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Background: Training of standardized patients (SPs) for national high-stakes OSCE helps to ensure a reliable assessment of student performance in various clinical scenarios. However, workflow protocols to train SPs vary. Medical schools adopt specific measures to ensure standardization., Approach: We present a development workflow of the SPs' training framework for high-stakes OSCE using a volunteer SPs' bank. Our approach was guided by the social learning theory. Three educators and 17/20 (85%) members of our volunteer SPs' bank worked in a collaborative partnership on the construction of pedagogical content of the training framework comprising three 2-hour sessions. Since SPs have to demonstrate acquired behaviors, intended learning outcomes used the words "apply", "perform" and "participate.", Evaluation: A principal part of the evaluation was the achievement of intended learning outcomes by the SPs during 3 formative OSCEs. Seventeen SPs, 356 fourth year medical students and 60 examiners participated. Quantitative and qualitative data were collected by post-session questionnaires and analyzed using descriptive statistics and thematic analysis. Twelve examiners evaluated a mean of 29.7+/-0.14 SD patient-student encounters. In total, 15/16 SPs (93.8%) considered the contact with students as easy and 4 SPs (31%) reported the experience as stressful. Two themes emerged from the free-text comments: "Gaining experience as SP" and "Concerns for evaluated students.", Implication: The proposed SPs' training framework for high-stakes OSCE may be useful for other medical disciplines and health professions initiating SP-based assessment programs. The strategy of development and evaluation are outlined to guide a successful application of the curriculum standards., (© 2024 The Author(s). The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Introduction: Student‐led Objective Structured Clinical Examinations (OSCEs) provide formative learning opportunities prior to Faculty‐led OSCEs. It is important to undertake quality assurance measurements of peer‐led assessments because, if they are found to be unreliable and invalid, they may have detrimental impacts. The objectives of this study were to explore and evaluate Student‐led OSCEs hosted by fifth‐year medical students. Methods: Student‐led OSCE results were analysed to examine reliability (Cronbach's alpha). The relationship between Student‐led and Faculty‐led OSCEs was evaluated using linear regression. Qualitative data were acquired by survey and semi‐structured interviews and were analysed using an inductive content analysis approach. Results: In total, 85 (94%) of 91 eligible students consented to study participation. Student‐led OSCEs had a low‐moderate reliability [Cronbach alpha = 0.47 (primary care) and 0.61 (human reproduction/paediatrics) (HRH)]. A statistically significant, positive relationship between Student‐led and Faculty‐led OSCE results was observed. Faculty‐led OSCE grades increased by 0.49 (95% CI: 0.18, 0.80) to 1.09 (95% CI: 0.67, 1.52), for each percentage increase in Student‐led OSCE result. Student‐led OSCE participants highly valued the authentic peer‐assessed experience. Reported benefits included a reduction of perceived stress and anxiety prior to Faculty‐led OSCEs, recognition of learning gaps, contribution to overall clinical competency and facilitation of collaboration between peers. Discussion: Student‐led OSCEs are moderately reliable and can predict Faculty‐led OSCE performance. This form of near‐peer assessment encourages the metacognitive process of reflective practice and can be effectively implemented to direct further study. Faculties should collaborate with their student bodies to facilitate Student‐led OSCEs and offer assistance to improve the quality, and benefits, of these endeavours. [ABSTRACT FROM AUTHOR]

The impact of information transfer on student examination performance is debatable,[[1]] but may confer advantage to students undertaking OSCE stations later in the exam diet. An alternative strategy is to quarantine students, which prevents students who have undertaken the OSCE from being able to liaise with candidates who have not yet taken the OSCE. The case for quarantining was further strengthened by a highly publicised instance of student collusion identified in the 2016/17 examination diet at Glasgow.[5] The Year-5 OSCE was subsequently re-run under quarantine conditions in 2016/17, and the Glasgow OSCEs for Years 2, 3 and 5 have been quarantined since the 2017/18 academic year. [Extracted from the article]

This toolbox highlights the lessons learned and the tools used to run the online OSCE at the College of Medicine and Medical Sciences, Arabian Gulf University (CMMS-AGU) using Zoom™️. The examiners considered the examination to be valid in assessing all clinical skills except for psychomotor skills and students found it to be highly acceptable. We describe three phases. Planning and preparation phase in which situation analysis, aligning stakeholders, mobilizing resources, creating a shared vision, and ownership of the exam project take place. For successful implementation of examinations, detailed plans are needed including manpower, timings, number of stations and detailed description of the steps of the examination process. We provide a set of guiding questions for proper decision making related to online clinical exams. Implementation Phase in which piloting is very useful to apply improvements to the original plan and to outline the needed capacity building of the participating staff. We give a detailed description of the guiding documents, means of communication and features of ZOOM that were used. Evaluation phase we provide a guide for evaluating the process and outcome, including a list of key performance indicators., (© 2020 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Background: Objective Structured Clinical Examinations (OSCEs) are commonly used to provide feedback to students on their performance in formative examinations. However, students are often unable to act independently on the feedback they receive. This study explored how the use of video‐assisted reflection in OSCEs can enhance students' ability to reflect and engage in sustainable feedback. Methods: Twenty‐one students undertaking a mock‐final OSCE consented to have one of their examination stations filmed. Participants completed a series of reflective forms immediately after the OSCE, after verbal feedback from an examiner and finally, after watching the video of their own performance. Students were asked to predict their overall grade as well as list areas for improvement. Pearson r correlations examined the relationship between the examiners' grades and the candidates' self‐predicted grades. Wilcoxon signed‐rank tests were used to compare the length of reflections at each stage. Semi‐structured interviews were conducted to explore students' beliefs on self‐efficacy and how the video‐assisted reflection altered their ability to act on feedback. Results: The students' ability to self‐assess and gauge their own performance improved significantly after undertaking the video‐assisted reflection (p < 0.01). Furthermore, video‐assisted reflection significantly increased the length of the student's reflections. In interviews, participants described multiple ways in which the video‐assisted reflection improved their confidence and ability to act on feedback, highlighting a clear enhancement in self‐efficacy. Discussion: Video‐assisted reflection of recorded OSCE stations represents an effective approach to increase student self‐efficacy and subsequently improve engagement in sustainable feedback practice. [ABSTRACT FROM AUTHOR]

