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Movin Peramuna Gamage,1 Ravanth Baskaran,1 Srinjay Mukhopadhyay,1 Nishaanth Dalavaye,1 Becky Leveridge,1 Sashiananthan Ganesananthan,2 Robert Spencer,3,4 Susruta Manivannan,5 Malik Zaben3,4 1School of Medicine, Cardiff University, Heath Park Campus, Cardiff, CF14 4YS, UK; 2Department of Digestion, Metabolism and Reproduction, Imperial College London, London, UK; 3Neuroscience and Mental Health Innovation Institute (NMHII), Cardiff University, Cardiff, UK; 4Department of Neurosurgery, University Hospital of Wales, Cardiff, UK; 5Division of Psychological Medicine and Clinical Neurosciences, University Hospital of Wales, Cardiff, UKCorrespondence: Malik Zaben, Department of Neurosurgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK, Tel +442920748153, Email ZabenM@cardiff.ac.ukPurpose: Objective Structured Clinical Examination (OSCE) is a vital examination that must be passed to graduate as a qualified doctor. The delivery of OSCE teaching was changed to an online format to accommodate COVID-19 restrictions. Therefore, this study evaluates factors that students perceive to affect their virtual learning of clinical skills for OSCE.Methods: In this cross-sectional study, all medical students from across the world who attended “The Respiratory Station” session delivered by OSCEazy (a medical student organization providing free online medical education) in the academic year 2020– 2021 received an online questionnaire about their perceptions of this learning opportunity. The survey was created on Google™ forms and consisted of 5-point Likert scales as well as free-text boxes.Results: A total of 556 responses were received (mean age: 24, female: 76.6%). Most students agreed that online OSCE teaching offers more flexibility and convenience (median: 5, IQR: 4– 5) but their likeliness to ask questions in either format was similar (median: 4, IQR: 3– 5 vs median: 4, IQR: 3– 4, p value: 0.94). The use of visual aids (median: 5, IQR: 4– 5) and breakout rooms (median: 3, IQR: 2– 4) were thought to enhance the quality of virtual OSCE teaching. The biggest concern about online teaching was access to a stable internet connection (69.1%).Conclusion: The flexibility and convenience of virtual OSCE teaching enables the sharing of knowledge and skills to a wider audience and thus may be a very useful adjunct to face-to-face OSCE teaching in the future.Keywords: medical education, COVID-19, online learning, student perceptions

Background/Aims: To avoid the negative impacts of the COVID-19 pandemic on clinical clerkship, supplemental teachings such as digital materials in the scenario-based distal simulations were implemented. This study utilized the OSCE (objective-structured clinical examination) to evaluate the impact of COVID-19 pandemic on the learning outcome of medical students from the regular group (class of 2020) and pandemic-impacted group (class of 2021). Methods: All medical students serially took, firstly, the mock-OSCE, secondly, the mock-OSCE, and the national OSCE. Then, the serial OSCE scores were compared between groups. Results: Although with similar scores in the first mock OSCE, the regular group (n = 78) had a higher average score in the national OSCE than the pandemic-impacted group (n = 80) (872.18 vs. 834.96, p = 0.003). In terms of improvement, the performances of the regular group were also better than the pandemic-impacted group between the second mock OSCE and the national OSCE (79.10 vs. 38.14, p = 0.014), and between the second mock OSCE and the national OSCE (125.11 vs. 77.52, p = 0.003). While separating distinct genres, the regular group had more of a score increment in standardized patient-based stations between the second mock OSCE and the national OSCE (regular vs. pandemic-impacted: 57.03 vs. 18.95, p = 0.003), as well as between the first mock OSCE and the national OSCE (75.97 vs. 26.36, p < 0.001), but there was no significant difference among the skill-based stations. In particular, the scores of the emergency medicine associated station in the national OSCE of the pandemic-impacted group was lower. Conclusions: Our study implies that the pandemic significantly hampered the learning outcomes of final year medical students in their clinical participation. Especially facing the COVID-19 pandemic, more supplemental teachings are needed to compensate the decreasing emergency medicine exposure.

We explored the use of a video-based reflective design in preparing first-year pharmacy students for their Objective Structured Clinical Examination (OSCE) in Victoria, Australia. This involved pre-workshop activities (a recording of themselves simulating the pharmacist responding to a simple primary care problem, written reflection, review of the OSCE video examples and pre-workshop survey); workshop activities (peer feedback on videos) and post-workshop activities (summative MCQ quiz and post-workshop survey). These activities took place three weeks before their OSCE. A mixed-method study design was employed with quantitative and qualitative analyses of the surveys and a focus group. A total of 137 students (77.4%) completed the pre- and post-workshop surveys, and ten students participated in the focus group. More student participants (54%) reported feeling prepared for the OSCE post-workshop than pre-workshop (13%). The majority (92%) agreed that filming, watching and reflecting on their video allowed them to learn and improve on their skills for the OSCE. The regression analysis found that video recording submissions and written reflections correlated positively with student OSCE performances, and the video-based reflective design learning experience was perceived to be beneficial in multiple ways. Thematic analysis of the focus group data revealed that students acquired metacognitive skills through the self-assessment of their video recordings, developed an awareness of their learning and were able to identify learning strategies to prepare for their first OSCE. Fostering students’ feedback literacy could be considered in future educational designs.

Aim: The aims were to describe the development of a modified national online OSCE during COVID-19 and assess related student feedback. Material and methods: The modified online OSCE comprising of eight question entities was organised simultaneously in all four dental institutes of Finland using the Moodle virtual learning environment. All fourth-year students (n = 179) attended the examination online at home. Student feedback was collected via an anonymous questionnaire with multiple-choice questions and open-ended questions concerning attitudes towards the modified online OSCE, as well as content and usability of the question entities in the examination. Means and standard deviations were calculated for multiple-choice questions. Content analysis was used for open-ended questions. Results: Of 179 students, 119 (66%) consented to the study. Students experienced they had received adequate information (mean 3.8; SD 1.2), had a positive attitude before the examination (4.0; 1.0) and found the practice test useful (3.7; 1.1) (range 1–5). Technical implementation (2.7; 0.7) and the difficulty of the questions (2.9; 0.6) (range 1–4) were found to be good. The teaching students received during their studies was sufficient (3.2; 0.5) (range 1–4). Content (mean 3.2; 0.4) and usability (2.9; 0.4) of the question entities were good (range 1–4). The themes arising from open-ended questions were importance and practicality of the topic (in questions) in relation to the work of a dentist and gratitude for the rapid conversion of the OSCE into an online examination despite COVID-19. The themes arising from negative experiences included difficulties in completing the examination within the time allocated, and dissatisfaction with the model answers provided after the examination. Conclusion: The positive student feedback towards the modified online OSCE encourages including an online examination to complement the traditional OSCE.

Pesquisa sem auxílio de agências de fomento Introdução: o Objective Structured Clinical Examination (OSCE) é reconhecido mundialmente como um instrumento válido e eficiente para avaliar habilidades cognitivas, psicomotoras e de comunicação na área da saúde. No entanto, níveis aumentados de estresse e ansiedade são frequentemente relatados por estudantes no momento de sua realização. Assim, o objetivo desta pesquisa foi avaliar a existência de associação entre o nível de ansiedade e estresse percebido e o desempenho no OSCE, assim como compreender a percepção do estudante sobre a prova e os fatores relacionados à sua performance no exame. Método: foi realizado um estudo misto, de corte transversal, com delineamento explanatório sequencial. Na abordagem quantitativa, utilizou-se questionários autoaplicados de sonolência diurna, ansiedade e estresse para 213 estudantes do internato médico, imediatamente antes de realizarem o OSCE. A regressão linear múltipla, pelo método hierárquico, foi usada para verificar as variáveis independentes associadas ao desempenho. Para a coleta dos dados da abordagem qualitativa, utilizou-se o método do grupo focal (GF), com posterior emprego do software IRAMUTEQ para auxiliar no processamento dos dados que foram analisados por meio da análise temática. Resultados: As variáveis gênero, período do curso, sonolência diurna, ansiedade e estresse não influenciaram o desempenho dos estudantes na realização do OSCE. O processo de saturação temática foi alcançado com cinco grupos focais, com a participação total de 38 estudantes. Quatro classes centrais emergiram das narrativas: “Significados do OSCE para o estudante”; “Sentimentos relacionados ao desempenho no OSCE”; “Fatores operacionais relacionados ao desempenho no OSCE”; e “Desafios relacionados às competências (não) avaliadas no OSCE”. Conclusão: O desempenho acadêmico no OSCE não foi influenciado pelo estresse e ansiedade percebidos pelos estudantes durante sua realização. O OSCE é visto pelos estudantes como um instrumento de avaliação puramente somativo, associado a emoções negativas, com o estresse e a postura do avaliador percebidos como fatores preponderantes no desempenho dos estudantes dentro do arcabouço avaliativo. Introduction: The Objective Structured Clinical Examination (OSCE) is recognized worldwide as a valid and efficient instrument to assess cognitive, psychomotor and communication skills in healthcare. However, increased levels of stress and anxiety are often reported by students at the time of their performance. Thus, the objective of this research was to assess the existence of an association between the level of anxiety and perceived stress and performance on the OSCE, as well as to understand the student's perception of the test and factors related to their performance. Method: A mixed, cross-sectional study with sequential explanatory design was carried out. In the quantitative approach, self-administered daytime sleepiness, anxiety and stress questionnaires were used for 213 students from the medical internship, immediately before taking the OSCE. Multiple linear regression, by the hierarchical method, was used to verify the independent variables associated with the performance. For data collection from the qualitative approach, the focus group method (FG) was used, with subsequent use of the IRAMUTEQ software to assist in the processing of data which were analyzed using Minayo's thematic analysis. Results: The variables gender, course term, daytime sleepiness, anxiety, and stress did not influence the students' performance in the OSCE. The thematic saturation process was achieved with five focus groups, with the total participation of 38 students. Four core classes emerged from the narratives: “Meanings of OSCE for the student”; “Feelings related to OSCE performance”; “Operational factors related to performance in the OSCE”; and “Challenges related to competences (not) assessed by the OSCE”. Conclusion: Academic performance in the OSCE was not influenced by the stress and anxiety perceived by students during its performance. The OSCE is perceived by students as a purely summative assessment tool, associated with negative emotions, with stress and the evaluator's posture perceived as preponderant factors in the performance of students within the evaluative framework. Tese (Doutorado)

