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Background and objectives: The COVID-19 pandemic has forced universities to move the completion of university studies online. Spain's National Conference of Medical School Deans coordinates an objective, structured clinical competency assessment called the Objective Structured Clinical Examination (OSCE), which consists of 20 face-to-face test sections for students in their sixth year of study. As a result of the pandemic, a computer-based case simulation OSCE (CCS-OSCE) has been designed. The objective of this article is to describe the creation, administration, and development of the test. Materials and methods: This work is a descriptive study of the CCS-OSCE from its planning stages in April 2020 to its administration in June 2020. Results: The CCS-OSCE evaluated the competences of anamnesis, exploration, clinical judgment, ethical aspects, interprofessional relations, prevention, and health promotion. No technical or communication skills were evaluated. The CCS-OSCE consisted of ten test sections, each of which had a 12-minutes time limit and ranged from six to 21 questions (mean: 1.1 minutes/question). The CCS-OSCE used the virtual campus platform of each of the 16 participating medical schools, which had a total of 2,829 students in their sixth year of study. It was jointly held on two dates in June 2020. Conclusions: The CCS-OSCE made it possible to bring together the various medical schools and carry out interdisciplinary work. The CCS-OSCE conducted may be similar to Step 3 of the United States Medical Licensing Examination.

Objective: Assessment of skills is an important part of medical education. The objective was to find out how students perceive their learning after being assessed through OSCE. Methods: It was a mixed convergent parallel study. The study was carried out in the gynaecology department of a private medical college in Lahore. Five groups of final year students posted for rotation in gynae wards were included in this study. Each group comprised of 18 students. They were exposed to OSCE once daily. After completion of one month, students were given a feedback questionnaire (developed and validated by medical educationists) and a focus group discussion was carried out. Eight participants were selected from each group randomly and interviews were recorded. Interviews were transcribed verbatim. Results: Quantitative data calculated by SPSS 21 and results were calculated as frequencies. Qualitative analysis was based on word frequency count and thematic analysis was followed. Almost 65.2% of the student Shows agreement to the response that OSCE should be part of internal assessments. Whereas 15% shows disagreement and 9% remain neutral. The themes extracted after interviews were, better assessment tool, exam fear, knowledge, confidence and change learning style. thus, triangulating the data. The outcome measured was the result of the final professional of obstetrics and gynaecology year 2017-2018 batch. The success rate was 100% in gynae/obs and one student was able to get a distinction. Conclusion: Students perceived OSCE as a better assessment tool that increased their knowledge and confidence level. Thus, they were an opinion that OSCE should be part of examinations held in college. doi: https://doi.org/10.12669/pjms.37.4.4005 How to cite this:Yusuf L. Objective Structured Clinical Examination? How students perceive their learning after OSCE. Pak J Med Sci. 2021;37(4):1206-1210. doi: https://doi.org/10.12669/pjms.37.4.4005 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: Objective Structured Clinical Exams (OSCEs) can assess professional competencies in a structured manner and facilitate objective evaluation of clinical performance. With limited data from the Eastern Mediterranean region, this study aims to describe the development, implementation, and evaluation of OSCEs for final year pharmacy students in Kuwait. The study also aims to compare students' performance in two academic years (2015–2016 and 2016–2017). Methods: The design, implementation, and evaluation of the competency-based OSCE followed a 3-phase systematic evidence-based approach. The development phase involved establishing an OSCE working group to develop a blueprint and scoring rubrics and to organise assessors and standardised patient/physician training. The implementation phase involved conducting formative and summative OSCEs. The evaluation phase involved undertaking student and staff perception surveys. Results: The overall students' OSCE scores for the academic years 2015–2016 and 2016–2017 were (median (interquartile range)) (71.6%, 32.2) and (60.0% (30.7)) and respectively (p

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.

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 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.

During the wake of the COVID-19 pandemic, many schools quickly transitioned their teaching and assessment strategies to online formats. In Spring 2020, a 3-station remote Objective Structured Clinical Examination (OSCE) was implemented for first-year pharmacy students. The day following the remote OSCEs students answered three open-text prompts about the remote OSCE experience: (1) “I liked...”, (2) “I learned…”, and (3) “I suggest…”. Responses were open-coded and frequency counts were calculated to determine the most prevalent codes. Concept maps were created to visualize and explore connections between the codes. Out of 157 students, 156 students completed the reflection assignment, a 99.36% response rate. The three major themes in the Liked data were: Logistics (n = 65, 41.7%), Differences In-person Versus Remote (n = 59, 37.8%), and Skill Development (n = 43, 27.6%). The three major themes in the Learned data were: Technology (n = 66, 42.3%), Communication (n = 58, 37.2%), and Skill Development (n = 56, 35.9%). The three major themes in the Suggest data were: Logistics (n = 89, 57.1%), Technology (n = 31, 19.9%), and Continuation of Remote OSCE (n = 31, 19.9%). Overall, the remote OSCE experience was well-received, and students described it as applicable to their future pharmacy practice. Future work should explore the design, implementation, and outcomes of remote OSCEs.

Objectives: This study aims to understand students’ perception of the usefulness of end-of-clerkship (EOC) as compared to professional exam Objective Structured Clinical Examinations (OSCE) and to compare student performance in both examinations. Methods: We conducted a cross-sectional study of medical students who were studying in the final year at Shifa College of Medicine, Shifa Tameer-e-Millat University, and appeared in both end-of-clerkship and final professional exams. The study was conducted in October 2019. The data was collected through a self-constructed questionnaire. The scores of all participants were also recorded. The data obtained was analyzed on IBM’s statistical package for the social sciences (SPSS) version 23 (IBM, Armonk, NY). Descriptive statistics were used for qualitative variables. Mean and standard deviation was calculated for quantitative variables. Chi-square test was also applied to assess for significant differences. Results: Out of 115 participants, 57 (49.6%) were males and 58 (50.4%) were females. Most of the participants (75.7%) agreed that both OSCEs were well-structured. Participants found that both the exams give a good cross-section of paediatrics and allowed them to learn something new (p=0.00). 45% of participants perceived that the end-of-clerkship OSCE exam helped in orienting them for the final professional exam by identifying their weaknesses. Conclusion: Although the EOC OSCE served as a good preparatory exercise, it did not alleviate the stress levels. However, the results in both OSCEs were comparable and students were satisfied with the current weightage of marks distribution. doi: https://doi.org/10.12669/pjms.37.2.3422 How to cite this:Khan SA, Aaraj S, Talat S, Javed N. Students’ perception and scores in Paediatrics end-of-clerkship and final professional Objective Structured Clinical Examination (OSCE): A comparative study. Pak J Med Sci. 2021;37(2):525-530. doi: https://doi.org/10.12669/pjms.37.2.3422 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: “Simulated-patient scenarios and role-playing” and OSCE are among the many non-traditional education methods with variable results in different clinical settings. Objectives: This cross-sectional study was performed to assess the correlation between the results of these two methods in senior anesthesiology residents, with a special focus on four of the six ACGME core competencies. Methods: During two years, senior anesthesiology residents were subject to “simulated patient scenario and role-playing” sessions. Two faculty members took the role of the patient and one of the relatives. An objective checklist with 15 items was prepared to be rated by other department faculty members. Meanwhile, an ordered pattern of OSCE was prepared to cover four core competencies that were more related to this academic process (from a total of six core competencies). The mean and standard deviation of the score of each of the 15 items in the checklist were calculated. The correlation between cumulative checklist scoring results and OSCE exam results was assessed. A P value of less than 0.05 was considered significant. Results: A total of 40 senior anesthesiology residents, with 344 assessments by faculty members in 40 sessions, were enrolled in the study. The questionnaire’s Cronbach’s alpha reliability was 0.74. No statistically significant disparity was detected between the results of the two assessment methods, while the results of the two assessments had a significant correlation (two-tailed correlation coefficient = 0.886; P value < 0.001). Conclusions: There was an objective relationship between the results of “simulated patient scenario and role-playing” strategies and the results of OSCE exams using an observer-based rating method. Thus, they could be used as surrogates in the assessment of core clinical competencies of senior anesthesiology residents.

