Slide Presentation

THE NUTS AND BOLTS OF CREATING AN OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) FOR MEDICAL STUDENTS AND RESIDENTS SOPHIA CHEN, DO, MPH COURSE DIRECTOR, PHYSICIAN’S CORE ASSISTANT DIRECTOR, PEDIATRIC EDUCATION CHRISTIN M. TRABA, MD, MPH ASSOCIATE PROGRAM DIRECTOR, PEDIATRICS SITE DIRECTOR, PEDIATRIC CERKSHIP SUSAN G. MAUTONE, MD, FAAP VICE-CHAIR FOR EDUCATION CLERKSHIP AND PROGRAM DIRECTOR DEPARTMENT OF PEDIATRICS, UMDNJ – NEW JERSEY MEDICAL SCHOOL, NEWARK, NJ

APPD/COMSEP Combined Annual Spring Meeting April 12, 2013

Disclosure Information 



In the past 12 months, we have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services. This presentation will not include discussion of pharmaceuticals or devices that have not been approved by the FDA.

Objectives 

At the conclusion of this session, participants will be able to:  Discuss

steps in creating an OSCE to assess the clinical competence of students and residents.

 Develop

a standardized patient encounter, including a patient script and scoring checklist.

 Identify

the common pitfalls in implementing an OSCE and strategies to overcome them.

Overview 

Introduction: 10 minutes 



Small groups: 30 minutes 



Case development

Large group: 30 minutes 

 

Brief overview of OSCEs in the preclinical and clinical years

Group presentations Discussion of obstacles encountered

Wrap-up: 20 minutes   

Video of a pediatric OSCE Lessons learned Q&A

LESSONS LEARNED

Case Development 





Choosing Diagnoses  Clinical conditions that standardized patient can simulate Developing Objectives  Focused HPI and Physical Examination  Linking milestones/competencies to objectives  Linking to Direct Observation requirement for ACGME and LCME Duration of encounter  How long?  How much time between each encounter?

Case Development (cont.) 



Grading Checklist  Assigning points

Revision of Cases  Faculty

and standardized patient feedback  Resident/Student performance

Recruitment of Faculty/SPs 



Faculty  Chair/Departmental Support  Faculty Training Standardized Patients (SPs)/Parents  Appropriate Age (min 6 years of age)  Script  SP Training  Immediate feedback post encounter  Dropouts  Reimbursement

Tech Support 





AV/Proctoring Support

Videotaping  Benefits  Consent Form  Turnaround Time  OSCE Remediation Testing Site

Grading

Time required to grade each encounter  Curving?  Outcomes 

Resident/Student Feedback OSCE vs. TOSCE  Score Sheet  Grade for each encounter 

References Harden RM, Stevenson M, Downie WW, Wilson GM. Assessment of clinical competence using objective structured examination. Br Med J. 1975 Feb 22;1(5955):447-51. PMID: 1115966 Smith LJ, Price DA, Houston IB. Objective structured clinical examination compared with other forms of student assessment. Arch Dis Child.1984 Dec;59(12):1173-6. PMID: 6524948 Joorabchi B. Objective structured clinical examination in a pediatric residency program. Am J Dis Child. 1991 Jul;145(7):757-62. PMID: 2058606 Carraccio C, Englander R. The objective structured clinical examination: a step in the direction of competency-based evaluation. Arch Pediatr Adolesc Med. 2000 Jul;154(7):736-41. Review. PMID: 10891028 Pierre RB, Wierenga A, Barton M, Branday JM, Christie CD. Student evaluation of an OSCE in paediatrics at the University of the West Indies, Jamaica. BMC Med Educ. 2004 Oct 16;4:22. PMID:15488152 Hafler JP, Connors KM, Volkan K, Bernstein HH. Developing and evaluating a residents' curriculum. Med Teach. 2005 May;27(3):276-82. PMID:16011952 Jefferies A, Simmons B, Tabak D, McIlroy JH, Lee KS, Roukema H, Skidmore M. Using an objective structured clinical examination (OSCE) to assess multiple physician competencies in postgraduate training. Med Teach. 2007 Mar;29(2-3):183-91. PMID: 17701631 Casey PM, Goepfert AR, Espey EL, Hammoud MM, Kaczmarczyk JM, Katz NT, Neutens JJ, Nuthalapaty FS, Peskin E; Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee. To the point: reviews in medical education--the Objective Structured Clinical Examination. Am J Obstet Gynecol. 2009 Jan;200(1):25-34. doi: 10.1016/j.ajog.2008.09.878. Review. PMID: 19121656 Dong T, Saguil A, Artino AR Jr, Gilliland WR, Waechter DM, Lopreaito J, Flanagan A, Durning SJ. Relationship between OSCE scores and other typical medical school performance indicators: a 5-year cohort study. Mil Med. 2012 Sep;177(9 Suppl):44-6. PMID: 23029860 Baig LA, Violato C. Temporal stability of objective structured clinical exams: a longitudinal study employing item response theory. BMC Med Educ. 2012 Dec 7;12:121. doi: 10.1186/1472-6920-12-121. PMID: 23216816

QUESTIONS?