Practice Makes Perfect: Objective Structured Clinical Examinations Across the UME-to-GME Continuum Improve Care of Transgender Simulated Patients
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SUBMITTER: Beltran C
PROVIDER: S-EPMC11234318 | biostudies-literature | 2024 Apr
REPOSITORIES: biostudies-literature
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Project description:BackgroundObjective Structured Clinical Examinations (OSCEs) aim to assess medical students' clinical skills rather than just their theoretical knowledge. We propose a study between the learning style of second-cycle medical students and their performance in OSCEs.MethodsDuring their internship at our hospital, students were invited to complete the LSQ-Fa, a questionnaire designed to identify their preferences among 4 learning styles: active, reflective, theoretical, and pragmatic. In parallel, an evaluation of their clinical skills was conducted through OSCEs. We then performed an analysis to establish a correlation between learning styles and OSCE performance, to better understand how learning preferences influence academic outcomes.ResultsBetween April 2021 and January 2023, 55 students were evaluated by OSCEs and had completed the LSQ-Fa. The average OSCE score was 14.8/20. The theoretical learning style was predominant in 47.3% of students, followed by active (27.3%), reflective (14.6%), and pragmatic (5.4%), with 3 cases of mixed active and theoretical styles (5.4%). No significant correlation was observed between learning style and OSCE performance (p = 0.28), although students with a pragmatic style recorded a slightly higher average.ConclusionThis study highlights the importance of considering diverse learning styles in the design of medical education programs.
| S-EPMC11451022 | biostudies-literature
Project description:Twenty core nursing skills have been identified by the Korean Accreditation Board of Nursing Education. Proficiency in these skills is essential for all nursing professions, and many educational strategies exist to develop these skills in nursing students, including the Objective Structured Clinical Examination (OSCE). To date, no study on the effects of the OSCE on nursing education has been published. Therefore, we evaluated the effects of the OSCE on the core nursing skills of 207 pre-licensure nursing students in Korea. We measured the nursing students' confidence, skills, and knowledge acquisition and retention. A one-way analysis of variance and Fisher's least significant difference were used for data analysis. Among the four nursing areas (fall, transfusion, pre-operative, and post-operative), students demonstrated the highest confidence level scores in pre-operative nursing. On the OSCE, students scored the highest in transfusion nursing. Significant differences were found between prior knowledge, knowledge acquisition, and retention. Our findings confirm that the OSCE, after lectures and core nursing skill practice, improved the retention of nursing students' knowledge. Therefore, this program can positively influence nursing students' knowledge level, and implementing the OSCE can strengthen students' clinical competency.
| S-EPMC10256199 | biostudies-literature
Project description:PurposeThe objective structured clinical examination (OSCE) is considered to be one of the most robust methods of clinical assessment. One of its strengths lies in its ability to minimise the effects of examiner bias due to the standardisation of items and tasks for each candidate. However, OSCE examiners' assessment scores are influenced by several factors that may jeopardise the assumed objectivity of OSCEs. To better understand this phenomenon, the current review aims to determine and describe important sources of examiner bias and the factors affecting examiners' assessments.MethodsWe performed a narrative review of the medical literature using Medline. All articles meeting the selection criteria were reviewed, with salient points extracted and synthesised into a clear and comprehensive summary of the knowledge in this area.ResultsOSCE examiners' assessment scores are influenced by factors belonging to 4 different domains: examination context, examinee characteristics, examinee-examiner interactions, and examiner characteristics. These domains are composed of several factors including halo, hawk/dove and OSCE contrast effects; the examiner's gender and ethnicity; training; lifetime experience in assessing; leadership and familiarity with students; station type; and site effects.ConclusionSeveral factors may influence the presumed objectivity of examiners' assessments, and these factors need to be addressed to ensure the objectivity of OSCEs. We offer insights into directions for future research to better understand and address the phenomenon of examiner bias.