Web-Objective Structured Clinical Examination (OSCEs) were piloted for the Clinical Skills Assessment (CSA) exams in the USA two decades ago and were shown to be an acceptable way to conduct OSCEs remotely. The learners valued the process yet expressed numerous limitations.1 In response to the COVID-19 outbreak in Qatar, medical schools stopped in-person teaching creating a hiatus in clinical instruction. The Clinical Skills and Simulation Lab (CSSL) team devised and piloted a Web-OSCE to determine its feasibility in this setting, and to evaluate stakeholders’ experiences. We describe the steps taken to create a Web-OSCE built on women’s reproductive and sexual health which is part of the third year Obstetrics and Gynecology Clerkship curriculum, using Zoom teleconferencing. It mirrored the steps taken when conducting this activity in person; however, all communication relied on emails before the event, Zoom during the event with WhatsApp as a backup for connectivity between learners, Zoom hosts and faculty. ### Pre-Web-OSCE steps #### Preparing students CSSL provided by email a step-by-step instruction guide plus a pre-OSCE task for students to complete to ensure that they could access the OSCE on the day of the activity. A live Zoom session led by faculty reviewed the learning objectives, expectations and assessment and served as an open forum for students to ask questions in order to mitigate any anxiety surrounding the new modality. #### Preparing simulated patients Simulated patients (SP) were surveyed to assess their interest and technology capabilities to participate in Zoom activities. Interested SPs joined a Zoom meeting with staff members, who ensured they had adequate technical capability. SPs were selected and confirmed according to requirements of the case. Training notes and checklists were sent …

Introduction Although menopause is a common condition, trainees still express high levels of discomfort with managing climacteric symptoms. Trainees also receive little preparation for conducting telemedicine visits, which have become increasingly important in clinical care. We present a formative standardized patient (SP) encounter to introduce medical students to the diagnosis and treatment of menopausal symptoms and the process of conducting a telemedicine visit. Methods We designed a virtual telemedicine encounter with an SP for medical students. Students received feedback via a post-encounter note on history taking, differential diagnosis, and diagnostics/management and an SP debrief. We collected student input on the experience at the midpoint and end of clerkship and analyzed it for recurring themes. We calculated summary statistics from student post-encounter notes. Results Thirty-two OB/GYN students completed the menopause telemedicine SP encounter between April and June 2020. Students scored a median of 20 out of 45 (interquartile range: 18, 22) on the post-encounter note. All students correctly provided a diagnosis of perimenopause/menopause; however, 50% did not offer any strategy for counseling or managing menopausal symptoms. Students expressed discomfort with using a telehealth format (78%) but found it a useful skill to practice (47%). A majority (66%) found the educational encounter to be of excellent or above-average educational value. Discussion While medical students demonstrated discomfort with both managing menopause and utilizing a telemedicine format, this SP case provided an opportunity for them to practice both skills in a safe learning environment. The majority of participants rated the learning experience highly.

Purpose: Intern assessment during advanced pharmacy practice experiences (APPEs) are generally based upon each individual preceptor’s perceptions without an objective measurement of intern understanding and performance. Therefore, we sought to determine whether a pre- and post-OSCE could be used to confirm that interns achieved the goals and objectives of the Ambulatory Care rotation. The aims of this study were to determine whether a pre-rotation OSCE can help pharmacy interns self-assess their clinical strengths and weaknesses and assess whether their knowledge and skills improved after completing a post-rotation OSCE. Methods: Pharmacy interns undergoing APPE Ambulatory Care rotations from September 2018 to March 2020 participated in a pre- and post-rotation OSCE to assess their knowledge of various chronic disease states. Interns completed pre- and post-OSCE surveys to assess their perceptions about their knowledge and the OSCE experience. Results: Pharmacy intern knowledge about diabetes, hypertension, dyslipidemia, and atrial fibrillation significantly improved post-OSCE compared to their pre-OSCE scores (p

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Background: Assessment drives learning and improving the quality of assessment has a remarkable impact on the quality of learning. Objective Structured Clinical Examination is termed more reliable and valid as compared to conventional practical examination. Objective: The objective of this study was to find the perception of postgraduate family medicine trainees about the OSCE assessment method and compare those having previous experience with those having no previous experience. Methodology: This was a cross-section study conducted at the end of exit examination of diploma in family medicine at the Family Medicine Department, Khyber Medical University Peshawar. Data were collected on an eleven items questionnaire on a five-point Likert Scale. Study participants were categorized based on their previous experience of the OSCE, and were grouped into two categories. Data were analyzed by using Fisher’s Exact test and a p-value of ? 0.05 was considered statistically significant. Results: 56 out of 60 candidates returned completed questionnaires. The response rate was 93.33% where the majority were males 52(92.9%). Participants with experience of the OSCE were 22 (39.3%) while 34 (60.7%) were having no experience of the assessment method. There was a significant difference (p= 0.001) in the perception about the OSCE with the simulated patient than real patient, fairness and reliability of the OSCE, stress and length of the OSCE and reduction of bias in the OSCE. The perception about weightage to be given to the OSCE in any examination was significantly different (p=0.004) between the two groups. Conclusion: Participants of both groups (experienced vs non-experienced) agreed on some aspects of the OSCE. Their opinion differed about the fairness, validity and stress related to the OSCE assessment method. This difference is probably explained by the inadequacy of an experience to form an opinion. Keywords: Conventional practical examination, Family medicine, OSCE.