John Blamoun,1– 3 Ahmad Hakemi,4 Teresa Armstead3 1Central Michigan University, College of Medicine, Mount Pleasant, MI, 48859, USA; 2MidMichigan Health, Midland, MI, 48670, USA; 3Central Michigan University, College of Health Professions, Physician Assistant Program, Mount Pleasant, MI, 48859, USA; 4Central Michigan University, College of Health Professions, Internal Medicine, Mount Pleasant, MI, 48859, USACorrespondence: Ahmad HakemiCentral Michigan University, College of Health Professions, Internal Medicine, 1280 East Campus Drive, Mailstop #2086, Mount Pleasant, MI, 48859, USATel +1 989-774-1273Email ahmad.hakemi@cmich.eduAbstract: The most important core competencies for medical learners to master are reviewing history, performing physical examination, communication skills and clinical reasoning. The Objective Structured Clinical Examination (OSCE) provides a consistent, reliable, and valid assessment of these integrated skills and is considered to be the gold standard. OSCEs are advantageous because they provide opportunities in evaluating skills that written tests cannot do (stage 3 of Miller’s Pyramid of Learning). In this article, we have provided tips and helpful pointers to medical students and residents, based on available literature and authors’ expertise in managing formative, summative, and virtual OSCE experiences. In virtual OSCEs, in-person learning objectives need to be modified to the virtual milieu and new competencies such as “webside manner” need to be introduced. Harmonizing the process and content of the OSCEs create operational challenges, thus learning the various moving parts of the OSCEs such as psychometrics, tasks of the standardized patients and checklists will ease optimal performance.Keywords: OSCE, checklist, virtual OSCE, assessment, reliability, validity

１年次の基礎看護学実習Ⅰ前の OSCE を通した準備状況および成長と課題を明らかにする事を目的に，2014，2015年度の OSCE 実施後に提出があった“OSCE振り返りシート”の分析を行った。準備では【状況を予測し複数パターンを想定した実施準備】，【個別性を配慮した実践的な積み上げ練習】，【学生相互の学び合いの経験】等６つのカテゴリーが抽出された。成長では【対象者を配慮した関わりの実践力獲得】，【学生相互の学び合う力の獲得】等７つ，課題では【想定外の状況での判断力・対応力】等６つのカテゴリーが抽出された。準備段階から，複数のパターンを考え個別性へ配慮し練習した事が根拠に基づく実践，対象者の配慮をした関わりにつながったと考える。また，学生同士での学び合いを通した準備が，学び合う力の獲得へとなっていたと考える。一方，振り返りシートを活用により，想定外の事に対応できない課題が明確となり，今後の更なる学びへつながることが期待される。, 資料

１年次の基礎看護学実習Ⅰ前のOSCEを通した準備状況および成長と課題を明らかにする事を目的に，2014，2015年度のOSCE実施後に提出があった“OSCE振り返りシート”の分析を行った。準備では【状況を予測し複数パターンを想定した実施準備】，【個別性を配慮した実践的な積み上げ練習】，【学生相互の学び合いの経験】等６つのカテゴリーが抽出された。成長では【対象者を配慮した関わりの実践力獲得】，【学生相互の学び合う力の獲得】等７つ，課題では【想定外の状況での判断力・対応力】等６つのカテゴリーが抽出された。準備段階から，複数のパターンを考え個別性へ配慮し練習した事が根拠に基づく実践，対象者の配慮をした関わりにつながったと考える。また，学生同士での学び合いを通した準備が，学び合う力の獲得へとなっていたと考える。一方，振り返りシートを活用により，想定外の事に対応できない課題が明確となり，今後の更なる学びへつながることが期待される。, 資料

Implementasi pendidikan tahap profesi ners adalah peserta didik menerapkan ilmu pengetahuan teori, konsep dan keterampilan teknis yang telah dikuasai pada program akademik pada klien langsung melalui program internship dimana peserta didik dibimbing oleh seorang perawat sebagai preceptor. Keberadaan pendidik klinik/preceptor sangat diperlukan dalam menjamin keterlaksanaan layanan pasien yang berkualitas serta menjamin kompetensi peserta didik. Disamping itu, pendidik klinik/preceptor juga diperlukan untuk mengurangi stres yang mungkin dialami oleh peserta didik sebagai lulusan sarjana keperawatan baru yang belum mengenal dunia kerja sebenarnya serta untuk menjamin bahwa tanggung jawab tidak sepenuhnya berada pada peserta didik, tidak diberikan secara lebih dini atau tidak seharusnya diberikan secara kurang tepat. Metoda pembelajaran pada tahap profesi berfokus pada pelaksanaan pendelegasian kewenangan dari preceptor kepada peserta didiknya. Sedangkan kegiatan evaluasi pada tahap profesi lebih terfokus pada pembuktian bahwa peserta didik telah memiliki kompetensi yang ditetapkan dan disertai dengan kemandirian dalam menjalankan kompetensinya sebagai cerminan kewenangan telah dimiliki. Tujuan dari pelatihan OSCE diharapkan dapat memberi pemahaman tentang evaluasi dengan metode OSCE, sehingga para evaluator dapat mengevaluasi secara objektif sesuai kemampuan mahasiswa. Metode yang akan dilakukan adalah pelatihan OSCE kepada preseptor klinik rumah sakit aliansi. Hasil yang didapatkan pre-tes dengan nilai rata-rata 65, setelah diberikan pelatihan meningkat menjadi 85. Kesimpulan yang didapatkan terjadi peningkatan pemahaman preseptor mahasiswa. Kata Kunci: Kompetensi Klinik, OSCE, Pendidikan Keperawatan, Pendidik Klinik, Preseptor Klinik ABSTRACT The implementation of the nursing profession education stage is that students apply theoretical knowledge, concepts and technical skills that have been mastered in academic programs to clients directly through an internship program where students are guided by a nurse as a preceptor. The existence of clinical educators/preceptors is very necessary in ensuring the implementation of quality patient services and ensuring the competence of students. In addition, clinical educators / preceptors are also needed to reduce stress that may be experienced by students as new nursing graduates who are not familiar with the real world of work and to ensure that the responsibility is not entirely on the students, is not given earlier or should not be given. given incorrectly. The learning method at the professional stage focuses on implementing the delegation of authority from the preceptor to his students. Meanwhile, evaluation activities at the professional stage are more focused on proving that students have the competencies defined and accompanied by independence in carrying out their competencies as a reflection of the authority they have. The purpose of the OSCE training is expected to provide an understanding of evaluation using the OSCE method, so that evaluators can evaluate objectively according to students' abilities. The method that will be used is OSCE training for clinical precepts of alliance hospitals. The results obtained pre-test with an average value of 65, after being given the training increased to 85. The conclusion obtained was an increase in the understanding of students' precepts. Keywords: Clinical Competence, OSCE, Nursing Education, Clinical Educator, Clinical Precept