Introduction: Simulated patients (SPs) are involved widely in the support of health care education for communication and consultation skills teaching. This study aimed to explore SPs' perspectives of their role and contribution to health professions education., Methods: A qualitative approach was used. Twenty-two SPs (actor and non-actor) involved in teaching at the Royal College of Surgeons Ireland (RCSI) participated in one of four focus groups, which were audiorecorded. Two focus groups involved professional actors (n = 7), and two focus groups involved non-actor SPs (n = 15). Transcribed data were analysed using thematic analysis., Results: The first theme 'Reward of Contribution' highlights how the SP role is situated in a position of mutual benefit for both SP and student. The second theme 'Multiple Personas' demonstrates the complexity of SP role portrayal. The third theme 'Culture and Communication' is a new finding and demonstrates the role SPs feel they have in helping to change the culture of health care practice. The fourth theme 'A touchy subject' addresses the preferences of SPs concerning involvement in both intimate and nonintimate physical examination., Conclusions: SPs believe they have an important role to play in health care education and they also learn from their involvement. SPs' perspectives need to be considered to ensure they feel supported in their role and that their unique insights remain beneficial for student learning., (© 2021 The Authors. The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Background The phenomenon of empathy decline among medical students during training is widely accepted, with evidence based largely on studies using self-administered instruments. Recently, researchers have called into question this phenomenon, in light of new findings that suggest a discrepancy between self-administered empathy scores and observed empathic behaviours: for example, during objective structured clinical examinations ( OSCEs). Our objective was to compare observed empathy among medical students in different clerkship years using an OSCE. Methods Participants were medical students in their first or second year of clinical clerkships, enrolled in a required family medicine clerkship at Stanford University. Participants completed an OSCE that was directly observed by trained faculty staff, who used the Measure of Patient-Centered Communication ( MPCC) instrument to measure empathic behaviours. Statistics were used to determine correlations between observed empathy and the students' year of clerkship, gender, and specialty preference. Results A total of 129 medical students, evenly divided by gender and clerkship year, participated. There was a possible trend towards higher MPCC scores among students in their second clerkship year compared with students in their first year (p = 0.09), which became more significant when adjusted for outlier effects (p = 0.05). There was no difference in performance by gender. Students interested in a 'people-oriented' specialty scored higher in 'handling the patient's frustration' compared with those who are interested in a 'technology-oriented' specialty. Discussion In our study, observed empathic behaviours were not lower in the second compared with the first year of clerkship training. More research is warranted to investigate the apparent discrepancy between self-administered empathy scores and observed empathic behaviours. [ABSTRACT FROM AUTHOR]

Background: Accessible and efficient opportunities for health professional faculty to hone feedback skills are limited. In addition, feedback models to apply to the objective structured clinical examination (OSCE) setting are lacking. Approach: Annually, paediatric interns from Children's National Hospital and Walter Reed National Military Medical Center participate in an OSCE, which includes faculty observation and immediate feedback to trainees. In 2018, we incorporated the subjective, objective, assessment, plan (SOAP) Feedback Training Program during 20 min of the pre‐OSCE faculty orientation. The SOAP Feedback Training Program introduced the SOAP feedback model (subjective, objective, assessment, plan), facilitated practice in pairs and distributed a cognitive aid referencing the model. We evaluated the quality of faculty feedback exchanges during the 2018 OSCE via retrospective video review using the Direct Observation of Clinical Skills Feedback Scale (DOCS‐FBS). We compared the results to the 2015 initial evaluation and used focus groups to understand how and why faculty feedback changed. Evaluation: Comparison of the initial evaluation to the post‐SOAP Feedback Training Program intervention data using a Wilcoxon signed rank test showed statistically significant improvement in six of eight feedback items on the DOCS‐FBS. Causal coding of focus group transcripts revealed that the SOAP Feedback Training Program evoked affective responses, reinforced prior practice in feedback delivery, improved feedback organisation and increased feedback delivery preparation. Implications: The SOAP Feedback Training Program is an effective intervention to teach the SOAP feedback model and improve faculty feedback quality in an OSCE setting. It is efficient and low resource, facilitating its potential use in settings beyond the OSCE. [ABSTRACT FROM AUTHOR]