| S-EPMC5801428 | biostudies-literature
Project description:Background Medical trainees must learn how to provide effective feedback as an essential communication skill, yet few models exist for training and assessing these skills. Objective To develop an observed structured feedback examination (OSFE) to provide feedback training to pediatric fellows and assess changes in skills and self-reported confidence. Methods This educational study was conducted from 2019 to 2020 at an academic children's hospital. Our team developed the OSFE and trained standardized feedback recipients and faculty. Fellows completed baseline self-assessments (31 items) on prior exposure to feedback training, application of skills, and confidence. They then participated in the OSFE, giving feedback to a standardized recipient using a standardized scenario, and were scored by faculty and recipients using a 15-item checklist for performance. Next, fellows participated in feedback training and received individualized feedback, after which they repeated the OSFE and confidence self-assessment. Three months later, fellows completed self-assessments on confidence and application of skills and another OSFE to assess retention. Descriptive statistics and signed rank sum test were used for analysis. Results Of 60 eligible fellows, 19 participated (32%), with 100% follow-up. After training and individualized feedback, all fellows improved feedback skills as measured by OSFE performance (mean change +0.89). All items, measured on a 5-point Likert scale, were sustained 3 months later (mean change +0.92). All fellows reported improved confidence in feedback knowledge (mean change +2.07 post, +1.67 3 months post). Conclusions Feedback training using simulation and individualized feedback moderately improved fellows' performance, confidence, and 3-month retention of feedback skills.
| S-EPMC10829923 | biostudies-literature
Project description:BackgroundInterpersonal and communication skills (ICS) are important core competencies in medical education and certification. In this study, we identified self- and simulated patient (SP)-reported ratings of US first-year medical students' ICS and the influence of age and gender on performance appraisal during the Objective-Structured Clinical Examination (OSCE).MethodsOSCE participants, including 172 first-year medical students and 15 SPs were asked to evaluate the students' ICS using the American Board of Internal Medicine-Patient-Satisfaction Questionnaire (ABIM-PSQ), electronically and via paper, respectively. Self- and SP-reported ratings of students' ICS were presented as the median on a 5-point Likert-scale and as three categories defined as "good," "very good," and "inadequate."ResultsSPs assessed all 172 students in the OSCE, while 43.6% of students assessed their own performance. The majority of students and SPs evaluated the students' ICS as very good. 23.3% of SPs and 5.3% of students rated the medical students' ability to encourage patient question-asking and answer questions as inadequate (P < 0.002). Neither age nor gender influenced the medical students' self-assessment of ICS. Female SPs assigned lower scores to students in regard to respecting patients and encouraging patient question-asking and answering. Older SPs was more likely to assign lower scores on all survey questions.ConclusionsIn the present study, self- and SP-reported ratings of first-year medical students' ICS were mainly "very good" with no influence of students' age or gender. Older age and female gender among the SPs were associated with a reduction in SP-reported ratings of students' ICS.
| S-EPMC7887830 | biostudies-literature
Project description:ObjectivesTo describe a simulation-based rater training curriculum for Objective Structured Clinical Examinations (OSCEs) for clinician-based training for frontline staff caring for mothers and babies in rural Tanzania.BackgroundRater training for OSCE evaluation is widely embraced in high-income countries but not well described in low-income and middle-income countries. Helping Babies Breathe, Essential Care for Every Baby and Bleeding after Birth are standardised training programmes that encourage OSCE evaluations. Studies examining the reliability of assessments are rare.MethodsTraining of raters occurred over 3 days. Raters scored selected OSCEs role-played using standardised learners and low-fidelity mannikins, assigning proficiency levels a priori. Researchers used Zabar's criteria to critique rater agreement and mitigate measurement error during score review. Descriptive statistics, Fleiss' kappa and field notes were used to describe results.ResultsSix healthcare providers scored 42 training scenarios. There was moderate rater agreement across all OSCEs (κ=0.508). Kappa values increased with Helping Babies Breathe (κ=0.28-0.48) and Essential Care for Every Baby (κ=0.42-0.77) by day 3 of training, but not with Bleeding after Birth (κ=0.58-0.33). Raters identified average proficiency 50% of the time.ConclusionOur study shows that the in-country raters in this study had a hard time identifying average performance despite moderate rater agreement. Rater training is critical to ensure that the potential of training programmes translates to improved outcomes for mothers and babies; more research into the concepts and training for discernment of competence in this setting is necessary.