La presente investigación se origina a través de la problemática existente en la Zona Registral de Lambayeque, es decir debido al congestionamiento en las funciones del OSCE, por partes de los funcionarios públicos; expresamente en los actos registrales concernientes en las contrataciones públicas. En ese sentido, el objetivo general es elaborar y determinar la propuesta de implementación en el reglamento de registros de contrataciones públicas de la SUNARP, que permita el descongestionamiento de las funciones del OSCE en la zona registral Lambayeque, para ello, se realizó una investigación de tipo descriptiva, propositiva, no experimental. Dentro de la metodología empleada se utilizaron técnicas e instrumentos como: la encuesta y el cuestionario respectivamente; el instrumento de recolección de datos fue diseñado en base a la operacionalización de la variable del estudio. Los resultados más resaltantes de la investigación, realizadas a las personas encuestadas muestra que el 100% está totalmente de acuerdo que se establezca un registro de contrataciones públicas en la SUNARP, el cual será totalmente factible y técnicamente viable, en beneficio del OSCE, específicamente en su labor de la Zona Registral de Lambayeque SUNARP. La propuesta de implementación permitirá contar con un registro de contrataciones públicas, con la finalidad de registrar contratos, incumplimientos de contratos y arbitraje, lo cual redundará en un trabajo funcional y eficaz, tanto de la inscripción, la publicidad, así como de la seguridad registral. Se utilizaron métodos del nivel teórico, empírico y estadístico. Abstract The present investigation is originated through the existing problematic in the Registration Zone of Lambayeque, that is to say due to the congestion in the functions of the OSCE, by parts of the public officials; expressly in the registration acts concerning public procurement. In that sense, the general objective is to elaborate and determine the implementation proposal in the SUNARP public contract registration regulations, which allows the decongestion of the OSCE functions in the Lambayeque registry area, for which an investigation was carried out. descriptive type, proactive, not experimental. Within the methodology used, techniques and instruments were used, such as: the survey and the questionnaire respectively; The data collection instrument was designed based on the operationalization of the study variable. The most outstanding results of the investigation, made to the people surveyed, shows that 100% fully agree that a registry of public procurement will be established in the SUNARP, which will be totally feasible and technically viable, in benefit of the OSCE, specifically in his work in the Registration Area of ​​Lambayeque SUNARP. The implementation proposal will allow for a registry of public contracts, in order to register contracts, breaches of contracts and arbitration, which will result in functional and effective work, both registration, advertising, as well as security registration . Methods of the theoretical, empirical and statistical level were used. Keywords: Registries, Public Contracting, SUNARP, OSCE

Md Anwarul Azim Majumder,1 Alok Kumar,1,2 Kandamaran Krishnamurthy,1,2 Nkemcho Ojeh,1 Oswald Peter Adams,1 Bidyadhar Sa31Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Barbados; 2Department of Pediatrics, The Queen Elizabeth Hospital, Bridgetown, Barbados; 3Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and TobagoBackground: The objective structured clinical examination (OSCE) is the gold standard and universal format to assess the clinical competence of medical students in a comprehensive, reliable and valid manner. The clinical competence is assessed by a team of many examiners on various stations of the examination. Therefore, it is found to be a more complex, resource- and time-intensive assessment exercise compared to the traditional examinations.Purpose: The objective of this study was to determine the final year MBBS students’ and OSCE examiners’ perception on the attributes, quality, validity, reliability and organization of the Medicine and Therapeutics exit OSCE held at the University of the West Indies (Cave Hill) in June 2017.Methods: At the end of the OSCE, students and examiners were provided with a questionnaire to obtain their views and comments about the OSCE. Due to the ordinal level of data produced by the Likert scale survey, statistical analysis was performed using the median, IQR and chi-square.Results: A total of 52 students and 22 examiners completed the questionnaire. The majority of the students provided positive views regarding the attributes (eg, fairness, administration, structure, sequence, and coverage of knowledge/clinical skills), quality (eg, awareness, instructions, tasks, and sequence of stations), validity and reliability (eg, true measure of essential clinical skills, standardized, practical and useful experiences), and organization (eg, orientation, timetable, announcements and quality of examination rooms) of the OSCE. Similarly, majority of the examiners expressed their satisfaction with organization, administration and process of OSCE. However, students expressed certain concerns such as stressful environment and difficulty level of OSCE.Conclusion: Overall, the OSCE was perceived very positively and welcomed by both the students and examiners. The concerns and challenges regarding OSCE can be overcome through better orientation of the faculty and preparation of the students for the OSCE.Keywords: OSCE, undergraduate medical education, students’ perception, examiners’ perception, medicine and therapeutics, Barbados

Assessment during pre registration in midwifery school is one of the necessary process which need to be concerned as it would strengthen the quality of the graduation. It also could become a tool to evaluate ability and competency of the pre registration midwifery student. There is an evaluation which applied in Indonesian midwifery school as national standard i.e. OSCE in which is considered could fulfil the validity, reliability and feasibility within Indonesian context. This study aimed to evaluate the implementation of OSCE among midwifery school in Yogyakarta. This research was a mixed methods study used sequential explanatory design method i.e. quantitative phase and qualitative phase. Analytic descriptive study was applied in quantitative phase, whilst a case study was applied in qualitative phase. Quantitative data collection was conducted by using a checklist sheet and analyzed by using descriptive analysis, whilst qualitative data by using in-depth interviews and analyzed by using content analysis. The quantitative result show that the implementation of OSCE among midwifery schools in Yogyakarta has score 68 out of 92. The qualitative analysis showed that OSCE was challenging to be implemented due to technical problems such as broken media of assessment, different phantom model in delivery stages, assessor has been late, assessment rooms were not conducive and there were limited model who skilled as OSCE model. Conclusion: Standardized OSCE implementation has not been carried out properly in midwifery school. Therefore there is a need of national evaluation of the OSCE itself in order to understand the real condition across Indonesian midwifery school.

Background: Objective Structured Clinical Examination (OSCE) is one of the final assessment components for nursing students. OSCE assessment uses the ON-OSCE (Online Nursing OSCE) application to fulfill the need and overcome the manual OSCE assessment challenges using papers. The manual OSCE assessment with multiple checklists is very detailed and takes a long time in scoring. Besides, the evaluation using papers tends to cause a miscalculation in scoring a total of ratings that can harm the student.Method: This research is a non-experimental study with a descriptive design and cross-sectional approach. The samples were 480 respondents of nursing students. The instrument of assessment of satisfaction was analyzed based on the score accuracy, time to retrieve score, and examiner's attention. Data analysis used descriptive frequency and percentage distributions. Results: Students' satisfaction based on the time to retrieve score revealed that 365 students (76%) were satisfied. Two hundred eighty-five students (59,4 %) were also satisfied with ON-OSCE related to the score accuracy. Regarding the examiners' attention, 273 students (56,9 %) felt the examiners ignored the students' actions. They focused on the laptop to provide an assessment. It could be due to the new ON-OSCE application for the examiners and their unfamiliarity with operating the application.Conclusion: Most students were satisfied with the assessment using the ON-OSCE application to retrieve scores and the score accuracy. However, they were less satisfied with the examiners' attention. The examiners should be more familiar with the ON-OSCE.

Objective: Simulated patients play a significant role in OSCE (Objective Standardized Clinical Examination) settings. Does the understanding of one's own role or task lead to more clarity for all protagonists involved in an OSCE? Methodology: Based on the range of professional experiences and qualifications of the training team it was possible to bundle medical, acting and didactic knowledge. It was against this background that the individual understanding of one’s role was examined from its respective points of view. Result: As a result, the authors have developed the so-called Case Space Model, which encourages critical exchange and discussion. It is a visualization of the relationships between the simulated patients, examiners and candidates. During the course of the model’s development a preference for the term believability instead of authenticity became clear. Conclusion: The Case Space Model can help to clarify the positions and provide certainty in the respective roles., Zielsetzung: Simulationspersonen spielen bei OSCE-Prüfungen (Objectiv Standardized Clinical Examination) eine tragende Rolle. Führt das Verständnis der eigenen Rolle oder Aufgabe der an einem OSCE beteiligten ProtagonistInnen zu mehr Klarheit? Methodik: Aus der Mischung der beruflichen Herkunft und Qualifikationen des TrainerInnenteams war es möglich, medizinisches, schauspielerisches und didaktisches Wissen zu bündeln. Ausgehend von diesem Hintergrund wurden die einzelnen Rollenverständnisse aus ihrer jeweiligen Sicht betrachtet. Ergebnis: Das Ergebnis ist das von den AutorInnen so genannte Rollenraum-Modell, welches zum Austausch und diskutieren anregen soll. Es macht die Beziehungen zwischen Simulationspersonen, PrüferInnen und KandidatInnen sichtbar. Im Verlauf der Entwicklung des Modells zeigte sich die Präferenz des Begriffs Glaubhaftigkeit anstelle von Authentizität. Schlussfolgerung: Das Rollenraum-Modell hilft dabei, die Positionen zu klären und gibt Sicherheit in der jeweiligen Rolle.