Background: After an initial period of uncertainty during the COVID‐19 pandemic, medical universities responded to the pandemic by innovating their methods of teaching‐learning and assessment. This scoping review aimed to identify innovations in assessment in medical, dental and nursing education at the undergraduate and postgraduate levels during the pandemic. Methods: This review was conducted utilising Arksey and O'Malley's framework where three electronic databases—PubMed, Embase and Web of Science—were systematically searched in February 2022 for articles in English describing innovations in assessments published in or after January 2020. Results: A total of 70 articles were included in the review. Among the primary research articles, 82.1% reported online assessment, 76.1% were related to medical speciality, 74.6% described assessment at the undergraduate level, 68.7% described summative assessment and 58.2% reported assessment of practical skills. All assessments of theoretical knowledge were done virtually with MCQ being the most used assessment tool and virtual OSCE being the most popular assessment tool to assess practical skills; however, it was acknowledged that the assessment of procedural skills was its limitation. Although the studies described the newer forms of assessments as feasible and acceptable, few studies reported the reliability and validity of the assessments. Conclusions: This scoping review identified several innovations in assessment during the COVID‐19 pandemic with an overall shift towards virtual or hybrid forms of assessment. However, there was a dearth of evidence regarding the effectiveness of these assessment tools suggesting a need for more research before the tools can be implemented post‐pandemic. [ABSTRACT FROM AUTHOR]

Objective: The accurate documentation of a medical history interview is an important goal in medical education. As students' documentation of medical history interviews is mostly decentralised on the wards, a systematic assessment of documentation quality is missing. We therefore evaluated the extent of details missed in students' medical history reports in a standardised setting. Methods: In this prospective, observational study, 123 of 380 students (32.4%) participated in an Objective Structured Clinical Examination (OSCE) regarding history taking and documentation. Based on the interviews and nine deductively selected main categories, a categorical system was established using a summarising qualitative content analysis. The items in the transcripts (defined as ground truth) and in students' reports were labelled and assigned to the correct subcategory. The ground truth and students' reports were compared to quantify students' documentation completeness. Results: Next to the nine deductively selected main categories, 61 subcategories were defined. A total of 8943 items were labelled in the 123 interview transcripts (ground truth), compared with 5870 items labelled in students' reports (65.6% completeness of students' reports compared with ground truth). The main category personal details overlapped with 94.2% between students' report and ground truth in contrast to the main category with the highest discrepancy, allergy, with 41.1% overlap. Pertinent negative items and non‐numerical quantifications were often missed. Conclusions: Medical students show incomplete documentation of medical history interviews. Therefore, accurate documentation should be taught as an important goal in medical education. [ABSTRACT FROM AUTHOR]

Summary: Background: Video review of OSCE (objective structured clinical examination) performance allows students to analyse their performance, identify actions and behaviours for correction or reinforcement, and develop a plan for improvement of clinical skills. Student perceptions of the utility of independent and mentored video review are unknown. Methods: We created a pilot programme of post‐OSCE structured video review. Students were randomised to mentored (M) or independent (I) review. In the mentored group, a faculty member facilitated the process. Both groups completed an assessment rubric and created an action plan. We examined student perceptions of the process, helpful elements of each type of review and perceived impact after a follow‐up OSCE. Results: The mentored group (n = 12) was more comfortable watching themselves than the independent group (n = 11); using a five‐point Likert scale, where 1 indicates 'strongly disagree' and 5 indicates 'strongly agree': 3.5 ± 1.2 (I) versus 4.5 ± 0.2 (M) (p = 0.02). The mentored group more strongly agreed that their clinical skills would improve: 3.6 ± 1.1 (I) versus 4.9 ± 0.2 (M) (p < 0.01). After the follow‐up OSCE, the mentored group (n = 10) tended to feel more strongly that their clinical skills had improved compared with the independent group (n = 9): 3.6 ± 1.3 (I) versus 4.3 ± 0.7 (M) (p = 0.14). Discussion: This pilot study demonstrates the utility of using a structured framework for post‐OSCE video review, both for the assessment of performance and for the development of a behavioural action plan. There are advantages to using a mentor‐guided model, but further study is needed to determine whether actual OSCE performances improve as a consequence. Video review of OSCE performance allows students to analyse their performance [ABSTRACT FROM AUTHOR]

Summary: Background: Objective structured clinical examinations (OSCEs) are integral to clinical competency‐based assessment in health care disciplines. Traditional paper‐based OSCEs require considerable administration time and students typically receive an assessment outcome with minimal feedback. We developed and implemented an iPad‐based OSCE assessment system in optometry that delivered timely and specific e‐feedback. Methods: The electronic assessment system contains all of the features of a paper‐based OSCE format, including a checklist score, a global score section and pre‐written feedback. It was trialed in a year‐3 OSCE assessment. We evaluated students and examiners' perceptions of this digital resource via surveys and focus group interviews. Results: Over 90% of the students reported that the e‐feedback was timely, facilitated self‐reflection and was appropriate for assessment. Students' focus group interviews highlighted the importance of the timeliness of feedback, and students found both verbal and written feedback useful. All examiners were satisfied with the features of the assessment system and felt confident using it for assessment. Discussion: The iPad‐based OSCE assessment system has enabled timely feedback to be delivered efficiently. This study has provided a model of what constitutes good e‐feedback. The technology was well received by both students and examiners. It has helped to close the assessment loop by delivering usable and developmental feedback to meet students' learning needs. [ABSTRACT FROM AUTHOR]

