were randomly assigned to two groups of control (n = 15) and intervention (n = 15). The evaluation of clinical skills was done by the traditional method in the control group and the DOPS method in the intervention group. Data collection was performed by a researcher-made checklist whose validity and reliability were confirmed. Statistical analysis of data was performed by SPSS-20 software using descriptive statistics and chi-square test, independent t-test, and Mann-Whitney test. Results: There was no significant difference between the two groups in terms of demographic characteristics including age, internship score, and gender (P > 0.05). Based on the results of the Mann-Whitney test, the mean rank of procedural techniques and clinical performance score was higher in the intervention group than in the control group (P < 0.05). Conclusions: The DOPS method can be more effective than routine methods for improving the clinical performance of operating room students. Therefore, it is suggested that the DOPS method be used as an alternative to traditional methods or even as a complementary method for evaluating the clinical performance of operating room students.

Assessing The Utility and Efficacy of e-OSCE Among Undergraduate Medical Students During The COVID-19 pandemic

Background The outbreak of coronavirus disease 2019 (COVID-19) and its quick progression to a global pandemic has urged medical schools to shift from didactic to distance learning and assessment approaches. The quality of clinical training and assessment have been jeopardized due to the regulatory restrictions and potential hazards to human lives. The aim of this paper is to evaluate the utility and efficacy of an electronic Objective Structured Clinical Examination (e-OSCE), which attempted to transform the format of a face-to-face OSCE to an e-OSCE. Methods We conducted three end of clerkship e-OSCEs for final year medical students in Surgery, Medicine and Family Medicine using the teleconferencing application of Microsoft Teams (MST). The e-OSCE blueprint included the assessment of all clinical skills except physical examination and procedural skills. Examiners supervised e-OSCE from the college campus, while all students were remotely assessed through the MST channels. During the exam, the students stayed in their specified MST channel and examiners rotated across all students. The utility and efficacy of e-OSCE was evaluated using a self-administered questionnaire for students, examiners and e-OSCE team. Results The data analysis showed that 93.4% students and 92.2% examiners agreed with the quality and process of e-OSCE. Similarly, 83.6% students and 98% examiners agreed with the seamless organization of e-OSCE. As many as 45.9% students and 74.5% examiners agreed that e-OSCE was close to real life practice. Approximately one fifth of students and one third of examiners preferred e-OSCE over the face-to-face OSCE. The analysis of qualitative data generated the themes of e-OSCE structure and technology. While majority of participants were satisfied with e-OSCE, students were concerned about examiners’ training and e-OSCE contents. Examiners and e-OSCE team recognized the paper-less, tech-savy, fast and reliable format of e-OSCE. Conclusion During and beyond COVID- 19 era, e-OSCE is a strong substitute to standard OSCE for assessing clinical competence except for physical examination and procedural skills. The planning and implementation of e-OSCE reflects an ingenuity in the assessment of clinical competencies of medical students.

Procedural Fluency from the View of Students of Mathematical Disposition Level through Google Classroom Assisted Learning

This study aims to describe procedural fluency in solving problems for students of the Mathematics Education Department at the STKIP Pamane Talino who obtain high and low mathematical dispositions through learning assisted by Google Classroom. This research is a qualitative research. The research subjects were two students in the third semester. Subjects were selected by purposive sampling. The research data was obtained by tests and interviews, and the validity of the data was obtained by using the triangulation method. The techniques of data analysis were trough: 1) classifying data into three indicators of the smoothness of the procedure; namely: a) implementing procedures appropriately, b) selecting and utilizing procedures, c) modifying procedures, then reducing data that are not included in the 3 indicators; 2) presenting data in a narrative; 3) concluding the procedural fluency obtained from the indicators of procedural fluency in problem-solving steps. The results of the high mathematical disposition analysis showed that students had excellent procedural skills because they could apply procedures appropriately. They were able to select and utilize procedures accurately, and were able to apply procedures properly and flexibly. In the other side, the students with low mathematical disposition, they had poor procedural skills because even though they were able to apply the procedure, choose, and use the procedure appropriately, they still could not comply with the procedure appropriately and accurately for they answered all the questions incorrectly.

The effectiveness of combining e-learning, peer teaching and flipped classroom for delivering physiology laboratory course to nursing students

The Internet and 5G era make e-learning a vital part of modern education, and extensive evidence has shown that peer teaching and flipped classroom contribute to increased success in medical teaching. However, the applicability of these pedagogies in laboratory courses remains largely unexplored. This study aimed to evaluate the academic performance, proficiency in procedural skills and perception of nursing students in physiology laboratory classes delivered using non-traditional classroom (NTC) pedagogies comprising the combination of e-learning, peer teaching and flipped classroom. Each class was sub-divided into two equal halves by successive student identification (ID) and randomly assigned to control or NTC group. Compared to control class, NTC teaching significantly enhanced mean score of six pre-class tests (67.77 ± 9.83 vs. 62.94 ± 9.70), with "B" graders increased obviously, suggesting pre-class e-learning was more effective than textbook-based preview, especially for general grasp of the topic. Similarly, average scores on post-class quizzes in NTC group was improved (79.40 ± 9.12 vs. 74.43 ± 8.88). Lesser time-cost and higher success rates were observed in trachea, artery and heart catheterizations in NTC group , although no disparities were found in ureteral intubation . Majority of (~74%) students supported the reform and shared positive experiences in NTC methodology. They reported virtual experiments and self-paced procedural skill videos affected pre- or in-class learning outcomes most, respectively. These findings indicated NTC pedagogy was workable to improve students' subject scores and proficiency in complicated and direct-viewing procedural skills, and was favorable by students.

EP.TU.657Scoping the role and content of a simulator-based endosim curriculum

Background Endoscopy training requires simultaneous acquisition of practical skill and knowledge. Virtual reality Simulators, such as EndoSim (SurgicalScience), offer the opportunity to deconstruct a skill into fundamental components (1), to allow repetitive practice, and achievement of task-specific objectives. Trainees with the least endoscopy experience benefit most from early simulated training (2,3), supporting the introduction of a simulation curriculum into SPRINT: Structured PRogramme for INduction and Training, an existing initiative to improve endoscopy training delivery in Wales. (4) The aim of this study was to design a pilot simulator curriculum for the EndoSim (Surgical Science, Gothemberg) simulator. Methods A focus group completed all EndoSim modules. Each EndoSim exercise was cross-examined against the relevant DOPS tool “Direct Observation of Procedural Skill” used by the Joint Advisory Group for Endoscopy Training and Certification. Exercises were chosen that represented each DOPS domain to teach basic skills in endoscopy scope handling. Results 12 exercises were chosen. These exercises addressed the insertion and withdrawal, and visualisation components of the JAG DOPS tool. Pre-procedural skills, management of findings, post-procedural skills and endoscopic non-technical Skills (ENTS) are beyond the scope of this simulator and require additional taught sessions to provide the context for current simulation training. Discussion This is the first step in developing and refining appropriate exercises to inform the proposed curriculum. The next step will be validating the chosen exercises against expert benchmark performance.