Dataset Information

Impact of integrating objective structured clinical examination into academic student assessment: Large-scale experience in a French medical school.

ABSTRACT:

Purpose

Objective structured clinical examinations (OSCE) evaluate clinical reasoning, communication skills, and interpersonal behavior during medical education. In France, clinical training has long relied on bedside clinical practice in academic hospitals. The need for a simulated teaching environment has recently emerged, due to the increasing number of students admitted to medical schools, and the necessity of objectively evaluating practical skills. This study aimed at investigating the relationships between OSCE grades and current evaluation modalities.

Methods

Three-hundred seventy-nine 4th-year students of University-of-Paris Medical School participated to the first large-scale OSCE at this institution, consisting in three OSCE stations (OSCE#1-3). OSCE#1 and #2 focused on cardiovascular clinical skills and competence, whereas OSCE#3 focused on relational skills while providing explanations before planned cholecystectomy. We investigated correlations of OSCE grades with multiple choice (MCQ)-based written examinations and evaluations of clinical skills and behavior (during hospital traineeships); OSCE grade distribution; and the impact of integrating OSCE grades into the current evaluation in terms of student ranking.

Results

The competence-oriented OSCE#1 and OSCE#2 grades correlated only with MCQ grades (r = 0.19, P<0.001) or traineeship skill grades (r = 0.17, P = 0.001), respectively, and not with traineeship behavior grades (P>0.75). Conversely, the behavior-oriented OSCE#3 grades correlated with traineeship skill and behavior grades (r = 0.19, P<0.001, and r = 0.12, P = 0.032), but not with MCQ grades (P = 0.09). The dispersion of OSCE grades was wider than for MCQ examinations (P<0.001). When OSCE grades were integrated to the final fourth-year grade with an incremental 10%, 20% or 40% coefficient, an increasing proportion of the 379 students had a ranking variation by ±50 ranks (P<0.001). This ranking change mainly affected students among the mid-50% of ranking.

Conclusion

This large-scale French experience showed that OSCE designed to assess a combination of clinical competence and behavioral skills, increases the discriminatory capacity of current evaluations modalities in French medical schools.

SUBMITTER: Matet A

PROVIDER: S-EPMC7808634 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Impact of integrating objective structured clinical examination into academic student assessment: Large-scale experience in a French medical school.

Matet Alexandre A Fournel Ludovic L Gaillard François F Amar Laurence L Arlet Jean-Benoit JB Baron Stéphanie S Bats Anne-Sophie AS Buffel du Vaure Celine C Charlier Caroline C De Lastours Victoire V Faye Albert A Jablon Eve E Kadlub Natacha N Leguen Julien J Lebeaux David D Malmartel Alexandre A Mirault Tristan T Planquette Benjamin B Régent Alexis A Thebault Jean-Laurent JL Dinh Alexy Tran AT Nuzzo Alexandre A Turc Guillaume G Friedlander Gérard G Ruszniewski Philippe P Badoual Cécile C Ranque Brigitte B Oualha Mehdi M Courbebaisse Marie M

PloS one 20210114 1

<h4>Purpose</h4>Objective structured clinical examinations (OSCE) evaluate clinical reasoning, communication skills, and interpersonal behavior during medical education. In France, clinical training has long relied on bedside clinical practice in academic hospitals. The need for a simulated teaching environment has recently emerged, due to the increasing number of students admitted to medical schools, and the necessity of objectively evaluating practical skills. This study aimed at investigating ...[more]