Summary: Background: Unprofessional behaviour can interfere with patient care. Empowering trainees to address each other's unprofessional behaviour can help address a larger number of incidents that may not be witnessed by supervisors, as well as promote a culture of professionalism in a teaching programme. The goal of the study was to teach trainees to effectively address observed unprofessional behaviour and to assess the impact of this exercise on the percentage of cases directly addressed, reported or ignored 6–12 months after the initial training. Methods: Eighty‐four trainees participated in objective structured clinical examination (OSCE) cases designed to address a colleague's inappropriate behaviour. Baseline and follow‐up surveys performed 6–12 months after the OSCE were completed detailing the number of incidents witnessed in colleagues and the method employed to address those incidents: personally address (with level of satisfaction), report or ignore. Results: There was a significant increase in the number of unprofessional incidents identified after the OSCE (pre‐OSCE, 1.12 per resident; post‐OSCE, 1.69 per resident; t = 2.27, p = 0.029). Of the 72 incidents at baseline, 43 per cent were addressed directly and 43 per cent of those had a satisfactory resolution. Of the 71 incidents described 6–12 months later, 61 per cent were addressed directly and 79 per cent of those had a satisfactory resolution. Trainees were more likely to address rather than to report unprofessional behaviour χ2(2, 58) = 13, p = 0.001. Empowering trainees to address each other's unprofessional behaviour can help promote a culture of professionalism Discussion: The intervention had a significant impact on the percentage of trainees that addressed any observed unprofessional behaviour, and the rate of satisfaction after doing so. It did not change the percentage of cases that were neither addressed nor reported. [ABSTRACT FROM AUTHOR]

Background: Those setting objective structured clinical exams (OSCEs) are likely to encounter candidates who dispute the examiners' scores and feedback. At our own institution, candidates have requested video recording to aid in later academic appeals. Before ceding to such requests, we wished to be certain that the marking of recorded OSCEs would give comparable results to live marking, and that technical challenges could be met within reasonable cost. Methods: We adopted a mixed‐methods approach to explore the use of video recording OSCEs. Following an initial literature review, we surveyed and interviewed the assessment leads of UK medical schools and postgraduate institutions setting high stakes OSCEs to explore their views and experience in using recordings as part of summative OSCE assessments. Results: Results from our literature review reveal inconsistent findings about the comparability of marks awarded from video marking and those awarded by examiner in‐station marking, with suggestions that video marking generates lower scores. The majority of UK medical education institutions were neither videoing OSCEs nor considering doing so. Many logistical and assessor‐related drawbacks to video review were identified, with significant concerns raised about how such a process could be feasibly managed. Discussion: Although the videoing of OSCEs may superficially appear an easy solution to provide defensibility of the process, the potential use is beset with challenge, going beyond purely logistical and technical difficulties. The use of videoing for the purpose of OSCE appeals is not currently supported by the literature, nor by the majority of UK undergraduate and postgraduate medical education institutions delivering high‐stakes summative OSCEs. [ABSTRACT FROM AUTHOR]

Summary: Background: For a procedure‐driven specialty such as anaesthesiology, hands‐on training has always been the primary method of teaching airway skills. Although this method will always be a necessary component, the current generation of learners tend to gravitate toward media as educational sources. We propose that the addition of watching a series of podcast videos on airway management will further enhance the medical student's procedural skills. Methods: A total of 34 medical students scheduled for an anaesthesia rotation were randomised into two groups. Both groups received the conventional one‐to‐one hands‐on training on airway skills in the operating room; however, the study group received an additional series of podcast videos on airway equipment, mask ventilation and intubation. At the end of the rotation, all of the students were given an objective structured clinical examination (OSCE) on a mannequin. Results: The study group who received the podcasts significantly out‐performed the control group on the OSCE (p = 0.003). The mean score for the podcast video group was 94.4%, versus 76.5% in the control group. Commonly missed steps by the control group included checking the endotracheal tube balloon before intubation, taping the eyes and auscultation of the epigastrium and lungs. Discussion: Our results showed that supplementing conventional hands‐on training with contemporary channels such as podcast videos improved learners' procedural skills. The media format was relatable for these modern learners and provided the added benefit of self‐paced learning. Overall, the podcast videos made a positive contribution to students learning airway techniques. [ABSTRACT FROM AUTHOR]

Background: Prescribing medicines is one of the most common interventions in health care, so even a small percentage of prescribing errors can affect many patients. Many of these errors are prevented by the intervention of pharmacists. Research has identified gaps in medical education and training that contribute to these errors. More effective learning opportunities for prescribing at undergraduate level will help to improve the preparation of junior doctors for their role. Context: Traditionally, doctors have acquired their prescribing skills through an apprenticeship model. Given the complexity of current health care and increasing polypharmacy, a more systematic approach to safe prescribing is required. The pharmacist can have a key role in education and the practice of safe prescribing. Innovation: Final-year students at the University of Dundee Medical School are invited to undertake sessions to rehearse safe prescribing practices using an objective structured clinical examination (OSCE) format. This helps to recreate the time pressures of practice with a focus on the elements of safe prescribing for patients. On a simulated ward, students rehearse six situations that represent the basis of commonly reported prescribing errors. Each scenario has four prescribing related tasks, one of which is feedback from a pharmacist. An evaluation of this approach and students' selfreported learning indicated that it was a useful way of enhancing awareness of errors and of increasing confidence. Implications: There are several benefits for students in having pharmacists design and facilitate the OSCE clinical scenarios, which include the immediate learning of accurate prescribing as well as the advisory role that the pharmacists play. [ABSTRACT FROM AUTHOR]

The recorded video visit was edited into clips, and, to preserve student clinical decision making, students generated written responses about how they would conduct the visit prior to watching the telehealth encounter. In comparison with their prior in-person OSCE, many students rated the telehealth module as an equal or better opportunity to employ critical thinking about their history taking (68%), physical examination (63%) and communication skills (77%). [Extracted from the article]