The spread of COVID-19 and social-distancing rules have increased the need for alternative learning environments with a focus on e-learning platforms. The objective of this study was to assess whether and to what extent the transition from traditional learning and assessment environment to the e-setting impacts the knowledge and skills acquired by students and their satisfaction with new e-solutions of taking the OSCE test. The study compared the results of three face-to-face (2018–2019) and one electronically conducted (2021) OSCE tests, as well as students’ feedback on the content and organization of the tests. For data analysis the one-way ANOVA test and post hoc multiple comparisons were used. The results demonstrated the feasibility and effectiveness of and students’ satisfaction with OSCE tests in the Zoom environment. However, more focus on communication techniques is required in a remote communication environment to better cover all patient health-related and drug communication aspects. There were identified differences between undergraduate students and practicing assistant pharmacists in assessing patients’ health problems and providing corresponding counseling. This result points to the need to implement the continuous development of patient-centered counseling techniques in the lifelong learning of pharmacists and the need to use innovative digital solutions, if applicable.

Background: The educational process in different medical schools has been negatively affected by the COVID-19 pandemic worldwide. As a part of the Saudi government’s attempts to contain the spread of the virus, schools’ and universities’ educational activities and face-to-face lectures have been modified to virtual classrooms. The purpose of this study was to explore the perceptions of the faculty and the students of an electronic objective structured clinical examination (E-OSCE) activity that took place during the COVID-19 pandemic in the oldest medical school in Saudi Arabia. Methods: An e-OSCE style examination was designed for the final-year medical students by the pediatrics department, College of Medicine at King Saud University in Riyadh, Saudi Arabia. The examination was administered by Zoom™ video conferencing where both students and faculty participated through their laptop or desktop computers. In order to explore the students’ and the faculty’s perceptions about this experience, a newly designed 13-item online questionnaire was administered at the end of the e-OSCE. Results: Out of 136 participants (23 faculty and 112 students), 73 respondents (e.g., 54% response rate) filled out the questionnaire. Most of the respondents (69.8%) were very comfortable with this new virtual experience. Most participants (53.4%) preferred the e-OSCE compared to the classic face-to-face clinical OSCE during the pandemic. Regarding the e-OSCE assessment student tool, 46.6% reported that it is similar to the classic face-to-face OSCE, however, 38.4% felt it was worse. Conclusions: The e-OSCE can be a very effective alternative to the classic face-to-face OSCE due to the current circumstances that still pose a significant risk of infection transmission. Future studies should examine different virtual strategies to ensure effective OSCE delivery from the perspective of both faculty and students.

The relevance of the main directions of research in this book is determined both by the general significance of the problem of transforming the political process of society for political science, and by the peculiarity of its state in the context of sociocultural dynamics in the member states of the Organization for Security and Cooperation in Europe (OSCE). The importance of a comparative analysis of social and cultural value bases in the political process and the dynamics of this phenomenon is due to increased attention to the consideration of the nature, essence and characteristics of value orientations in the era of globalization, changes and complication of the evolution of the political system, on the basis of which the development of society in the political environment is carried out. The immediate stability and effectiveness of the political process directly depends on the value components in the public mind. This aspect is of particular importance in the face of the challenges of the surrounding world, when a transformational society is faced with a choice of political alternatives. In this regard, it becomes important to study the problem of the regulatory role of social, cultural and value factors in the transformation of the political process in the OSCE member states.

Background: Objective Structural clinical evaluation (OSCE) is newly emerging evaluation methods that has been used in recent years in the medical and paramedical fields. However, one of its disadvantages is that it causes anxiety, which, in turn, reduces the effectiveness of the test. Therefore, the main purpose of the present study was to evaluate the OSCE test familiarity workshop effectiveness on test anxiety in anesthesia students and operating room of Ilam University of Medical Sciences, Iran. Methods: This research was of quasi-experimental study nature performed on 72 students who were studying anesthesia and operating room. In doing so, the students in each class were randomly assigned into control and intervention groups. Then, a workshop was held one hour before the test to familiarize students with OSCE stations, how to ask questions and how to answer students in the intervention group. Then, the Spielberger questionnaire was also completed. Besides, data analysis was performed using SPSS 21 statistical software (Chicago, IL, USA). Results: The highest frequency (52.77%) was related to anesthesia participants, of whom 58.33% were girls. The mean score of anxiety before the intervention was 48.15 7 7.15 which decreased to 30.80 98 6.98 after the intervention (P

Objective structured clinical examinations (OSCEs) can generate more anxiety than other forms of assessment. Ginny Chappell looks at methods of overcoming this Objective structured clinical examinations (OSCEs) are used to assess competency in advanced practice programmes. OSCEs generate more anxiety than other forms of assessment, which can be helpful to motivate studying but 20% of students find their performance is affected. OSCE anxiety may activate the sympathetic nervous system (flight for fight response). Worrying and catastrophising can lead to negative self-talk and increase stress levels further. These thought patterns and behaviours can be overcome using mindfulness techniques (including deep breathing exercises and grounding techniques), thought reframing or cognitive behavioural therapy (CBT), and with careful preparation for the examination. Mindfulness reduces the sympathetic response and CBT retrains the brain to increase the positive self-talk. Together these techniques help students overcome OSCE anxiety and give their best performance in the examination.

ZusammenfassungDie Vermittlung ethischer Kompetenzen ist wesentlicher Bestandteil in berufsqualifizierenden und postgraduellen Studiengängen. Dabei werden praktisch-ethische Problemlösungskompetenzen, je nach Studiengang aber auch die forschungsethische Betrachtung von Studien thematisiert. Die Überprüfung dieser ethischen Kompetenzen stellt sich als Herausforderung dar. Das schriftliche oder mündliche Abfragen von Lehrinhalten greift zu kurz, da somit lediglich Wissen, jedoch nicht Fertigkeiten oder gar Haltung erfasst werden können.Bei der Reakkreditierung des Masterstudiengangs Pflegewissenschaft an der Universität Witten/Herdecke wurde dieser Herausforderung mit der Umsetzung eines für die postgraduelle Ausbildung innovativen Prüfungsformats begegnet. Für das Modul „Ethik in der Pflegepraxis und -forschung“ wurde ein Format ausgearbeitet, welches sich an den „Objective Structured Clinical Examinations“ orientiert und somit die erworbenen Fertigkeiten und Haltungen der Studierenden mit einbezieht. Der Beitrag zeigt auf, wie das OSCE-Prüfungsformat (kurz: OSCE) konzipiert und eine Adaption erfolgt ist.

Purpose: The objective structured clinical examination (OSCE) has become a standard assessment tool in undergraduate medical school training. The aim of this study was to assess the Perception of Students and Faculties for OSCE as a tool for assessment of clinical competence in Summative Examination of General Medicine. Methods: In this Study a total of 150 Final Professional Medical Students appeared for final MBBS part II clinical exam of Sri Aurobindo Institute Of Medical Science & PG Institute, Indore, and 10 faculties of Medicine Department were included. 150 students underwent exam by OSCE method in the presence of 10 Medicine faculty members. The 12-item questionnaire included questions based on to assess the faculties and students awareness and to evaluate their overall satisfaction for OSCE based on the level of agreement. Results: We collected the feedback structured questionnaire from faculties and students and were analysed. A total of 73% study subjects strongly agreed, 51% agreed and 14% disagreed respectively as per their perception for conduct, utility acceptability and feasibility of OSCE as an assessment tool in subject of medicine. Conclusions: An overall positive perception of OSCE by students and examiners was seen. The OSCE was rated strongly in favor as clinical assessment tool in present study and yields dependable information about the performance capabilities of competencies of Final Professional MBBS students.

This paper attempts to explain what efforts have been made by the Organization for Security and Cooperation in Europe (OSCE) to deal with the conflicts that occurred in Transnistria. OSCE is an intergovernmental cooperation organization in the field of defense and security. Transnistria is a region in Moldova. The history of this conflict occurred at a time of weakening influence until the collapse of the power of the Soviet Union. Which after Moldova's independence there was a group that declared independence from Moldova and made the name of a new country with the name Pridnestrovian Moldavian Soviet Socialist Republic or Transnistria. One of the triggers for this conflict is linguistic and cultural differences, where most Moldovan people are close to Romania while Transnistria is close to Slavic. This conflict caused many casualties, as well as ethnic and national sentiments from various groups. For this reason, OSCE, as the organization's defense and security organization, helps this conflict by carrying out several functions such as the Information function, regulatory function, and operational function. Keywords — OSCE, Conflict, Moldova, Transnistria

A descriptive study is used to assess the knowledge level on objective structured clinical examination (OSCE) among B. Sc Nursing students at selected colleges, Puducherry. The aim is to assess the existing level of knowledge regarding OSCE among B. Sc Nursing students and to find the association with the knowledge level with selected demographic variables. The study was conducted among 100 B. Sc Nursing students (50 B. Sc Nursing III and IV-year students) and they were selected through Probability Sampling-Simple random sampling technique. After getting consent from the subjects, the data was collected by using Semi Structured Questionnaire to assess knowledge level on OSCE among B. Sc Nursing students. The study result showed that out of 100 students, 79 students (79%) had previous knowledge and experience on OSCE in that 92% of students possess moderate level of previous knowledge and experience, 5 % of students had adequate knowledge and 3 % had inadequate knowledge and experience on OSCE. The study concluded that majority of students had previous knowledge and experience on OSCE and it also reveals that there is no significant association between selected socio- demographic variables with knowledge level on OSCE among B.sc Nursing students.