PMID: 33444375

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Project description:BACKGROUND:Objective structured clinical examinations (OSCEs) are a useful method to evaluate medical students' performance in the clerkship years. OSCEs are designed to assess skills and knowledge in a standardized clinical setting and through use of a preset standard grading sheet, so that clinical knowledge can be evaluated at a high level and in a reproducible way. OBJECTIVE:This study aimed to present our OSCE assessment tool designed specifically for radiology clerkship medical students, which we called the objective structured radiology examination (OSRE), with the intent to advance the assessment of clerkship medical students by providing an objective, structured, reproducible, and low-cost method to evaluate medical students' radiology knowledge and the reproducibility of this assessment tool. METHODS:We designed 9 different OSRE cases for radiology clerkship classes with participating third- and fourth-year medical students. Each examination comprises 1 to 3 images, a clinical scenario, and structured questions, along with a standardized scoring sheet that allows for an objective and low-cost assessment. Each medical student completed 3 of 9 random examination cases during their rotation. To evaluate for reproducibility of our scoring sheet assessment tool, we used 5 examiners to grade the same students. Reproducibility for each case and consistency for each grader were assessed with a two-way mixed effects intraclass correlation coefficient (ICC). An ICC below 0.4 was deemed poor to fair, an ICC of 0.41 to 0.60 was moderate, an ICC of 0.6 to 0.8 was substantial, and an ICC greater than 0.8 was almost perfect. We also assessed the correlation of scores and the students' clinical experience with a linear regression model and compared mean grades between third- and fourth-year students. RESULTS:A total of 181 students (156 third- and 25 fourth-year students) were included in the study for a full academic year. Moreover, 6 of 9 cases demonstrated average ICCs more than 0.6 (substantial correlation), and the average ICCs ranged from 0.36 to 0.80 (P<.001 for all the cases). The average ICC for each grader was more than 0.60 (substantial correlation). The average grade among the third-year students was 11.9 (SD 4.9), compared with 12.8 (SD 5) among the fourth-year students (P=.005). There was no correlation between clinical experience and OSRE grade (-0.02; P=.48), adjusting for the medical school year. CONCLUSIONS:Our OSRE is a reproducible assessment tool with most of our OSRE cases showing substantial correlation, except for 3 cases. No expertise in radiology is needed to grade these examinations using our scoring sheet. There was no correlation between scores and the clinical experience of the medical students tested.

Project description:This study aimed to investigate the impact of student e-learning on the development of clinical competencies. The study participants were 3rd year students (n = 43) at a private mid-sized medical school located in a South Korean suburb on a four-year medical program. Educational intervention was implemented to enhance student clinical performance. Students engaged in learning activities that intended to promote their self-directed learning abilities and clinical performances using e-learning resources. Intervention was conducted for the duration of six months during the 3rd year and its effectiveness was investigated by comparing student performances in OSCEs in a pre- and post- comparison format and also by comparing them with national scores. In addition, student perceptions of the impact of e-learning on their OSCE performances were assessed using a questionnaire, which included 36 items that elicited student perceptions of their experiences of e-learning and readiness for e-learning. Student OSCE scores improved significantly after educational intervention in all domains of clinical competencies assessed and for total scores (p < 0.001). Furthermore, students achieved higher OSCE scores than national average scores in the post-test, whereas they had performed lower than national average scores in the pre-test. Students showed neutral or slightly positive responses to the effectiveness of e-learning, and their perceptions of e-learning were not associated with their e-learning readiness scores. The study shows student OSCE performance improved significantly after educational intervention, which indicate the effectiveness of e-learning to support student learning of clinical performance. Despite significant improvements in student OSCE scores after e-learning, their perceptions of its effectiveness were neutral. Furthermore, student perceptions of e-learning were not associated with their readiness for it. Suggestions are made to help students use e-learning more effectively to enhance their clinical competencies.

Project description:BACKGROUND:Peer-assisted learning (PAL) refers to a learning activity whereby students of similar academic level teach and learn from one another. Groupe de perfectionnement des habiletés cliniques (Clinical Skills Improvement Group), a student organization at Université Laval, Canada, propelled PAL into the digital era by creating a collaborative virtual patient platform. Medical interviews can be completed in pairs (a student-patient and a student-doctor) through an interactive Web-based application, which generates a score (weighted for key questions) and automated feedback. OBJECTIVES:The aim of the study was to measure the pedagogical impact of the application on the score at medical interview stations at the summative preclerkship Objective Structured Clinical Examination (OSCE). METHODS:We measured the use of the application (cases completed, mean score) in the 2 months preceding the OSCE. We also accessed the results of medical interview stations at the preclerkship summative OSCE. We analyzed whether using the application was associated with higher scores and/or better passing grades (≥60%) at the OSCE. Finally, we produced an online form where students could comment on their appreciation of the application. RESULTS:Of the 206 students completing the preclerkship summative OSCE, 170 (82.5%) were registered users on the application, completing a total of 3133 cases (18 by active user in average, 7 minutes by case in average). The appreciation questionnaire was answered online by 45 students who mentioned appreciating the intuitive, easy-to-use, and interactive design, the diversity of cases, and the automated feedback. Using the application was associated with reduced reported stress, improved scores (P=.04), and improved passing rates (P=.11) at the preclerkship summative OSCE. CONCLUSIONS:This study suggests that PAL can go far beyond small-group teaching, showing students' potential to create helpful pedagogical tools for their peers.

Dataset Information

Impact of integrating objective structured clinical examination into academic student assessment: Large-scale experience in a French medical school.

Purpose

Methods

Results

Conclusion

Publications

Impact of integrating objective structured clinical examination into academic student assessment: Large-scale experience in a French medical school.

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