Background Distractions and interruptions on the ward pose substantial patient safety risks, but medical students receive little training on their management. Although there is some evidence that medical students can be taught how to manage distractions and interruptions in a simulated ward environment, the only model to date is based on individual feedback, which is resource-expensive, mitigating curricular integration. Our aim was to assess the educational utility of a cost-efficient approach to a patient safety-focused simulated ward round. Methods Twenty-three of 55 final-year medical students took part in a cost-reduced simulated ward round. Costs were minimised by providing group rather than individualised feedback, thereby shortening the duration of each simulation and reducing the number of interruptions. The utility of the simulation was assessed via student evaluation and performance on a patient safety station of an objective structured clinical examination ( OSCE). Findings The direct costs of the simulation were more than 50 per cent lower per student compared with the original study, mostly as a result of a reduction in the time that faculty members took to give feedback. Students managed distractions better and received higher scores in the OSCE station than those who had not undergone the ward round. Group feedback was evaluated positively by most participants: 94 per cent of those who provided feedback agreed or strongly agreed that the simulation would make them a safer doctor and would improve their handling of distractions. Discussion The costs of a simulated ward round can be significantly reduced whilst maintaining educational utility. These findings should encourage medical schools to integrate ward simulation into curricula. [ABSTRACT FROM AUTHOR]

Background Single-best answer ( SBA) questions are widely used for assessment in medical schools; however, often clinical staff have neither the time nor the incentive to develop high-quality material for revision purposes. A student-led approach to producing formative SBA questions offers a potential solution. Methods Cardiff University School of Medicine students created a bank of SBA questions through a previously described staged approach, involving student question-writing, peer-review and targeted senior clinician input. We arranged questions into discrete tests and posted these online. Student volunteer performance on these tests from the 2012/13 cohort of final-year medical students was recorded and compared with the performance of these students in medical school finals (knowledge and objective structured clinical examinations, OSCEs). In addition, we compared the performance of students that participated in question-writing groups with the performance of the rest of the cohort on the summative SBA assessment. Results Performance in the end-of-year summative clinical knowledge SBA paper correlated strongly with performance in the formative student-written SBA test ( r = ~0.60, p <0.01). There was no significant correlation between summative OSCE scores and formative student-written SBA test scores. Students who wrote and reviewed questions scored higher than average in the end-of-year summative clinical knowledge SBA paper. Conclusion Student-written SBAs predict performance in end-of-year SBA examinations, and therefore can provide a potentially valuable revision resource. There is potential for student-written questions to be incorporated into summative examinations. [ABSTRACT FROM AUTHOR]

The article presents information about a study conducted at the University of Pretoria in Lynwood, South Africa on the use of personal digital assistants (PDA) as assessment tools during the clinical anatomy component of the Orthopedics Block of the Medical curriculum of the University. A 30-minute training session on the use of the PDA was held for the assessors.

Summary: Background: Integrating undergraduate medical curricula horizontally across clinical medical specialties may be a more patient‐centred and learner‐centred approach than rotating students through specialty‐specific teaching and assessment, but requires some interspecialty calibration of examiner judgements. Our aim was to evaluate the acceptability and feasibility of an online pilot of interdisciplinary examiner calibration. Fair clinical assessment is important to both medical students and clinical teachers Methods: Clinical teachers were invited to rate video‐recorded student objective structured clinical examination (OSCE) performances and join subsequent online discussions using the university's learning management system. Post‐project survey free‐text and Likert‐scale participant responses were analysed to evaluate the acceptability of the pilot and to identify recommendations for improvement. Results: Although 68 clinicians were recruited to participate, and there were 1599 hits on recordings and discussion threads, only 25 clinical teachers rated at least one student performance, and 18 posted at least one comment. Participants, including rural doctors, appeared to value the opportunity for interdisciplinary rating calibration and discussion. Although the asynchronous online format had advantages, especially for rural doctors, participants reported considerable IT challenges. Discussion: Our findings suggest that fair clinical assessment is important to both medical students and clinical teachers. Interspecialty discussions about assessment may have the potential to enrich intraspecialty perspectives, enhance interspecialty engagement and collaboration, and improve the quality of clinical teacher assessment. Better alignment of university and hospital systems, a face to face component and other modifications may have enhanced clinician engagement with this project. Findings suggest that specialty assessment cultures and content expertise may not be barriers to pursuing more integrated approaches to assessment. [ABSTRACT FROM AUTHOR]