Introduction: OSCE has been used increasingly in assessing learners globally. Standard Setting for OSCE is necessary to distinguish between a competent and an incompetent learner. This study was conducted to enhance the quality of assessment of the MDI OSCE for MS-2 at CECICS. Objective: 1. To describe steps in implementing Standard Setting for MDI Station; 2. To determine the content validity of the MDI checklist. Method: This is a cross-sectional study. To calculate the pass mark, we followed five steps of the Angoff method. To determine the content validity of the checklist, we calculated S-CVI, I-CVI and CVR. Result: We recruited a group of 8 SMEs who are qualified to define the required level of knowledge and skills of MCC. During the online orientation organized by CECICS’ Director, all items of checklist were clarified. To avoid the time-consuming process, each SME will only determine the percentage of MCC would answer the item correctly for the first 3 items. SMEs explained their decisions on each item and discussed to resolve the discrepancies when the difference between the lowest and highest scores are greater than 15%. All SMEs made their judgements for the remaining items after the meeting. One week later, the 2nd online meeting was organized to collect all the judgements and repeated all steps to collect MCC. Finally, we obtained the passing score of 81% for this station by averaging the total score of 8 SMEs. The calculated value of S-CVI/average, S-CVI/UA, and CVR were all equal to 1. The results provided good evidence of content validity. Conclusion: In this study, Angoff method has shown to be practical in providing defensible passing score for the MDI station. Besides that, MDI checklist has evidence to support the content validity. In the future, to achieve a higher standard in measuring performance assessment, the passing scores of all OSCE at CECICS should be determined by appropriate standard setting methods.

Objectives: To evaluate the process and the comprehensiveness of advanced care planning (ACP), we designed a national ACP-OSCE (Objective Structured Clinical Examination) program. Methods: The program was designed as a 40-minute OSCE test. Participants were categorized as different ACP team members to illustrate realistic scenarios. Preceptors were asked to observe ACP professionals’ actions, responses, and communication skills during ACP with standardized patients (SP) through a one-way mirror. Participants’ communication skills, medical expertise, legal knowledge, empathetic response and problem-solving skills of ACP were also self-evaluated before and after OSCE. Thematic analysis was used for qualitative analysis. Results: In Nov 2019, a total of 18 ACP teams with 38 ACP professionals completed the ACP-OSCE program, including 15 physicians, 15 nurses, 5 social workers, and 3 psychologists. After the ACP-OSCE program, the average score of communication skills, medical expertise, legal knowledge, empathetic response, ACP problem-solving all increased. Nurses felt improved in medical expertise, legal knowledge, and problem-solving skills, psychologists and social workers felt improved in legal knowledge, while physicians felt no improved in all domain, statistically. Thematic analysis showed professional skills, doctoral-patient communication, benefit and difficulties of ACP were the topics which participants care about. Meanwhile, most participant agreed that ACP-OSCE program is an appropriate educational tool. Conclusion: This is the first national ACP-OSCE program in Asia. We believe that this ACP-OSCE program could be applied in other countries to improve theACP process and quality.

The current official model of training in Intensive Care Medicine (ICM) in Spain is based on exposure to experiences through clinical rotations. The main objective was to determine the level of competency (I novice to V independent practitioner) achieved by the residents at the end of the 3rd year of training (R3) in ICM through a simulation-based OSCE. Secondary objectives were: (1) To identify gaps in performance, and (2) To investigate the reliability and feasibility of conducting simulation-based assessment at multiple sites.Observational multicenter study.Thirteen Spanish ICU Departments.Thirty six R3.The participants performed on five, 15-min, high-fidelity crisis scenarios in four simulation centers. The performances were video recorded for later scoring by trained raters.Via a Delphi technique, an independent panel of expert intensivists identified critical essential performance elements (CEPE) for each scenario to define the levels of competency.A total of 176 performances were analyzed. The internal consistency of the check-lists were adequate (KR-20 range 0.64-0.79). Inter-rater reliability was strong [median Intraclass Correlation Coefficient across scenarios: 0.89 (0.65-0.97)]. Competency levels achieved by R3 were: Level I (18.8%), II (35.2%), III (42.6%), IV/V (3.4%). Overall, a great heterogeneity in performance was observed.The expected level of competency after one year in the ICU was achieved only in half of the performances. A more evidence-based educational approach is needed. Multiple center simulation-based assessment showed feasibility and reliability as an evaluation method of competency.COBALIDATION. NCT04278976. (https://register.gov).

Background: Patient-centredness (PCN) is an increasingly demanded objective in health care and has gained importance for the care situation, for research, and the education of healthcare professions. The literature shows that the term PCN is not uniformly defined. Key aspects for the concept of PCN can be found in the integrative model and its dimensions by Scholl and colleagues (2014), which are incorporated into the acquisition of competencies in Objective Structured Clinical Examination (OSCE) examination formats. The inclusion of subjective experiences of persons directly affected in health-related situations is recognized as an important factor for continuous improvement in health care. In the interprofessional education of healthcare professions, subjective experiences serve as a starting point in relation to OSCE exams. In this context, the project “DIPEx” “Database of Individual Patients’ Experiences” stands for the systematic collection and evaluation of subjective experiences of illness using scientific methods. Aim: The aim of this interprofessional training workshop was to show how PCN can support the writing of case vignettes based on real experiences from systematically collected narratives within the DIPEx project, as well as the preparation of simulation subjects for OSCE examinations in the healthcare professions. Methods: Interactive, moderated workshop with two theory-based input presentations on the systematic development of interprofessional case vignettes based on four steps, group work with synthesis in the form of statements, and a concluding outlook. Results: With regard to the aims of the workshop, the synthesis included results at two levels: exemplary results on aims not explicitly addressed: Interprofessional teaching is full of presuppositions and requires clarification of four different perspectives in advance to be included in case development; exemplary results on explicitly addressed aims: Listening to and incorporating the real-life experiences and narratives of persons directly affected in health-related situations and their families was seen as an important learning aspect for PCN in relation to the practitioner-patient relationship. Five key statements on explicit aims for case development involving PCN emerged from the group work. Conclusion: Competency-based interprofessional education of health professionals and PCN can benefit from real patient narratives of health and illness as simulated patients can portray roles in OSCE formats in a realistic and convincing manner., Hintergrund: Patient*innenorientierung (PO) ist in der Gesundheitsversorgung ein zunehmend gefordertes Ziel und hat für die Versorgungssituation, Forschungslage und für die Ausbildung von Gesundheitsberufen an Bedeutung gewonnen. In der Literatur zeigt sich, dass der Begriff PO nicht einheitlich definiert ist. Zentrale Aspekte für das Konzept der PO finden sich im integrativen Modell und seinen Dimensionen von Scholl und Kollegen aus 2014, die in den Kompetenzerwerb bei Objective Structured Clinical Examination (OSCE) Prüfungsformaten Eingang finden. Der Einbezug subjektiver Erfahrungen von Betroffenen wird als wichtiger Faktor für die kontinuierliche Verbesserung der Gesundheitsversorgung anerkannt. In der interprofessionellen Ausbildung der Gesundheitsberufe dienen sie als Ausgangspunkt in Bezug auf OSCE Prüfungen. Das Projekt „DIPEx“ „Database of Individual Patients’ Experiences“ steht dabei für die systematische Erhebung und Auswertung subjektiver Krankheitserfahrungen anhand wissenschaftlicher Methoden. Ziel des Beitrags: Ziel des Interprofessionellen Ausbildungs-Workshops war es aufzuzeigen, wie PO anhand realer Erfahrungen aus systematisch erhobenen Narrativen im Rahmen des DIPEx-Projektes das Verfassen von Fallvignetten unterstützen kann, wie auch die Vorbereitung von Simulationspersonen für OSCE Prüfungen in den Gesundheitsberufen. Methode: Interaktiver, moderierter Workshop mit zwei theoriegeleiteten Inputpräsentationen zur systematischen Entwicklung interprofessioneller Fallvignetten anhand von vier Schritten in Gruppenarbeit mit Synthesebildung in Form von Statements und abschliessendem Ausblick. Ergebnisse: Mit Bezug auf die Ziele des Workshops umfasste die Synthese Ergebnisse auf zwei Ebenen: exemplarische Ergebnisse zu nicht explizit adressierten Zielen: Interprofessionelle Lehre ist voraussetzungsreich und verlangt vorab die Klärung von vier verschiedenen Perspektiven, die in die Fallentwicklung einbezogen werden; exemplarische Ergebnisse zu explizit adressierten Zielen: Das Zuhören und der Einbezug der realen Erfahrungen und Erzählungen von Betroffenen und ihren Angehörigen wurde als wichtiger Lernaspekt für PO in Bezug auf die Behandler*innen-Patienten-Beziehung gesehen. Aus der Gruppenarbeit gingen fünf zentrale Statements zu expliziten Zielen für die Fallentwicklung unter Einbezug der PO hervor. Fazit: Die kompetenzorientierte interprofessionelle Ausbildung der Gesundheitsberufe und PO kann von realen Patient*innennarrativen zu Gesundheit und Krankheit profitieren, indem Simulationspersonen in OSCE-Formaten Rollen realitätsnah und überzeugend darstellen können., GMS Journal for Medical Education; 38(5):Doc91