Objectives: To investigate and compare the views of undergraduate pharmacy students in two Malaysian pharmacy schools (one private and one public) regarding the organisation, quality, and objectivity of Objective Structured Clinical Examination (OSCE). Methods: A cross-sectional study was undertaken among penultimate and final year students in two Malaysian pharmacy schools between October to December 2019 (International Islamic University Malaysia [IIUM] and University of Cyberjaya [UoC]). A questionnaire was developed, tested, validated and then distributed to study participants through online Google forms. Results: A total of 221 undergraduate pharmacy students participated in the study. Students from the public university disagreed with the allocated time for the OSCE stations (IIUM 63.9% and 48.7% vs UoC 11.6% and 14.3%). Relatively few students agreed that OSCE is a less stressful type of assessment compared to other traditional methods (IIUM 7.2% and 10.3% vs UoC 39.5% and 23.8%). Both groups of students’ also disagreed that OSCE marks were likely to be affected by the student’s gender (IIUM 73.2% and 66.7% vs UoC 67.4% and 78.6%). Conclusion: The majority of participants had positive views on the organisation, quality, and objectivity of OSCE, with several differences between students in public and private universities. There are few areas to be further considered to ensure more positive OSCE experience for students such as revision on the time allocation for every station and on the provision of timely constructive feedback.

Background: Communication skills are essential in a patient-centred health service and therefore in medical teaching. Although significant differences in communication behaviour of male and female students are known, gender differences in the performance of students are still under-reported. The aim of this study was to analyse gender differences in communication skills of medical students in the context of an OSCE exam (OSCE = Objective Structured Clinical Examination).Methods: In a longitudinal trend study based on seven semester-cohorts, it was analysed if there are gender differences in medical students' communication skills. The students (self-perception) and standardized patients (SP) (external perception) were asked to rate the communication skills using uniform questionnaires. Statistical analysis was performed by using frequency analyses and t-tests in SPSS 21.Results: Across all ratings in the self-and the external perception, there was a significant gender difference in favour of female students performing better in the dimensions of empathy, structure, verbal expression and non-verbal expression. The results of male students deteriorated across all dimensions in the external perception between 2011 and 2014.Discussion & conclusion: It is important to consider if gender-specific teaching should be developed, considering the reported differences between female and male students. peer-reviewed

Background: The national board exam for residents in Iran is held in two parts: Multiple-choice and Objective Structured Clinical Examination (OSCE). The OSCE is a suitable method for evaluation of residents' clinical qualifications. However, it requires experienced human resources, accurate planning, facilities and reliable evaluation tools. Objective: To determine the challenges of the OSCE National Board Exam in Iran. Methods: This cross-sectional study was conducted on all the final-year pediatrics and gynecology residents of Mashhad University of Medical Science, who participated in the board exam in September 2014. A questionnaire was designed to evaluate the residents’ opinion on challenges of the OSCE. Data was analyzed with SPSS16. We used U Mann–Whitney test independent t-test, and Pearson correlation coefficient. Results: Fourteen pediatrics and eleven gynecology residents participated. In the gynecology group, there was no significant statistical correlation between the individual marks and questionnaire scores. However, in the pediatrics group, there was a significant correlation (p=0.046, r=-0.763). Based on pediatrics residents’ perspective, the main challenge of the OSCE part of the exam was the imbalance and disproportion between the allowed time and the task load in each exam stage. In other words, they believed that the tasks could not be fulfilled in the given time. In the gynecology group, the main challenge reported was the delay in announcing the exam results. In the pediatrics group, the main complaint was the disproportion of the allowed time and the task load in the exam stages. Conclusion: Some of the challenges of the board exam were associated with the examiners and the exam environment, and some of them were related to the home university where the candidates had studied. To solve the problems, both aspects should be considered.

Современный уровень развития медицины требует от врача-анестезиолога овладения большим объемом теоретических знаний и практических навыков, способности использовать их в сложных и критических условиях. Исходя из этого оптимизация учебного процесса нуждается в реструктуризации систем оценки и контроля приобретенных знаний и практических навыков. На кафедре анестезиологии, интенсивной терапии и медицины неотложных состояний факультета последипломного образования три года назад для промежуточного контроля теоретических знаний и практических умений врачей-интернов первого года обучения был введен объективный структурированный клинический экзамен (Objective Structured Clinical Exam — ОSСЕ). Цель данной работы — анализ результатов проведения объективного структурированного клинического экзамена и оценка промежуточных знаний и практических навыков у врачей-интернов первого года обучения по специальности «анестезиология и интенсивная терапия» в соответствии с методологией OSСЕ. Для проведения экзамена было подготовлено 7 станций: клинические станции, включавшие взаимодействие врачей-интернов с реальным или стандартизированным пациентом; практические станции (выполнение технических процедур и манипуляций) и статические (теоретические) станции. Инструментами оценки были оценочные листы и адаптированная к профессиональным требованиям глобальная рейтинговая шкала. Из 32 интернов, которые сдавали экзамен, только 10 набрали более половины от возможного количества баллов, остальные — меньше. Средний балл составил 10,3 (из 14 возможных). Большинство интернов, которые, как мы считали, успешно сдадут данный экзамен, едва превысили показатель в 60 %. Самые высокие оценки врачи-интерны получили за предоперационную подготовку больных, гемотрансфузиологию, а также за демонстрацию реанимационных навыков на манекене. Низкие оценки интерны получили за ответы по внутривенной анестезии и за практический навык по установке ларингеальной маски. В дальнейшем мы планируем разработать дополнительные станции, согласно требованиям типовой учебной программы по интернатуре Министерства образования Украины, усовершенствовать методическое обеспечение для каждой новой станции, адаптировать критерии оценки практических навыков и внедрить их для итоговой аттестации на звание врача-специалиста.

Published online: 8 October 2021 Despite the Lisbon Treaty's modifications in the foreign and security policy domain, the EU has frequently relied on third parties to address external conflicts and crises. Using the Ukrainian conflict as a case study, this article adopts the orchestration model to explain why and how the EU enlists intermediary actors over which it has no formal control to pursue its objectives. It finds that in this conflict the EU outsourced part of its crisis management activities to the Organization for Security and Co-operation in Europe because it lacked the civilian and military capabilities, as well as the regulatory competence and reputation to challenge Russia. Indeed, the Ukrainian case shows that orchestration has emerged as a crucial governance arrangement for the functioning of EU crisis management, raising serious questions about the EU overall capacity to act as a security provider in an international system marred by contestation and hard security concerns.