Background: With a growing number of Spanish-speaking patients in the United States, it is crucial for clinicians to communicate effectively with their patients. However, the number of Spanish-speaking clinicians is disproportionately low. Our module aims to provide healthcare students with a practical foundation of basic Spanish for taking vital signs. We evaluated this module's impact on student knowledge acquisition and self-perceived confidence in taking vitals in Spanish through pre- and post-module assessments., Approach: Our 7-h hybrid educational module comprised two in-person sessions with pre- and post-session assignments. Through the module, students learned grammar, vocabulary and cultural principles before practising speaking skills through team-based learning in small groups led by bilingual facilitators., Evaluation: Seventy-nine of the 98 originally enrolled students completed the module. Students completed pre- and post-module surveys to gauge knowledge of grammar, vocabulary, comprehension and cultural understanding in addition to measuring self-reported confidence levels using a 5-point Likert scale. A Wilcoxon rank-sum test was used to analyse the difference between the tests with p < 0.05 representing statistical significance. Students showed statistically significant improvement in all tested domains as well as in self-confidence reporting even after controlling for prior Spanish exposure and Hispanic ethnicity. Students who had prior exposure to Spanish showed a greater increase in confidence reporting vital signs in Spanish., Implications: With a need for more Spanish-proficient clinicians, medical education institutions in the United States will seek to augment trainee exposure to and competence in Spanish. This module provided an effective environment for healthcare students to learn and practice medical Spanish., (© 2025 Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Background It has been argued that the best method of acquiring clinical reasoning is through seeing new out-patients. The purpose of this interventional study was to establish a clinical clerkship course for Japanese medical students in an out-patient care setting, with multiple opportunities for reflective practice and improving the clinical reasoning abilities of the students. The effectiveness of the course was also examined. Methods Students performed examinations of new patients and made diagnostic decisions in 20 minutes. They presented their case using the SNAPPS (Summarize the case, Narrow the differential, Analyze the differential, Probe the preceptor, Plan management, and Select an issue for self directed learning) method, and this was followed by feedback from faculty members using the 1-minute preceptor method and a mini clinical evaluation exercise (mini- CEX). Students' clinical reasoning abilities were assessed by the objective structured clinical examination ( OSCE) and the script concordance test ( SCT). Students' written comments and responses to an interview about the course were also analysed. Cross-sectional data were examined by comparing individual OSCE and SCT scores, and the multiple-choice question examination ( MCQ) completed by students who did and did not participate in this project. Results Students in the programme had higher scores on the mini- CEX in all areas. The SCT and OSCE scores were also significantly higher than the scores for the control group. Students' comments about the course, which provided an opportunity for daily reflection, were positive. Discussion Students rapidly acquired clinical reasoning skills through reflective practice. Students also demonstrated motivation to learn through the examination of new patients. The clinical clerkship programme with multiple opportunities for reflective practice in an out-patient care setting substantially improved the clinical reasoning abilities of medical students. [ABSTRACT FROM AUTHOR]

In this article, the author discusses a study conducted by J. Ogle and colleagues to measure observed and self-rated empathy for third year Australian graduate medical students who participated in a summative objective structured clinical examination. She mentions that further their examination scores were compared with empathy scores. The study found that the clinical competence is associated with observed behavior indicative of empathy.

The article discusses the study "Comparison of student examiner to faculty examiner scoring and feedback in an OSCE," by G. Moineau and colleagues. It states that the study investigated the topic of student examiners (SEs) in objective structured clinical examinations (OSCEs), which were use in health care education. It mentions that the researchers utilized formative nine-station OSCE composed of clinical skills, communication skills, and physical examination stations.

Summary: Background: The assessment of clinical competence is critical in medical education. Understanding the effect of general experience on a physician's self‐assessment would help design more effective curricula and evaluations of procedural skills in postgraduate training and continuing professional development (CPD). In this observational study, we assessed the effect of general experience on the correlation between confidence and competence amongst experienced clinicians (ECs) and postgraduate trainees (PGTs) when learning an office‐based procedure in pessary care. Methods: We recruited 19 first‐year family medicine residents and 18 family medicine faculty members in two outpatient academic clinics. All participants attended a simulation‐based workshop for a routine gynaecological office procedure. We used a confidence survey as a measure of the participants' self‐assessed competence and an objective structured clinical examination (OSCE) to evaluate participants' competence before and after the workshop. The assessment of clinical competence is critical in medical education Results: We found no significant correlation between confidence and competence at baseline for either group (EC, r = 0.25, p = 0.35; PGT, r = 0.15, p = 0.60). After the workshop, we observed a statistically significant correlation between confidence and competence for ECs (r = 0.60, p = 0.01), but not for PGTs. The change in this correlation was not statistically significant for either group, however. Discussion: Our findings suggest that ECs are not any more accurate in the assessment of their competence compared with PGTs. All procedural skills curricula can benefit from OSCE‐format evaluation to better evaluate the improvement in performance of participants. [ABSTRACT FROM AUTHOR]

In 2008 there were 262 episodes of incorrect blood component transfusion. Safer Practice Notice 14, Right patient, right blood, introduced a mandatory requirement for all clinical staff involved in the blood transfusion process to be assessed against competencies developed on a national basis. It was recommended that the assessment should be an observed, formalised process. The National Patient Safety Agency (NPSA) produced an assessment framework, but this has never been validated. We developed the Nottingham Anaesthesia Transfusion OSCE (NATO). This consists of an interactive clinical scenario that examines the key aspects of transfusion medicine. After gaining informed consent, the NATO assessments of 12 anaesthetists were filmed. Three experienced assessors independently viewed the recorded material and scored the candidates. Cronbach's alpha was subsequently calculated. All participants were asked to complete a feedback form. The pass rate during the study was 58 per cent (7/12). Cronbach's alpha for NATO was 0.929. Seventy-five per cent of candidates judged NATO to be a fair assessment of transfusion competency. NATO allows the objectives detailed by the NPSA to be assessed formally in a format that is perti-nent to anaesthetic practice. Internal reliability and face validity evaluation are the first steps in utility assurance of this assessment tool. [ABSTRACT FROM AUTHOR]

Although ultrasound is a core skill for many clinical specialties, UK medical schools are not currently required to teach this skill. The College of Emergency Medicine (CEM) has championed the use of ultrasound to answer focused clinical questions in emergency settings. We have designed and piloted an ultrasound training course for undergraduate medical students addressing one important indication: ultrasound assessment of the abdominal aorta. Fourteen clinical students, who had no prior experience of using ultrasound, received focused ultrasound training in the form of didactic instruction, a short bedside practical workshop and self-directed learning over a 20-day period. At the end of this period, the students were assessed by a structured viva and an observed structured clinical examination (OSCE) used for accreditation by the CEM. The primary endpoint was the number of students who passed the assessment. The secondary endpoint was the accuracy of the students' anatomical measurements. Thirteen of the 14 (93%) students completed the training and assessment. Eight of the 13 (62%) students passed both the viva and OSCE, and were deemed to have achieved the CEM standard. The measurements by the competent students were not statistically different from those of experienced practitioners. We have shown for the first time that it is feasible to train inexperienced undergraduate students to scan the abdominal aorta to a professional standard using a focused training course. It is time for the medical education community to address whether focused ultrasound training should accompany traditional clinical skills, such as using a stethoscope, in UK medical school curricula. [ABSTRACT FROM AUTHOR]