| S-EPMC7722831 | biostudies-literature
Project description:BackgroundShared decision-making (SDM) may support widespread uptake of progestin-containing long-acting reversible contraceptives in the immediate postpartum period. We piloted an Objective Structured Clinical Examination (OSCE) to evaluate first-year obstetrics and gynecology resident physicians' use of SDM in postpartum contraception counseling.MethodsAs part of their 2015 and 2016 OSCEs, first-year OB/GYN residents were instructed to provide contraceptive counseling to a Standardized Patient (SP) portraying a 29-year-old postpartum patient seen during rounds on the morning following her delivery. Three investigators independently scored each resident encounter using a 10-item rubric adapted from a 9-item SDM measure and assigned scores of 0 (absent), 1 (partial), or 2 (complete). Each encounter was video and audio recorded, then transcribed for qualitative analysis. Descriptive statistics was produced using SPSS version 24.ResultsEighteen residents participated. The majority (78%) discussed contraceptive options and timing of initiation. Nearly 33% elicited factors most important to the SP in influencing her preference. Only 6% discussed the benefits of exclusive breastfeeding, and few addressed the uncertainty of progesterone on milk supply and production.ConclusionAlthough residents conveyed ample clinical information, the vast majority did not discuss elements of SDM, such as her preferences, values, and goals for future fertility and breastfeeding. Our work revealed that critical elements of SDM are often not explored and deliberated by resident physicians. Trainings (e.g., OSCEs) are needed to equip residents with effective communication skills to facilitate more SDM in postpartum contraceptive care.
| S-EPMC9811846 | biostudies-literature
Project description:IntroductionProfessionalism in physician assistant (PA) students is an essential behavior to assess during formative medical education. Objective structured clinical examinations (OSCEs) provide an opportunity to evaluate PA students performing professional behaviors within simulated clinical settings. This scoping review aims to explore insights the existing literature offers regarding evaluating the professional behaviors of PA students using an OSCE. A secondary objective is to identify gaps in the literature to clarify future research.MethodsThis scoping review was conducted in March 2024. From January 2018 until March 2024, CINAHL, MEDLINE Ultimate, Health Source-Nursing/Education, and PubMed online databases were searched for publications in English. Records included research studying PA or medical students evaluated on professional behaviors using an OSCE or performance-based assessment instrument. Allied health profession students were excluded from the primary search because of their heterogeneous curriculum models outside the population of interest.ResultsThis review includes 5 papers. All papers reported communication as a professional behavior measured in an OSCE or performance-based assessment. A consensus or formal definition of professional behavior is a notable absence in this scoping review.DiscussionMore definitive homogenous evidence is needed to assess the professional behaviors of PA students using an OSCE. This limits the guidance and educational standards for future health profession educators. Comprehensive research into professional behaviors among PA students is essential. Scholars must publish their findings on professionalism curriculum design and outcomes to facilitate a broader understanding and improvement in educating future PA professionals.
| S-EPMC11841713 | biostudies-literature
Project description:A large variability in performance is observed when participants recall briefly presented lists of words. The sources of such variability are not known. Our analysis of a large data set of free recall revealed a small fraction of participants that reached an extremely high performance, including many trials with the recall of complete lists. Moreover, some of them developed a number of consistent input-position-dependent recall strategies, in particular recalling words consecutively ("chaining") or in groups of consecutively presented words ("chunking"). The time course of acquisition and particular choice of positional grouping were variable among participants. Our results show that acquiring positional strategies plays a crucial role in improvement of recall performance.
| S-EPMC4793200 | biostudies-literature
Project description:IntroductionAlthough shared decision making (SDM) is optimal for trial of labor after cesarean (TOLAC) counseling, resources to assess residents' clinical competency and communication skills are lacking. We addressed this gap by developing and testing an objective structured clinical examination (OSCE) to evaluate whether learners were able to use SDM in TOLAC counseling.MethodsWe created three simulation scenarios with increasing complexity to assess the skills of residents in their first, second, or third postgraduate year in using SDM in TOLAC counseling. All cases involved a standardized patient requesting a TOLAC consultation. Residents were provided with a medical history and instructed to counsel and develop a care plan. A 10-item scoring rubric was used, and each item was rated 0 (absent), 1 (partial), or 2 (complete). Three coders independently rated the encounters; discrepancies were resolved by consensus.ResultsOver 3 years, 39 residents participated in 60 OSCE encounters. The majority provided complete discussions of the clinical issue (93%), chances of success (72%), and maternal and fetal risks (100% and 85%, respectively) but obtained partial assessments of understanding (78%). Discussions of benefits were typically absent, with the exception of the maternal benefits (47%). More than 40% of residents did not discuss the patient's goals, 53% lacked discussion of uncertainties related to TOLAC, and half failed to explore the patient's preference, with most deferring a decision to a future encounter.DiscussionResidents consistently discussed diagnosis, prognosis, and maternal risks yet infrequently addressed goals and preferences-two critical elements of SDM.
| S-EPMC7182044 | biostudies-literature