Background: Objectively structured clinical examinations (OSCEs) are a stressful experience for many health care students and professionals in training. Mock OSCEs have been shown to be beneficial for student OSCE preparation. However, due to their expense and administrative burden students may only get a few opportunities to partake in these. To address this gap in student preparation a series of regularly run totally peer led multi-role practice OSCEs (PrOSCEs) was developed. Methods: Fifteen PrOSCEs were run over five-months. A total of 32 second year medical students took part, all of whom were enrolled on the graduate-entry programme at the University of Southampton. In each PrOSCE, 18 participants rotated through the roles of 'student', 'examiner' and 'patient' in six simulated stations designed by their peers. Peer feedback was provided after each station. At the end of the series of PrOSCEs students were asked to fill in an anonymous online feedback survey to assess the usefulness of the PrOSCEs in exam preparation. Results: Twenty-two students responded to the survey. 100% of respondents deemed routine participation either 'very useful' or 'useful' in preparing for their exam. PrOSCEs were found to improve confidence (mean = 7.9/10, 95% CI 7.4-8.3), expected performance (mean = 7.5/10, 95% CI 6.8-8.2) and help guide revision (mean = 8.3/10, 95% CI 7.6-9.0). Self-perceived teaching performance and confidence in providing feedback was also positively associated with participation. The most beneficial roles were 'student' and 'station creator'. Free-text feedback suggests that the informal setting and regular practice were particularly beneficial. Conclusion: The peer-led nature of the PrOSCEs allows for a low cost, low administrative burden and easy to replicate adjunct or alternative to large scale mock OSCEs. In addition the multi-role aspect of this approach could enhance exam preparation and may also improve aptitude as a clinical teacher. Further studies are required to understand if repeated practice has beneficial implications on OSCE performance.

Purpose: Ensuring examiners in different parallel circuits of Objective Structured Clinical Exams (OSCEs) collectively judge to the same standard is critical to the chain of validity. Recent work suggested that the examiner-cohort (i.e. the particular group of examiners) a candidate meets could significantly alter outcomes for some candidates. Despite this, examiner-cohort effects are rarely examined as fully-nested data (i.e. no cross-over between the students judged by different groups of examiners) limit comparisons. This study aimed to replicate and further develop a novel method called Video-based Examiner Score Comparison and Adjustment (VESCA), so that it can be used to enhance quality assurance of distributed or national OSCEs. Method: Six volunteer students were filmed on all12 stations in a summative OSCE. In addition to examining live performances, examiners from all 8 separate examiner-cohorts collectively scored the same pool of video performances. Examiners scored videos specific to their station. Video scores provided linkage within otherwise fully-nested data, enabling comparisons by Many Facet Rasch Modelling. Analysis primarily compared and adjusted for examiner-cohort effects. Additional analyses compared examiners’ scoring when videos were embedded (interspersed between live candidates within the OSCE) or judged later via the internet. Results: Having accounted for differences in students’ ability, different examiner-cohorts scores for the same ability of student ranged from 18.57(68.7%) to 20.49(75.9%), Cohen’s d=1.3. Score adjustment changed up to 16% of students’ classification (pass-fail/ fail-pass) depending on modelled cut score. Internet and embedded video scoring showed no difference in mean scores or variability. Examiners’ accuracy did not deteriorate over the 3 week scoring period allowed for internet-based scoring. Conclusions: Examiner-cohorts produced a replicable significant influence on OSCE scores which was unaccounted for by typical assessment psychometrics. VESCA offers a promising means to enhance validity and fairness in distributed OSCEs or national exams, whilst internet-based scoring may enhance VESCA’s feasibility.

Objective: Clinical education is an important component of undergraduate medical education. This study compares the efficacy of blended learning (BL) with contemporary face to face (F2F) teaching among medical students by assessing their OSCE scores at end of clinical posting. Methods: This experimental study was conducted in Dow University of Health Sciences from March to August 2014. Third-year medical students posted in the surgical units were divided into two groups. In the first month, one group in the unit was taught by BL while the second group posted in another unit was taught by F2F teaching. Both groups were assessed by same OSCE. In the second month, teaching method was flipped for both the groups with new learning contents. assessment was by the same OSCE for both groups. Data was analyzed by SPSS version 23 with inferential statistics with independent sample t test. Results: A total of 28 students were assessed at the end of posting OSCE in F2F group and 31 students in blended group. There was significant difference in OSCE score [p value = 0.049] after F2F teaching method (78.01 ± 13.29) as compared to BL (85.12 ± 13.77). The domain of “log book” and “clinical examination” scored higher in F2F as compared to BL group. Conclusion: This study showed that student performance can be improved with a blended surgical learning program. BL has proven to be more effective in comparison to face-to-face teaching alone, even in the setting of skill based curriculum like surgery.

Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE). Methods: In this descriptive study, 70 EMS staff from selected Emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0.7 and 0.8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0.89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests. Results: Findings showed that 56.3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P=0.02) and work experience (P=0.03) as well as clinical skills in confronting trauma. Conclusion: Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.

Background:The Objective Structured Clinical Exam (OSCE) is a comprehensive, structured and consistent approach for assessing aspects of the students clinical competence with maintenance of high objectivity. Aim of the Study:To assess student evaluation of an OSCE in community health nursing clinical course at St. Johns College of Nursing. Materials and Methods: Study Design: A descriptive cross sectional study design was used for the study. Study Setting:The study was conducted in St. Johns College of Nursing. Sample: A non probability convenient sample of (33) Nursing students who completed their community health nursing OSCE examination was selected for the study. Tool of Data Collection:A self administered questionnaire (Pierre et al., 2004 OSCE evaluation sheet) was used It is divided into 4 sections which contain 32 items. Only 25 items of Pierre et al., 2004 questionnaire were used in this study and few items were modified to suit the current setting and to give a clear meaning. Results: OSCE was considered as a fair examination method by 81.82 percentage of students and 72.73 % of them felt that it provides a true measure of essential clinical skills. (81.82%) of the studied students reported that, OSCE is less stressful than other exams and still (30.30 %) felt that the exam was stressful. Conclusion: OSCE is a realistic assessment for the community health nursing clinical course. It could assess a wide range of learned materials it is a fair exam and covered a wide range of knowledge. Recommendation:The present study recommended that, OSCE should be implemented in Community Health Nursing and continued to be used as a method of evaluating clinical practice when the students are posted in urban and rural posting as a practice before the final practical exam.