Background Despite its relevance to medical practice, occupational medicine has been poorly represented in undergraduate training. This article describes a model for the teaching of occupational medicine to student doctors. Methods The model comprises two didactic lectures, a student-selected component ( SSC) of five interactive two-hour sessions and one occupational medicine objective structured clinical examination ( OSCE) station in the final MB ChB clinical exam. Interested final-year students are invited to join the SSC. In session 1, students discuss the scope of occupational medicine practice, which includes a job title-occupational illness quiz, the use of environmental measurements and audiovisual recordings of selected workplaces. Sessions 2-4 involve visits to workplaces such as a laundry, a foundry and a bakery, during which students are asked to record relevant hazards to health, their controls, health effects and how occupational causality might be determined. The final session allows students to present their findings and gain feedback from the occupational physicians and their peers. Results Twenty-seven student doctors chose to undertake the SSC in three cycles. Students appreciated the relevance of the specialty and the opportunity to systematically evaluate workplaces. Eighty per cent of all final-year medical students ( n = 250) passed the occupational medicine station in the OSCE in 2014. Conclusions This model for the teaching of occupational medicine links work and medical practice at three stages of undergraduate training and could be adopted by all medical schools. The SSC gave students skills for undertaking illness prevention, workplace evaluation and risk assessment that they had not previously encountered. [ABSTRACT FROM AUTHOR]

This report analyzes the impact of climate change on coastal communities in Northern Ireland. It discusses the potential risks and vulnerabilities faced by these communities, such as rising sea levels, increased storm intensity, and coastal erosion. The report emphasizes the need for adaptation strategies and policy interventions to protect these vulnerable communities from the effects of climate change. The authors provide an in-depth analysis of the situation and highlight the importance of taking action to mitigate these risks. [Extracted from the article]

Summary: Background: Medical students do not have many formal opportunities to practise physical examinations during their pre‐clerkship years. Consequently, they often practise their examination skills with peers outside of formal teaching sessions. There are also few opportunities for observation and feedback on their skills in this area. Context: The undergraduate medical programme at the University of Toronto is a 4‐year programme where students learn clinical skills in the first 2 years prior to beginning clinical rotations. Innovation: We describe a web‐based, mobile device‐friendly tool to facilitate structured peer–peer observation and feedback of physical examination skills. The tool is designed for use by pre‐clerkship medical students, and includes assessment criteria for select physical examinations based on expectations for pre‐clerkship medical students. In addition, supplemental instructional material was developed to aid the students’ learning. The tool was piloted with first‐year medical students as they prepared for their autumn objective structured clinical examination (OSCE) at the University of Toronto. Its use was voluntary. Implications: The tool has been used enthusiastically by students, and their feedback has been positive. This tool is an innovation that guides students as they practise their physical examination skills, and gives them a framework to provide feedback to one another during this process. It also encourages students to reflect critically on their own skills, as well as those of their peers, through the use of an engaging digital platform. The tool will be expanded to include history‐taking vignettes, photos and videos. The tool is sustainable, and could be easily implemented at other institutions without a substantial investment. Students often practise their examination skills with peers outside of formal teaching sessions [ABSTRACT FROM AUTHOR]

Since telemedicine traditionally has not been integrated into medical training, academic centres have been left to independently develop "just in time" curricula or implement telemedicine services without formal training. This often entails faculty-precepted visits with scheduled patients; however, if participation in telemedicine visits is not available to the learner, simulation or standardised patients can be used to replicate the telemedicine experience. TELEMEDICINE CURRICULUM DEVELOPMENT Now that you have begun to implement telemedicine in your practice, you wonder how best to train your faculty and trainees on appropriate and effective telemedicine usage. Structured observations should include self-reflection from the trainee and formative feedback that addresses telemedicine-specific competencies and corresponding trainee documentation.14 In addition to or in place of OCEs, telemedicine evaluation may take place via OSCE (12, 13). [Extracted from the article]

Background: Senior medical students organised and delivered a teaching day to prepare an academic year of junior colleagues for their end-of-year objective structured clinical examination (OSCE). Methods: The day involved a series of mini lectures, followed by group-based teaching to reflect the various stations in the proceeding examinations. Feedback forms were completed at the start and end of the teaching day. Results: As indicated through feedback, senior medical students are capable of organising a successful revision day to prepare more junior peers for their end-of-year examinations. Discussion: Having completed the same set of assessments, senior medical students are well placed to prepare more junior colleagues for their examinations. This exercise offered valuable teaching experience for the tutors, and also highlighted numerous areas of development for future iterations. As found in other such projects, this approach was also rated as effective by the participants. [ABSTRACT FROM AUTHOR]