Latar Belakang: Kebijakan Study from Home (SfH) dan Work from Home (WfH) selama pandemi Coronavirus Disease-19 (Covid-19) berdampak pada proses pendidikan mahasiswa kedokteran, salah satunya dalam penyelenggaraan evaluasi keterampilan klinis atau Objective Structured Clinical Examination (OSCE). Diperlukan sebuah model OSCE berbasis dalam jaringan (daring) agar uji kompetensi tetap berjalan dengan optimal. Tujuan: Mengembangkan model OSCE berbasis daring yang disesuaikan pada kondisi pandemi Covid-19. Metode: Metode observasional deskriptif digunakan melalui dua tahapan. Tahapan pertama meliputi proses pelaksanaan OSCE berbasis daring. Tahap kedua adalah evaluasi pelaksanaan melalui survei kuesioner online kepada 149 mahasiswa Fakultas Kedokteran Universitas Wahid Hasyim yang mengikuti OSCE berbasis daring pada periode Agustus 2020. Hasil: Proses pelaksanaan OSCE berbasis daring meliputi tahap pra-OSCE, OSCE, dan pasca-OSCE. Pada evaluasi selama pra-OSCE, 79,5% mahasiswa menyebutkan bahwa sarana telah dipersiapkan dengan baik dan 46,1% menyebutkan bahwa informasi yang disampaikan saat technical meeting jelas. Pada tahap pelaksanaan, 91,3% mahasiswa menyebutkan soal OSCE jelas, 65,9% memiliki koneksi internet dan komunikasi berjalan lancar, 53% menyebutkan dukungan technical support baik, dan 88% menyatakan waktu pengerjaan cukup. Kesimpulan: Pelaksanaan OSCE berbasis daring dapat diimplementasikan. Meskipun demikian, dukungan teknis dan persiapan yang matang diperlukan sehingga dalam pelaksanaannya tetap berlangsung secara efektif.

Background Assessment of emergent, rare or complex medical conditions in Endocrinology and Metabolism (E&M) is an integral component of training. However, data is lacking on how this could be best achieved. The purpose of this study was to develop and administer an Objective Structured Clinical Examination (OSCE) for E&M residents, and to gather validity evidence for its use. Methods A needs assessment survey was distributed to all Canadian E&M Program Directors and recent graduates to determine which topics to include in the OSCE. The top 5 topics were selected using a modified Delphi technique. OSCE cases based on these topics were subsequently developed. Five E&M residents (PGY4-5) and five junior Internal Medicine (IM) residents participated in the OSCE. Performance of E&M and IM residents was compared and results were analyzed using a Generalizability study. Examiners and candidates completed a survey following the OSCE to evaluate their experiences. Results The mean score of IM and E&M residents was 41.7 and 69.3 % (p 2 = 0.75). Overall reliability of the OSCE was 0.74. Standard setting using a borderline regression method resulted in a pass rate of 100 % of E&M residents and 0 % of IM residents. All residents felt the OSCE had high value for learning as a formative exam. Conclusions The E&M OSCE is a feasible method for assessing emergent, rare and complex medical conditions and this study provides validity evidence to support its use in a competency-based curriculum.

Background The objective structured clinical examination (OSCE) is a part of emergency medicine (EM) examinations such as the Masters of Medicine in Emergency Medicine (MMed) examination and the equivalent Member of the Royal College of Emergency Medicine (MRCEM) examination. The use of formative OSCEs to prepare EM residents for summative OSCEs has not been investigated. This study aimed to evaluate the role of formative OSCEs in preparing EM residents for the MMed and MRCEM OSCE. Methods This was an observational, retrospective, mixed-methods cohort study. We analysed data from formative OSCEs conducted by the National Healthcare Group EM residency programme from 2013 to 2019, and from a questionnaire distributed to all residents during the study period. Residents’ formative OSCE participation and scores were compared with first-attempt summative OSCE success. Qualitative analysis of residents’ opinions on the usefulness of the formative OSCE was performed. Results Forty-three of the 50 (86.0%) residents attended at least one formative OSCE. Of the 46 who responded to the questionnaire, 40 (87.0%) had attempted and succeeded in the MMed or MRCEM OSCE, of whom 35 (87.5%) had succeeded on the first attempt. Residents who succeeded in the summative OSCE on the first attempt tended to have higher proximate (mean = 70.6, SD = 8.9 vs mean = 64.3, SD = 10.8) and mean (mean = 67.4, SD = 7.1 vs mean = 62.8, SD = 7.3) formative OSCE scores. All 8/40 (20.0%) residents who attended more than three formative OSCEs succeeded in the summative OSCE on their first attempt. Residents’ formative OSCE scores tended to improve with successive formative OSCEs, demonstrating a positive training effect. All residents felt that the formative OSCE was useful in preparing them for the summative OSCE. Conclusions Participation in multiple formative OSCEs was beneficial in preparing residents for the summative OSCE. The formative OSCE was useful in familiarising residents with the examination, giving them an opportunity to perform in near-examination conditions, and providing feedback to residents and faculty about their progress. Our findings may support the implementation of formative OSCEs in other training programmes to prepare learners for high-stake summative OSCEs.

The aim of the present research was to analyze the autonomic stress response of nursing students in a nursing Objective Structured Clinical Evaluation (OSCE). We analyzed, in 41 s-year nursing degree students (20.1 ± 2.3 years), modifications in heart rate variability (HRV) to monitor the autonomic stress response before, during and after the 18 different scenarios of a complete OSCE. Heart rate mean response of nurse students was consistent with an anticipatory anxiety response at the beginning of the OSCE, showing a sympathetic nervous system activation, but HRV parameters show contradictory results. The most stressful OSCE station was the CPR maneuver, the stress response varying according to the station’s demands.

In this unprecedented situation of COVID-19 era, the educational institutions have to attune not only the teaching strategies but also the assessment. Similarly, just as COVID precautions have become the “new normal” practice, hence implementation changes during face-to-face examinations may become standard practice in the Post- COVID era. The Objective structured clinical exams (OSCEs) which usually require a face-to-face assessment of skills, posed a special challenge to health professionals in COVID-19. This commentary paper is written on shared experiences of the examination cell principal resource faculty for OSCE and exam coordinators. It addresses how to plan and implement objective, valid, feasible and reliable clinical skills examinations (OSCEs) keeping in place COVID precautions to ensure the utmost wellbeing of all stakeholders involved. doi: https://doi.org/10.12669/pjms.37.7.4568 How to cite this:Babar S, Afzal A. The “new-normal” OSCE examination: Executing in the COVID-19 era. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4568 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background Feedback is an essential element of learning. Despite this, students complain about receiving too little feedback in medical examinations, e.g., in an objective structured clinical examination (OSCE). This study aims to implement a written structured feedback tool for use in OSCEs and to analyse the attitudes of students and examiners towards this kind of feedback. Methods The participants were OSCE examiners and third-year medical students. This prospective study was conducted using a multistage design. In the first step, an unstructured interrogation of the examiners formed the basis for developing a feedback tool, which was evaluated and then adopted in the next steps. Results In total, 351 students and 51 examiners participated in this study. A baseline was created for each category of OSCE station and was supplemented with station-specific items. Each of these items was rated on a three-point scale. In addition to the preformulated answer options, each domain had space for individual comments. A total of 87.5% of the students and 91.6% of the examiners agreed or rather agreed that written feedback should continue to be used in upcoming OSCEs. Conclusion The implementation of structured, written feedback in a curricular, summative examination is possible, and examiners and students would like the feedback to be constant.