The COVID -19 pandemic has affected many aspects of life, one of which is in the field of education. Transformation toward various e-learning process has been conducted in order to prevent transmission of the disease caused by massive gathering. Obstacles appear when trying to deliver and assess practical skills which are usually done face to face with the teachers or instructors. These obstacles are also seen in pharmacy schools where skills such as patient counselling, compounding and dispensing, etc. are important competencies for the students to achieve. In order to overcome these obstacles, we developed a method for conducting the objective structured clinical examination (OSCE) through online process. This study was aimed to evaluate the new online OSCE method for pharmacy students to be conducted in the pandemic era. The evaluation of online OSCE trial was conducted using a simple Google form-based questionnaire which evaluated the platform used, the process of online OSCE and the instruction understandings. Respondents consisted of 52 examinees from the students of Pharmacist Profession Program UMY and 15 examiners from the lecturers or assistants who participated in the online OSCE trial held in June 2020. Data was analyzed descriptively to give a comprehensive picture on respondents’ perception towards the new method. The result showed that 78.8% examinees and 73.3% examiner agreed that the platform was easy to use, 65.4% examinees and 100% examiner agreed that the whole process of the exam was easy to understand, only 15.4% examinees and 26.7% examiner agreed that the time was sufficient, 73.1% examinees and 100% examiner agreed that the instructions of each station was clear. It can be concluded from the study that online OSCE method was feasible to be conducted during pandemic, particularly, for clinical pharmacy skills. Adjustment should be done to ensure that the time allocation for each station is adequate.

Both the United Nations and the osce are working to improve their peace operations technologically. While the emphasis is more often placed on new collection tools (e.g., satellite imagery, uavs, night-vision tools, etc.), the challenge remains to exploit the imagery and the copious other data that has been collected. By examining the software and evolving methods used by UN operations and the osce Special Monitoring Mission in Ukraine, we evaluate two often neglected steps of the information/intelligence cycle: analysis and dissemination. Lessons are drawn from both UN and osce experience in war-torn locations. Both organizations still need to establish strong and effective data-analysis and -sharing systems within their missions, and to find better ways to share information with the conflicting parties, and with humanitarian partners.

Introduction Telemedicine is a growing practice with minimal training in US medical schools. Telemedicine OSCE (TeleOSCE) simulations allow students to practice this type of patient interaction in a standardized way. Methods The Insomnia–Rural TeleOSCE was implemented as part of a required clinical clerkship for students in their second, third, or fourth year of medical school. This case addressed a patient with depression in a medically underserved area. Students performed it as a formative experience and received immediate feedback. They then completed a survey to evaluate the experience. Results Students (n = 287) rated the quality of the experience 7.59 out of 10. Comments showed that 61 learners thought the TeleOSCE was a positive experience, 35 wanted more teaching about telemedicine, 28 improved their understanding of barriers to care, 25 expressed concern over minimal other training, 23 found the TeleOSCE important and challenging, 16 appreciated the differences between in-person and remote visits, and 15 wanted fewer distractions. Eight students worried about how they would be judged, five learned from the technical limitations, five requested more time, five were skeptical of the utility, and five saw telemedicine as triage. Discussion The TeleOSCE allows learners to gain exposure to telemedicine in a safe simulated teaching environment and assesses learner competencies. The TeleOSCE also improves students’ understanding of barriers to care and the utility of telemedicine. It logistically allows faculty to directly assess distance students on their clinical reasoning and patient communication skills.

Globalization of medical education is occurring at a rapid pace and many regions of the world are adapting curricula, teaching methods, and assessment tools from established programs. In the Middle East, the use of Objective Structured Clinical Examinations (OSCEs) is rare. The College of Pharmacy at Qatar University recently partnered with the University of Toronto and the Supreme Council of Health in Qatar to adapt policies and procedures of a Canadian-based OSCE as an exit-from-degree assessment for pharmacy students in Qatar. Despite many cultural and contextual barriers, the OSCE was implemented successfully and is now an integrated component of the pharmacy curriculum. This paper aims to provide insight into the adoption and implementation process by identifying four major cultural and contextual challenges associated with OSCEs: assessment tools, standardized actors, assessor calibration, and standard setting. Proposed solutions to the challenges are also given. Findings are relevant to international programs attempting to adapt OSCEs into their contexts, as well as Canadian programs facing increasing rates of cultural diversity within student and assessor populations.

BACKGROUND Objective Structured Clinical Examination (OSCE) is in its preliminary stage in the Indian Medical Curriculum. OSCE provides an established and reliable way of skill assessment in an objective and transparent manner. There is a need to rethink and reorganise our medical examination system in a more rational way so that much emphasis should be given to the formative assessment of the students rather than the traditional long/short case presentation and assessing theoretical knowledge. AIM To assess the clinical skills of undergraduate students of final year MBBS via 6 observed stations of OSCE and to compare the results with the traditional practical examination theoretical assessment. SETTINGS AND DESIGN Cross-sectional study conducted in the Department of Paediatrics of a tertiary level Medical College Hospital. MATERIALS AND METHODS The study was conducted on the 90 students of final year MBBS who have completed their one month posting in Paediatrics Department. Students were asked to undergo an OSCE examination at 6 observed stations and time of 5 minutes was allotted for each station. After that, they were asked to write down the answers of the same questions in the notebook provided and the results of the OSCE and written answers were then compared. RESULTS Only 12 (13.33%), 15 (16.66%), 9 (10%), 21 (23.33%), 4 (4.44%) and 6 (6.66%) of students performed all steps correctly respectively at 1st, 2nd, 3rd, 4th, 5th and 6th station. Significant improvement in the results was seen when OSCE scores were compared to the written results. CONCLUSION OSCE is the most preferred way of assessing clinical skills of students. More efforts should be made to integrate it into each and every institution’s medical curriculum.

Background The Objective Structured Clinical Examination (OSCE) is a widely used assessment tool used to evaluate the clinical and practical skills of UK medical students. It has been shown that participating in a mock OSCE can benefit students by reducing anxiety and increasing confidence in their summative assessment (Robinson et al, 2017). The current COVID-19 pandemic has made traditional face-to-face learning events, such as mock OSCEs, unviable and opens the door to online initiatives that effectively substitute in-person teaching. Objectives We set out to design and run a novel, peer-led virtual OSCE experience for paediatric undergraduate students. Our aim was two-fold. First was to produce a viable and reproducible way of running an online mock OSCE which provided our students with a simulation comparable to an inperson session. Second, was to develop this session using feedback from students about the design and content with an aim to increase their 'buy-in' and confidence in the process and ensure we provide a meaningful learning experience. Methods The first session was designed and run by a multidisciplinary group of educators. We devised an online learning session which comprised of peer-led, multi-role OSCE stations with integrated expert clinician feedback. Using the online system Blackboard Collaborate (BC) we were able to accommodate 120 students simultaneously in 3 sessions, each facilitated by an administrator, paediatric consultant and clinical teaching fellow. The students were split in to smaller 'break out rooms' of 4 and rotated through 10 OSCE stations of varying clinical scenarios. The students simulated the roles of candidate, actor and examiner, each giving a distinctive learning perspective. The clinicians observed stations and then ran feedback sessions at the end of each circuit. This was an opportunity for students to ask questions and for the clinicians to provide guidance based on their observation. Using Likert scales, we asked the students to rank their confidence at the beginning and end of the session and gathered qualitative feedback from faculty and students. Results Students gave overwhelmingly positive feedback. 14% vs 70% of students indicated a confident response about passing the OSCE in the pre-course vs post-course question. The average confidence score was 2.72 vs 3.69 for pre and post;a statistically significant change (p =