Simulation in medicine is a useful tool for assessing clinical competencies. The liaison committee on medical education expects students to have simulation experiences in the curriculum. The integration of simulators has been encouraged for clinical clerkships. The use of the human simulator in a safe environment should result in enhanced teamworking, communication and critical thinking skills. During the academic year 2007-08, a formative activity using the simulator was implemented in the paediatrics clerkship. The objectives included exposing students to an emergent general paediatric medical scenario using the human simulator. It was imperative that students would adequately go through the critical thinking process. The paediatrics clerkship has incorporated a formative activity using the high-fidelity simulator. A faculty member debriefed the students, and feedback was offered. A total of 124 students participated in the activity. Ninety-eight per cent agreed that the use of the simulator in a scenario such as the one presented allowed for a better understanding of the clinical issues studied in the clerkship. More than 85 per cent of the students recommended the integration of the simulator in other major clinical clerkships. Performance in the objective structured clinical exam (OSCE) at the end of the clerkship has improved after the implementation of this formative activity. The use of the high-fidelity simulator during the paediatrics clerkship has been identified as an excellent teaching tool. This formative activity has been deemed successful by the students, who feel that it serves as an extra tool to strengthen learned concepts and skills. [ABSTRACT FROM AUTHOR]

The authors discuss the use of objective structured clinical examination (OSCE) to test the documentation skills of medical students. The authors cite that the skill is crucial for the qualified junior doctor who are starting to work. The authors also discuss that the written summary of a patient interaction which reflects the student's ability for a thorough documentation.

Background The ability to carry out a neurological examination and make an appropriate differential diagnosis is one of the mainstays of our final Bachelor of Medicine ( MB) exam; however, with the introduction of objective structured clinical examinations ( OSCEs) it has become impossible to arrange for adequate numbers of suitable real patients to participate in the exam. Context It is vital that newly qualified doctors can perform a basic neurological examination, interpret the physical signs and formulate a differential diagnosis. Innovation Since 2010 we have introduced an objective structured video examination ( OSVE) of a neurological examination of a real patient as part of our final MB OSCE exam. The students view clips of parts of the examination process. They answer questions on the signs that are demonstrated and formulate a differential diagnosis. Implications This type of station is logistically a lot easier to organise than a large number of real patients at different examination sites. The featured patients have clearly demonstrated signs and, as every student sees the same patient, are perfectly standardised. It is highly acceptable to examiners and performed well as an assessment tool. There are, however, certain drawbacks in that we are not examining the student's examination technique or their interaction with the patient. Also, certain signs, in particular the assessment of muscle tone and power, are more difficult for a student to estimate in this situation. [ABSTRACT FROM AUTHOR]

Summary: Background: Action plans have been shown to be important in changing behaviour. In learners, action plans have been proposed as a mechanism by which feedback leads to an increase in expertise: feedback leads to action plans, which lead to changes in learning behaviours and finally to improvement. Little is known about the extent to which students are able to make specific actions plans that relate to the feedback they are given, however. We explored whether medical students created action plans after being given feedback, the quality of those plans and whether the action plans were related to the feedback given. Action plans have been shown to be important in changing behaviour Methods: We collected data from a communication session for Year‐1 medical students on the feedback they were given and the action plans they made for improvement. Results: Most students (185/196, 94%) made one or more action plans, but only 31/196 (16%) made one or more action plans that were directly related to the feedback given to them. Conclusions: Although educators may include action planning in education, students are not making specific enough action plans to effect change. Future work should include support for students in making better‐quality action plans. ...students are not making specific enough action plans to effect change [ABSTRACT FROM AUTHOR]

Summary: Background: The assessment of medical students' clinical skill acquisition is variable and is driven by differences in curricula and health services requirements. This project aimed to ascertain whether different assessment models impact on students' performance of as intravenous (i.v.) cannulation. Recency of practice was also explored as a factor influencing performance. Methods: A total of 137 students in the first clinical year (years 2 or 3 of a 4‐year course) of their medical degree, from four regional clinical schools, participated in a multiple‐station mock objective structured clinical examination (MOSCE). Intravenous cannulation was one of the stations examined. Fifty‐nine students came from a model that required the assessment of i.v. proficiency during their clinical year (model 1). Seventy‐eight students came from a model that required no assessment of i.v. proficiency (model 2). Students reported their most recent clinical i.v. cannulation experience relative to the MOSCE. Results: The MOSCE pass rate of 73% for students in model 1 was significantly higher than the corresponding MOSCE pass rate of 45% for students in model 2. There was a highly significant association between assessment model and MOSCE pass/fail rate. The assessment model was also highly associated with recency of practice. The assessment of medical students' clinical skill acquisition is variable Conclusions: The results support an assessment model that promotes the continuing clinical practice of i.v. cannulation. Integration of this model will require innovative approaches by staff and collaboration with affiliated organisations. [ABSTRACT FROM AUTHOR]

Dear Editor, We read with interest Morrison & Chimkupete's article on the challenges they have faced as Black female medical professionals.1 As Black female final year medical students ourselves, it was interesting to witness the 2020 Black Lives Matter protests result in our own universities launching overdue institutional reviews of race inequality. Furthermore, we note that disparities in communication styles between ethnic minority students and their white peers in objective structured clinical examinations (OSCE) are perhaps another contributing factor to the attainment gap.4 We propose that the filming and review of clinical examinations by a group of examiners, OSCE simulated and real patients of different ethnicities and genders - where feasible - may see improvement in the examination scores of Black students and other ethnic minority students as well as help reduce the anxiety induced by fear of being stereotyped. Black, Asian and Minority Ethnic (BAME) students underperform in medical school examinations and training compared to white students: this is termed the "differential attainment gap".2 Studies suggest fear of negative stereotyping is a contributing factor to this gap.3 In our experience, we recognise this fear whereby counteracting anticipated negative stereotypes during preparation for clinical examinations - for example, by "putting on certain accents" or "wearing particular hairstyles" - has compounded exam stress and anxiety. [Extracted from the article]