Background: Assessment has been shown in studies to have a significant impact on the learning process. There has been a lot of interest in making assessment an important element of the learning process for students. Senior medical students may be able to assist teachers with peer evaluations. There is little evidence to support the idea that peer examiners should be officially trained before taking on the job. Aim: To find the difference in teaching faculty scores of untrained and trained peer examiners in Obstetrics & Gynecology OSCE. Study design: Cross-sectional (analytical) study Place and duration: The study was conducted at Sialkot Medical College Sialkot” affiliated with Imran Idrees Teaching Hospital in Obstetrics /Gynecology department over the period of 6 months from January 2022 to June 2022 Methodology: One hundred and five medical student of 4th year were enrolled for practice of OSCE examination. Forty final year medical students took part in the assessment program as peer examiners. One group of examiners were given 2-hour training session describing about the assigned OSCE stations, marking method, evaluation, and feedback methods. Other group was given only checklist to read with no prior training. Using the checklist and a global rating, senior faculty and peer student examiners (both trained and untrained groups) simultaneously assessed students in basic Obstetrics /Gynecology clinical skills at 4 OSCE stations. Every station ran for five minutes (3 minutes of evaluation while 2 minutes of feedback). A comparison between the check list and global rating scores of trained and untrained peer student examiners was made. SPSS version 21 was used to calculate intra-rater reliability was assessed to build the consensus of faculty examiners with the trained and untrained peer examiners according to checklist scores and global rating. Results: Student examiners found sitting at OSCE stations as a useful learning experience. Observing different performances at OSCE stations was so absorbing and it gave them awareness about examination procedure. Practical implication. Peer assessors in a formative OSCE could be successfully implemented in the curriculum of a large medical school with more than 100 students annually. They can be trained to conduct undergraduate assessments of their junior peers and can prove to be very reliable and effective assessors. Conclusion: Peer markers who underwent the formal training session showed the capacity to assess fourth-year students with suitable consistency and devotion. Hence training helped to improve peer marker consensus with faculty. Keywords: Peer examiners, OSCE, trained peer examiner, untrained peer examiner.

Background: Objective Structured Clinical Examination (OSCE) is a method to evaluate students’ nursing skills. OSCE uses checklist as an instrument to test hand washing and gloving skills. While reliability values of both checklists are vital aspect for the instrument, they have not been measured in PSIK FKKMK UGM.Objective: To identify the interrater reliability in the hand washing and gloving skills of OSCE checklists at PSIK FKKMK UGM.Method: This research used non-experimental descriptive quantitative research type with cross-sectional design. The respondents were 92 first-year students at PSIK FKKMK UGM participating in the OSCE examination. Assessment on students performance were conducted using hand washing and gloving checklists by two raters. The scores were analyzed using Kappa and percent agreement (PA).Result: Hand washing checklist had Kappa value of 0,146 (quite poor) and PA 80,40% (acceptable). Gloving checklist had Kappa value of 0,228 (poor) and PA 78,20% (acceptable). The results were divided into two categories, first Kappa not acceptable and PA acceptable or called Kappa paradox consisting of 14 checklist items. Furthermore, there were 11 checklist items in the second category namely Kappa not acceptable and PA not acceptable.Conclusion: Hand washing and gloving skill checklists which are used by PSIK FKKMK UGM do not possess good interrater reliability in measuring the skills of nursing students. These checklists need revision and statistical test in order to improve education quality at School of Nursing at FKKMK UGM.ABSTRAKLatar belakang: Salah satu metode untuk mengevaluasi keterampilan keperawatan mahasiswa adalah menggunakan Objective Structured Clinical Examination (OSCE). Instrumen yang dapat digunakan dalam OSCE adalah checklist. Reliabilitas merupakan aspek penting dalam suatu instrumen. Pengujian reliabilitas dari checklist mencuci tangan dan memakai sarung tangan di PSIK FKKMK UGM belum pernah dilakukan.Tujuan: Untuk mengetahui interrater reliability pada checklist OSCE keterampilan mencuci tangan dan memakai sarung tangan di PSIK FKKMK UGM.Metode: Penelitian ini merupakan jenis penelitian deskriptif kuantitatif non-eksperimental dengan rancangan penelitian cross-sectional. Responden pada penelitian adalah 92 mahasiswa PSIK FKKMK UGM tahun pertama yang mengikuti ujian OSCE. Penilaian performa mahasiswa dilakukan menggunakan instrumen checklist mencuci tangan dan memakai sarung tangan oleh dua orang penguji. Hasil penelitian dianalisis menggunakan Kappa dan percent agreement (PA).Hasil: Checklist mencuci tangan memiliki nilai Kappa 0,146 (cukup buruk) dan PA 80,40% (dapat diterima). Checklist memakai sarung tangan memiliki nilai Kappa 0,228 (buruk) dan PA 78,20% (dapat diterima). Terdapat 14-unit checklist yang masuk dalam kategori Kappa tidak dapat diterima, namun PA dapat diterima (paradoks Kappa). Terdapat 11-unit checklist yang masuk dalam kategori Kappa dan PA tidak dapat diterima.Kesimpulan: Checklist keterampilan mencuci tangan dan memakai sarung tangan di PSIK FKKMK UGM belum memiliki interrater reliability yang baik dalam mengukur keterampilan mahasiswa. Checklist tersebut memerlukan perbaikan untuk menghasilkan reliabilitas baik demi kualitas pendidikan di Program Studi Ilmu Keperawatan FKKMK UGM yang lebih baik.

In the wake of the Covid-19 pandemic, people over 65 or suffering from certain conditions were deemed at high risk and asked to isolate themselves. This led to the simulated patient (SP) program at the University of Bern being depleted of middle-aged and elderly SP. Meanwhile, an OSCE had to be delivered using adapted cases that minimized physical contact between candidates and SP. Short of suitable cases at such short notice, the case of an elderly patient with postural instability had to be added to the exam blueprint. With elderly SP off the roster, it was decided to use makeup effects to achieve visual authenticity. A combination of wigs (grey hair, hairdo), 3D Probondo transfers (forehead wrinkles), old age stipple (crow’s feet), and colouring (age spots) were used to achieve the old-age effects, while SPs wore scarves to cover their neckline. The lower face was covered with protective face masks in accordance with the exam’s Covid-19 hygiene protocol. Case-related feedback from candidates and examiners was analysed for any direct or indirect remark attributable to the ageing effects. As no comment touched upon the subject of the appearance of age, this was interpreted as success, as any distracting effect from the SPs’ appearance in this regard would surely have prompted remarks or even complaints. The SPs’ feedback revealed how applying the ageing effects helped them adopt the octogenarian’s role. This report explains how SP in their fifties were made fit for an octogenarian’s case in an OSCE using makeup effects. The effort required for the ageing simulation was considerable, but it is hoped that in future, with more planning time, the amount of effort required can be reduced. The feedback obtained from the candidates suggest the appearance of SPs was not experienced as a distraction, which was the primary objective of this exercise. Adapting our approach to their own contexts allows educators to include cases with elderly patients in their OSCE that cannot be re-written for younger SP, so long as Covid-19 prevents elderly SP from participating., In der Covid-19-Pandemie wurden ein Lebensalter über 65 oder das Vorliegen bestimmter Gesundheitszustände als Risikofaktoren definiert und Betroffene entsprechend zur Selbstisolation aufgefordert. Dies führte auch dazu, dass das Simulationspersonenprogramm der Universität Bern auf den Einsatz vieler SP v.a. mittleren und vorgerückten Alters verzichten musste. Für eine unaufschiebbare OSCE-Prüfung wurden die Stationen derart angepasst, dass physische Nähe zwischen Kandidat*innen und SP minimiert war. Da sich in der kurzen zur Verfügung stehenden Zeit nur wenige Stationen derart anpassen liessen, musste der Fall einer älteren Patientin mit Haltungsinstabilität in den Prüfungsplan aufgenommen werden. Da ältere SP jedoch nicht aufgeboten werden konnten, wurde beschlossen, die visuelle Authentizität an dieser Station mittels Make-up-Effekten zu erzielen. Die Alterungseffekte wurden mithilfe von Perücken (graues Haar, Frisur), 3D-Probondo-Transfers (Stirnfalten), Old Age Stipple (Krähenfüsse) und Schminke (Altersflecken) bewirkt. Schals bedeckten die Dekolletés und gemäss Covid-19-Schutzreglement wurden chirurgische Masken getragen. Das stationsbezogene Feedback der Kandidat*innen und Prüfer*innen wurde auf direkte oder indirekte Bemerkungen zu den Alterungseffekten überprüft. Dass keine Äusserung bezüglich der altersgerechten Erscheinung der SP identifiziert werden konnte, wurde als Erfolg interpretiert, da jede ablenkende Wirkung des dargestellten Alters sicherlich zu Bemerkungen oder sogar Beschwerden geführt hätte. Das Feedback der SP zeigte ausserdem, wie die Alterungseffekte halfen, die Rolle der Achtzigjährigen anzunehmen. Dieser Bericht erläutert, wie SP in ihren Fünfzigern mithilfe von Make-up-Effekten für die Rolle einer Achtzigjährigen in einem OSCE vorbereitet wurden. Der Aufwand für die Alterungssimulation war beträchtlich, aber mit mehr Planungszeit könnte dieser bei zukünftigen Anwendungen reduziert werden. Die Rückmeldungen der Kandidat*innen deuten darauf hin, dass die Erscheinung dieser SP nicht als Ablenkung empfunden wurde, was Hauptziel der Intervention war. Der beschriebene Ansatz lässt sich adaptieren, sodass auch andernorts Stationen mit älteren Patient*innen in OSCE aufgenommen werden können, wo eine Verjüngung der Rolle nicht infrage kommt, zumindest solange Covid-19 die Teilnahme älterer SP verhindert.