Construct: Authors examined the use of narrative comments for evaluation of student communications skills in a standardized, summative assessment (Objective Structured Clinical Examinations [OSCE]). Background: The use of narrative evaluations in workplace settings is gaining credibility as an assessment tool, but it is unknown how assessors convey judgments using narratives in high-stakes standardized assessments. The aim of this study was to explore constructs (i.e., performance dimensions), as well as linguistic strategies that assessors use to distinguish between poor and good students when writing narrative assessment comments of communication skills during an OSCE. Approach: Eighteen assessors from Qatar University were recruited to write narrative assessment comments of communication skills for 14 students completing a summative OSCE. Assessors scored overall communication performance on a 5-point scale. Narrative evaluations for the top and bottom 2 performing students for each station (based on communication scores) were analyzed for linguistic strategies and constructs that informed assessment decisions. Results: Seventy-two narrative evaluations with 662 comments were analyzed. Most comments (77%) were written without the use of politeness strategies. A further 22% of comments were hedged. Hedging was used more commonly in poor performers, compared to good performers (30% vs. 15%, respectively). Overarching constructs of confidence, adaptability, patient safety, and professionalism were key dimensions that characterized the narrative evaluations of students' performance. Conclusions: Results contribute to our understanding regarding the utility of narrative comments for summative assessment of communication skills. Assessors' comments could be characterized by the constructs of confidence, adaptability, patient safety, and professionalism when distinguishing between levels of student performance. Findings support the notion that judgments are arrived at by clustering sets of behaviors into overarching and meaningful constructs rather than by solely focusing on discrete behaviors. These results call for the development of better-anchored evaluation tools for communication assessment during OSCEs, constructively aligned with assessors' map of the reality of professional practice.

Objective structured clinical examinations (OSCEs) are a series of controlled, timed stations in which students demonstrate clinical skills. OSCEs are commonly used within health professions education to demonstrate competence, prepare for clinical education, and conduct program evaluation. The body of literature addressing the use of OSCEs in occupational therapy (OT) is growing; however, there are no available guidelines for developing an OSCE specific to the profession. The purpose of this paper is to describe the design of an OSCE for OT students prior to fieldwork placement. Twelve OT practitioners participated in a modified-Delphi method to generate possible OSCE scenarios. The authors developed a blueprint, designed items, implemented an OSCE, and collected data. Quantitative analysis suggests OSCEs to be valid assessment of clinical skills. Qualitative analysis suggests students perceive OSCEs to be stressful but valuable learning experiences. The authors are conducting additional analysis of outcome data, exploring the utility of OSCEs as a strategy to assess clinical competence in OT. Stakeholders concurred with the need to investigate the experience of learning through doing. The authors believe OSCEs could address universal professional rather than program specific clinical competencies.

The COVID-19 pandemic has impacted all walks of life including the education sector. The suspension of on-campus activities within universities in the last few months, in the middle of a semester, allowed pharmacy educators to capitalise on existing technology in teaching and assessment. Objective structured clinical exams (OSCEs) which usually require a face-to-face assessment of skills, posed a special challenge to educators in the health profession including pharmacy. Several teleconference programmes have been trialed to conduct online or virtual OSCEs. Lack of resources and human workforce compelled faculty to utilise MyDispense, a web-based community pharmacy simulation programme, for conducting web-based OSCEs. The students agreed that this was an overall better learning experience compared to the traditional face-to-face OSCE. There is a need for a robust evaluation of these alternate methods of OSCE in contrast with traditional face-to-face OSCE. The accumulation of more literature is expected to be seen that would highlight the feasibility of the online or virtual OSCE capitalising on advancements in technology. This coupled with the emerging role of tele- pharmacy, and less complicated skills needing to be assessed in pharmacy education compared to nursing and medication education, could this method of OSCE be the future of pharmacy education?

Qualitative research approach could be as important as quantitative one, particularly in medical education, as long as it meets the common goal of both—improving the quality of education. In contrary to the end—i.e. achieving the common goals, the means of both approaches of inquiry is different. Their dissimilarity in the means or process is not confined to data collection techniques, study designs or analysis methods; but, they also differ in assumptions about the world, reality, science and knowledge. Implicitly or explicitly, these assumptions are revealed in a researcher's discussion about philosophical assumptions and research paradigms. The researcher's inclination towards any of paradigms and assumption in light of the most common philosophical concepts such as ontology, epistemology and methodology results in choice of either of the dominant research paradigms to follow such as objectivism/positivism and interpretivisim/constructivism. This is common practice in the quantitative-qualitative dichotomy of research world disregarding the emerging mixed approach with predominantly pragmatism paradigm. Besides framing the methodology of the study, researcher's explicit description of philosophical assumptions and paradigms helps readers easily understand study findings. Many authors from both dominant traditions fail to describe this important aspect of the research in their published works. In our study, the ontological and epistemological assumptions led us choose interpretivist/constructivist paradigm and phenomenological qualitative approach with Collaizi's descriptive phenomenological analysis adapted to our context. The experience and lesson learned from the study found to be worse sharing in a modified and extended construct of methodology part. Therefore, this article deals with philosophical positions, research paradigms and traditions that led to the specific qualitative approach from the perspective of methodology part in our study about objective structure clinical examination (OSCE) experience in a medical department., Highlights • Qualitative research approach can be as important as quantitative approach. • A research approach can be determined by preference to certain research paradigm. • Major philosophical concepts in research are ontology, epistemology and methodology. • Disclosing one's research paradigm help research readers easily understand findings. • Collaizi's seven step descriptive phenomenology fits for our OSCE experience study.

Purpose : The Objective Structured Clinical Examination (OSCE) is a widely employed tool for measuring clinical competence. In the drive toward comprehensive assessment, OSCE stations and checklists may become increasingly complex. The objective of this study was to probe inter-observer reliability and observer accuracy as a function of OSCE checklist length. Method : Study participants included emergency physicians and senior residents in Emergency Medicine at Dalhousie University. Participants watched an identical series of four, scripted, standardized videos enacting 10-min OSCE stations and completed corresponding assessment checklists. Each participating observer was provided with a random combination of two 40-item and two 20-item checklists. A panel of physicians scored the scenarios through repeated video review to determine the ‘gold standard’ checklist scores. Results : Fifty-seven observers completed 228 assessment checklists. Mean observer accuracy ranged from 73 to 93% (14.6–18.7/20), with an overall accuracy of 86% (17.2/20), and inter-rater reliability range of 58–78%. After controlling for station and individual variation, no effect was observed regarding the number of checklist items on overall accuracy ( p =0.2305). Consistency in ratings was calculated using intraclass correlation coefficient and demonstrated no significant difference in consistency between the 20- and 40-item checklists (ranged from 0.432 to 0.781, p -values from 0.56 to 0.73). Conclusions : The addition of 20 checklist items to a core list of 20 items in an OSCE assessment checklist does not appear to impact observer accuracy or inter-rater reliability. Keywords: medical education; assessment; OSCE; reliability; metrics (Published: 20 October 2015) Citation: Med Educ Online 2015, 20: 29242 - http://dx.doi.org/10.3402/meo.v20.29242

Background and objectives Acute kidney replacement therapy (KRT) prescription is a critical nephrology skill. We administered a formative objective structured clinical examination (OSCE) to nephrology fellows to assess acute KRT medical knowledge, patient care, and systems-based practice competencies. Design, setting, participants, & measurements Prospective cohort study of an educational test using the unified model of construct validity. We tested 117 fellows: 25 (four programs) in 2016 and 92 (15 programs) in 2017; 51 first-year and 66 second-year fellows. Using institutional protocols and order sets, fellows wrote orders and answered open-ended questions on a three-scenario OSCE, previously validated by board-certified, practicing clinical nephrologists. Outcomes were overall and scenario pass percentage and score; percent correctly answering predetermined, evidence-based questions; second-year score correlation with in-training examination score; and satisfaction survey. Results A total of 76% passed scenario 1 (acute continuous RRT): 92% prescribed a ≥20 ml/kg per hour effluent dose; 63% estimated clearance as effluent volume. Forty-two percent passed scenario 2 (maintenance dialysis initiation); 75% correctly prescribed 3–4 mEq/L K+ dialysate and 12% identified the two absolute, urgent indications for maintenance dialysis initiation (uremic encephalopathy and pericarditis). Six percent passed scenario 3 (acute life-threatening hyperkalemia); 20% checked for rebound hyperkalemia with two separate blood draws. Eighty-three percent correctly withheld intravenous sodium bicarbonate for acute hyperkalemia in a nonacidotic, volume-overloaded patient on maintenance dialysis, and 32% passed overall. Second-year versus first-year fellow overall score was 44.4±4 versus 42.7±5 (one-tailed P=0.02), with 39% versus 24% passing (P=0.08). Second-year in-training examination and OSCE scores were not significantly correlated (r=0.15; P=0.26). Seventy-seven percent of fellows agreed the OSCE was useful in assessing “proficiency in ordering” acute KRT. Limitations include lack of a validated criterion test, and unfamiliarity with open-ended question format. Conclusions The OSCE can provide quantitative data for formative Accreditation Council for Graduate Medical Education competency assessments and identify opportunities for dialysis curriculum development. Podcast This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2019_08_08_CJASNPodcast_19_09_.mp3

Background.An Objective Structured Clinical Examination (OSCE) is an effective means for clinical evaluation related to clinical competence. Historically, clinical assessment is based on direct observation which can be rooted in subjectivity. Evidence is minimal regarding psychometric properties of an OSCE in undergraduate mental health nursing education, although established as a valid measure of clinical competence. Method.A pilot study was conducted with a convenience sample of 13 sixth semester nursing students to evaluate the validity and reliability of an OSCE framework designed to assess undergraduate mental health nursing students’ clinical competence. The research questions asked: What are the psychometric properties of a mental health OSCE developed for undergraduate nursing education? How do students perceive the OSCE? Results.Preliminary validity and reliability measures were established, including content and criterion validities and inter-rater reliability. Students perceived the OSCE as both a beneficial and challenging learning experience. Conclusion.The OSCE was initially established as a valid, reliable tool for the assessment of clinical competence in undergraduate mental health nursing education. This evaluation method may be used to objectively assess mental health nursing knowledge, skills, and attitudes in conjunction with existing clinical assessment methods to provide a valid, reliable measure of clinical competence. More testing is needed.

Issue of high-quality vocational training is crucial for any sphere of activity, health care is not an exception. Modern trends of socioeconomic development require professionals, which use multi-disciplinary and highly competitive approaches. Thus, improving an educational process and process of assessing training of medical university graduates is an essential element of modern reformation of health care and medical education. Implementation of newest world educational technologies and methods of learning assessment is key to its improvement. Methodology. The methodological basis of the paper is the complex of methods, including methods of scientific cognition, analysis and synthesis, systematization and scientific abstraction. The informational basis of the conducted research is the scientific works of the domestic and foreign scientists in the sphere of improving higher education on the basis of using skill approach.Results. In the paper organizational and managerial aspects of implementing objective structural clinical exam (OSCE) into the process to the state examination of medical graduates are considered. Process of planning and preparation for state attestation in OSCE format is worked out in detail. We consider use of principles of teamwork and project management as the main advantage of this process, what considerably increases the quality of assessment process. Objective structural clinical exam is viewed by authors as a tool for upgrading the quality of educational process in higher medical school.Practical importance of this scientific research results lies in defining principles of planning and preparation process for implementing skill approach into the educational and assessment process of medical graduates. The proposed format of exam can be used not just in medical education, but in other humanitarian spheres of education. Further research directions are aimed at study of sociological and psychological research of usage for OSCE format in state examination process, and also assessment of its effectiveness.

Background The purpose of this study was to develop an objective, content-valid, and reliable assessment method for Kampo medicine using an objective structured clinical examination (OSCE) for the assessment of clinical competence in Kampo medicine. Methods We developed a blueprint followed by a list of 47 assessment items and three task scenarios related to clinical competence in Kampo medicine. An eight-member test committee checked the relevance of the assessment items on a Likert scale. We calculated a content validity index and content validity ratio, and used the Angoff method to set the passing threshold. We trained a total of nine simulated patients with three assigned to each scenario. We conducted an OSCE for 11 candidates with varying medical abilities, and conducted three stations per person, which were evaluated by one evaluator in one room by direct observation. We used video recordings to test the inter-rater reliability of the three raters. We used the test results to verify the reliability of the assessment chart. Results The inter-rater reliability (intraclass correlation coefficient [2,1]) was 0.973. The reliability of the assessment chart for each scenario (Cronbach’s α) was 0.86, 0.89, and 0.85 for Scenarios 1, 2, and 3, respectively. The reliability of the assessment chart for the whole OSCE (Cronbach’s α) was 0.90. Conclusions We developed a content-valid new OSCE assessment method for Kampo medicine and obtained high inter-rater and test reliabilities. Our findings suggest that this is one of the most reliable evaluation methods for assessing clinical competence in Kampo medicine.