There is an expectation that healthcare professionals display competence in teaching, assessment and providing feedback. Development begins with formative peer-assisted learning and teaching in the undergraduate environment. Using peers or near-peers (in this case having 1 year more experience than the examination cohort) to provide assessment in summative exams remains unexplored. This study investigates how the use of near-peers compares to marking by academic staff in a summative OSCE.BDS4 Peer assessors (PAs) developed an OSCE question and marking schedule. Each PA (n = 3) was paired with an academic staff assessor (ASA) (n = 3). Peer and academic marked the candidates independently. Two years later, the process was repeated on the same cohort of candidates with the PA now 1-year post qualification. Statistical analysis compared the scores awarded by PA during each timeframe and against the marks awarded by the ASA.During round 1, 28 students (62.2%) were awarded the same score by PA and ASA. On 17 occasions, there was a discrepancy (37.8%). Bias was skewed in favour of PA scoring higher (mean difference of differences -0.0667). During round 2, 27 students (55.1%) were awarded the same score by PA and ASA. On 22 occasions (44.9%), there was a discrepancy. Bias was skewed in favour of ASA scoring higher (mean difference of differences 0.0612).Levels of agreement between PA and ASA are strong. Our results show PA mark more leniently as undergraduates and less leniently at 1-year post graduation.Peer assessors are able to write OSCE stations, produce marking schemes and effectively assess their near-peers.

Background: Anxiety is a mood disorder characterized by fears and worries over something. It includes fears and worries about exams which then make someone get prepared for the exams. Previous research conducted on November 14, 2014 found that OSCE was an exam that triggered tenseness, fears, restlessness, and worries. Objectives: This research is to find out the correlations between one's readiness and the level of anxiety when facing OSCE exam among the students of Nursing Undergraduate Program, Respati University Yogyakarta. Research Methodology: This research was a descriptive correlational one with a cross sectional design. A simple random sampling method was used to collect the data from as many as 68 people. The data were collected using questionnaires on April 24 and 26, 2021. The data were then analyzed by the kendal tau analysis. Results : The results indicate that as many as 34 respondents (50%) of 18 years old and as many as 56 female respondents (82.4%) showed the level of anxiety and readiness when facing the OSCE exam. Those having a medium level of readiness were 45 people (66.2%) and those who have a serious level of anxiety were 44 people (64.7%). The statistical analysis indicates that the p-value is 0.037 0.05) with the level of low homogeneity of -0.246. Conclusion: There was a positive correlation between one's readiness and the level of anxiety when facing the OSCE exam among the students of Nursing Undergraduate Program, Respati University Yogyakarta.

Restrictions in face-to-face contact during the COVID-19 pandemic have necessitated the conversion to online teaching-learning activities. To assess relevant competencies of a Master's in Clinical Pharmacy student cohort, an online tele-objective structured clinical examination (OSCE) was developed and conducted using Microsoft Teams®. Afterward, a survey was conducted to determine the acceptance of tele-OSCE by students and faculty members. Students' performance was also compared to a previous cohort that underwent face-to-face OSCE. The majority of students generally agreed that tele-OSCE was operationally easy to undertake (94.0%) and did not deter their exam performance. The majority of faculty members also generally agreed that the online platform did not deter the assessment of students' performance and a minority disagreed on the ease of assessing counselling tasks or calculation work (13.0%). There was no statistically significant difference in students' overall scores between the tele-OSCE and the face-to-face cohort (

Worldwide, trauma-related deaths are one of the main causes of mortality. Appropriate surgical treatment is crucial to prevent mortality, however, in the past decade, general surgery residents' exposure to trauma cases has decreased, particularly since the COVID-19 pandemic. In this context, accessible simulation-based training scenarios are essential.A low-cost, previously tested OSCE scenario for the evaluation of surgical skills in trauma was implemented as part of a short training boot camp for residents and recently graduated surgeons. The following stations were included bowel anastomosis, vascular anastomosis, penetrating lung injury, penetrating cardiac injury, and gastric perforation (laparoscopic suturing). A total of 75 participants from 15 different programs were recruited. Each station was videotaped in high definition and assessed in a remote and asynchronous manner. The level of competency was assessed through global and specific rating scales alongside procedural times. Self-confidence to perform the procedure as the leading surgeon was evaluated before and after training.Statistically significant differences were found in pre-training scores between groups for all stations. The lowest scores were obtained in the cardiac and lung injury stations. After training, participants significantly increased their level of competence in both grading systems. Procedural times for the pulmonary tractotomy, bowel anastomosis, and vascular anastomosis stations increased after training. A significant improvement in self-confidence was shown in all stations.An OSCE scenario for training surgical skills in trauma was effective in improving proficiency level and self-confidence. Low pre-training scores and level of confidence in the cardiac and lung injury stations represent a deficit in residency programs that should be addressed. The incorporation of simulation-based teaching tools at early stages in residency would be beneficial when future surgeons face extremely severe trauma scenarios.

Variation in examiner stringency is a recognised problem in many standardised summative assessments of performance such as the OSCE. The stated strength of the OSCE is that such error might largely balance out over the exam as a whole. This study uses linear mixed models to estimate the impact of different factors (examiner, station, candidate and exam) on station-level total domain score and, separately, on a single global grade. The exam data is from 442 separate administrations of an 18 station OSCE for international medical graduates who want to work in the National Health Service in the UK. We find that variation due to examiner is approximately twice as large for domain scores as it is for grades (16% vs. 8%), with smaller residual variance in the former (67% vs. 76%). Combined estimates of exam-level (relative) reliability across all data are 0.75 and 0.69 for domains scores and grades respectively. The correlation between two separate estimates of stringency for individual examiners (one for grades and one for domain scores) is relatively high (r=0.76) implying that examiners are generally quite consistent in their stringency between these two assessments of performance. Cluster analysis indicates that examiners fall into two broad groups characterised as hawks or doves on both measures. At the exam level, correcting for examiner stringency produces systematically lower cut-scores under borderline regression standard setting than using the raw marks. In turn, such a correction would produce higher pass rates—although meaningful direct comparisons are challenging to make. As in other studies, this work shows that OSCEs and other standardised performance assessments are subject to substantial variation in examiner stringency, and require sufficient domain sampling to ensure quality of pass/fail decision-making is at least adequate. More, perhaps qualitative, work is needed to understand better how examiners might score similarly (or differently) between the awarding of station-level domain scores and global grades. The issue of the potential systematic bias of borderline regression evidenced for the first time here, with sources of error producing cut-scores higher than they should be, also needs more investigation.

The Objective Structured Clinical Examination (OSCE) is a highly valued performance-based competency assessment that is extensively employed in medical and health professions education. In pharmacy undergraduate programmes, OSCE is an integral component of the curriculum, constituting both formative and summative assessments of the course. When the COVID-19 pandemic posed an overarching challenge in the delivery of face-to-face teaching and learning activities, academic institutions around the world ineluctably transitioned to online mode of education. Conducting OSCEs on virtual platforms presents its unique set of challenges. In the absence of physical isolation and invigilation of students, the risk of cheating and collusion is particularly high during virtual OSCEs. With the experience of conducting high-stakes OSCEs on virtual platforms at two different campuses simultaneously, the authors outline several strategies that can be implemented to ensure the academic integrity of the assessment.

Central Asia is a region where the osce has been engaged for more than two decades, including with missions and field presences in all five participating states. This engagement reflects the hope that these countries will gradually align themselves with the values, principles and norms of the organization. The region, however, presents the following challenges. First, Central Asian states strictly adhere to state sovereignty and want to constrain the osce’s involvement in domestic affairs. Second, these states prioritize the organization’s economic and ecological dimension, and want to reduce the importance of its human rights dimension. Finally, the activity programmes of the remaining osce field presences in the region are subject to the approval of host governments.