Introduction: Nurses are trained with specific clinical skills, and objective structured clinical examination (OSCE) could be a better approach to assess clinical skills of nursing students. Materials and Methods: A comparative study was conducted by observational checklist regarding antenatal care and opinionnaire on the usefulness of OSCE and tradition evaluation method (TEM) was used to assess the clinical skills and to get opinion. Results: The mean score of OSCE was more than TEM and the difference was statistically significant (P < 0.001). The opinion of students regarding the usefulness of OSCE was higher than TEM. Conclusions: The study concluded that implementing OSCE will overweigh the advantages of the TEM.

From the mid-2000s on, new types of security challenges have emerged at a global level. Their prevention, management and recovery, given their characteristics, is a serious challenge for the countries. Cybersecurity challenges require special attention and close interaction both at national and international level. In this paper the author presents the highlights of OSCE and V4 cooperation on cyber defence.

With the wide application of the OSCE in the field of pharmacy, the development of e-assessment in OSCE is a predictable trend. However, the feasibility of its practical application and the acceptance of examiners who are accustomed to using traditional paper-based methods are worthy of being discussed. The e-assessment system (EAS) was constructed in this study and used in the examination process. Examiner satisfaction and changes in acceptance of EAS were evaluated. Examiners showed high recognition for the advantages of EAS in data processing, but EAS obviously made the examiner more nervous than the paper-based method. After repeated use of the e-OSCE system, the examiner’s satisfaction and acceptance significantly improved, which showed that there was a certain correlation between examiner’s familiarity with the assessment method and their acceptance. Besides, EAS has great advantages over traditional paper-based methods, and it is feasible in clinical practice examination of pharmacy education.

[Purpose] The difficulty levels of level-2 OSCE (examination and measurement skills) items were examined, with a view to providing reference data for the determination of students’ skills. [Subjects] A total of 284 graduates of physical (PT) and occupational (OT) therapy classes of 2011 (59 and 40), 2012 (46 and 36), and 2013 (61 and 42, respectively) were studied, with PT or OT faculty members as OSCE examiners and a simulated patient. [Methods] Scores for 11 level-2 OSCE items were compared between before and after clinical training. [Results] Scores markedly increased after clinical training. On comparison among the items, scores for sensory examination were the highest, and those for interviews were the lowest. [Conclusion] The results of this study indicate the necessity of considering an appropriate combination of different difficulty levels when adopting OSCE-based educational approaches.

Background: A uniform and reliable clinical and practical evaluation of medical students is always desirable. The method of objective structured practical examination (OSPE)/objective structured clinical examination (OSCE) tests the students on what they can do rather than what they know. This method is now believed to meet the deficiencies of the conventional system of practical/clinical examination. Aims: The aim of the present study is to take the perceptions and opinions of the medical education training (MET)-trained faculty regarding OSCE/OSPE, and their interest in introducing it as an assessment tool. Materials and Methods: This is a detailed, structured questionnaire study carried out in Government Medical College, Ananthapuramu, Andhra Pradesh, India in the period from May 2014 to July 2014 and was conducted on 50 members of MET-trained faculty. Results: Among the faculty, 96% agreed that it was a good and useful learning methodology; 98% agreed that it was a good assessment tool; 100% agreed that it assessed all the three domains; 80% agreed that it was a transparent, comprehensive, and fair assessment tool, 90% were of the opinion that it was mentally and physically taxing and required additional faculty hours to construct, review, and implement the arrangement of stations initially; 100% agreed that the combination with classical practical examination (CPE) produced good results; and 84% responded that it could partially replace CPE. Conclusion: We conclude that any change must first be thoroughly evaluated before it can uproot a well-defined and time-tested assessment methodology. OSCE/OSPE has several distinct advantages. In the current situation, it may be realistic to expect its inclusion in the evaluation schedule of universities and in day-to-day assessment of students to improve their clinical competence.

The Objective Structured Clinical Examination (OSCE) is an assessment tool used to objectively evaluate clinical competence in medical schools and, more recently, in the nursing profession as well. However, few studies have been conducted to elicit the views of dental students in KSA regarding the OSCE. The present study was designed to explore, evaluate, and analyse students' perceptions of the OSCE and to explore the strengths and weaknesses of this assessment tool as perceived by dental students.This was a cross-sectional analytical observational study using a survey design. It took place in the College of Dentistry, Taibah University, KSA. The study sample consisted of third, fourth, and fifth-year students who took the OSCE assessment during their studies.Of 138 invited students, 119 responded (response rate of 86.2%). Almost half the students (47.1%) agreed that the OSCE exam was fair, while 19.3% agreed that a broad range of clinical skills were included in the OSCE exam. A low percentage of students believed to a great extent that the scores were standardised; however, the practicality and usefulness of the OSCE was questioned. Students perceived that issues pertaining to personality, ethnicity, and gender would not impact the scores.The findings of this study indicated that the OSCE is a meaningful and fair assessment tool for clinical skills.الاختبارات السريرية المبنية موضوعيا هي أداة تقييم مستخدمة لتقييم الكفاءة السريرية بشكل موضوعي في كليات الطب، ومؤخرا في مهنة التمريض أيضا. إلا أنه لم تجرَ سوى دراسات قليلة للحصول على وجهات نظر الطلاب حول الاختبارات السريرية المبنية موضوعيا في كليات طب الأسنان في المملكة العربية السعودية. تم تصميم الدراسة الحالية لاستكشاف وتقييم وتحليل تصورات الطلاب حول الاختبارات السريرية المبنية موضوعيا، وكذلك لاستكشاف جوانب القوة والضعف لأداة التقييم هذه كما يراها طلاب طب الأسنان.هذه دراسة تحليلية مقطعية مستعرضة باستخدام تصميم مسحي. تمت الدراسة في كلية طب الأسنان بجامعة طيبة في المملكة العربية السعودية. تكونت عينة البحث من طلاب السنوات الثالثة والرابعة والخامسة الذين خضعوا لتقييم الاختبارات السريرية المبنية موضوعيا خلال دراستهم.من بين ١٣٨ طالبا مدعوا للمشاركة، استجاب ١١٩ (بمعدل استجابة ٨٦.٢٪). وافق ما يقارب نصف الطلاب (٤٧.١٪) على أن الاختبارات السريرية المبنية موضوعيا كانت عادلة، في حين وافق ١٩.٣٪ من الطلاب على أن مجموعة واسعة من المهارات السريرية أُدرجت في الاختبارات السريرية المبنية موضوعيا. واعتقدت نسبة منخفضة من الطلاب بأن النتائج كانت موحدة إلى حد كبير في حين كانت هناك تساؤلات حول ما إن كانت هذه الاختبارات عملية ومفيدة. رأى الطلاب أن القضايا المتعلقة بالشخصية والعِرق والجنس لن تؤثر على الدرجات.خلصت نتائج هذه الدراسة إلى أن الاختبارات السريرية المبنية موضوعيا هي أداة تقييم عادلة وذات معنى بالنسبة للمهارات السريرية.