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Background and Purpose: Upon graduation and licensing, pharmacists work very closely with pharmacy technicians. Despite this, opportunities for learning together as students are limited. We developed and implemented a pilot intraprofessional event for pharmacy and pharmacy technician students. The purpose of this study was to evaluate the perceived value and learner confidence through analysis of participant feedback., Education Activity and Setting: Pharmacy students from the University of Waterloo School of Pharmacy and pharmacy technician students from Lambton College participated in an intraprofessional event that included a three-station practice objective structured clinical exam (OSCE) and a case discussion regarding a methadone dispensing error, followed by a facilitated debrief. Upon completion of the event, students were invited to complete an online feedback questionnaire., Findings: Twenty-one pharmacy students and 22 pharmacy technician students participated in the event. Twenty-one students completed the questionnaire, for a response rate of 49%. The majority of respondents agreed or strongly agreed that the event enhanced learning and confidence in working together to provide interprofessional care. Students seemed to find the OSCE to be particularly valuable. Feedback suggestions for improvement indicated a desire for more activities and time allocated to the event., Summary: We designed and implemented a pilot intraprofessional event that was well-received by pharmacy students and pharmacy technician students. This supports the development of future similar events., Competing Interests: Declaration of competing interest None., (Copyright © 2019 Elsevier Inc. All rights reserved.)

An objective structured clinical examination (OSCE) has been recognised as a reliable but workload-intensive assessment method across health sciences studies. Though a variety of digital marking tools have been employed to improve marking and feedback provision for OSCEs, many of these require specialist software or maintenance. This pilot study examines the development and trialling of Microsoft Forms as a marking and feedback instrument for an OSCE within a Sport and Exercise Therapy module. This study aims to assess whether the use of a non-specialist digital tool, such as Microsoft Forms, might be able overcome limitations in current assessment procedures and ultimately provide a more effective method for marking and feedback provision for an OSCE. Results from OSCE examiners (N = 8) and students (N = 30) who participated in the pilot indicate that Microsoft Forms does have the potential to provide a more effective experience for examiners and ultimately improve upon feedback provision for students when compared with a paper-based marking tool. However, concerns around the form’s ease-of-use may ultimately influence its adoption as a marking instrument above current paper-based methods.

Santé Numérique Rouen-Nice (SaNuRN; "Digital Health Rouen-Nice" in English) is a 5-year project by the University of Rouen Normandy (URN) and Côte d'Azur University (CAU) consortium to optimize digital health education for medical and paramedical students, professionals, and administrators. The project includes a skills framework, training modules, and teaching resources. In 2027, SaNuRN is expected to train a significant portion of the 400,000 health and paramedical students at the French national level. Our purpose is to give a synopsis of the SaNuRN initiative, emphasizing its novel educational methods and how they will enhance the delivery of digital health education. Our goals include showcasing SaNuRN as a comprehensive program consisting of a proficiency framework, instructional modules, and educational materials and explaining how SaNuRN is implemented in the participating academic institutions. SaNuRN is aimed at educating and training health and paramedical students in digital health. The project is a cooperative effort between URN and CAU, covering 4 French departments. It is based on the French National Referential on Digital Health (FNRDH), which defines the skills and competencies to be acquired and validated by every student in the health, paramedical, and social professions curricula. The SaNuRN team is currently adapting the existing URN and CAU syllabi to FNRDH and developing short-duration video capsules of 20-30 minutes to teach all the relevant material. The project aims to ensure that the largest student population earns the necessary skills, and it has developed a 2-tier system involving facilitators who will enable the efficient expansion of the project's educational outreach and support the students in learning the needed material efficiently. With a focus on real-world scenarios and innovative teaching activities integrating telemedicine devices and virtual professionals, SaNuRN is committed to enabling continuous learning for health care professionals in clinical practice. The SaNuRN team introduced new ways of evaluating health care professionals by shifting from a knowledge-based to a competencies-based evaluation, aligning with the Miller teaching pyramid and using the Objective Structured Clinical Examination and Script Concordance Test in digital health education. Drawing on the expertise of URN, CAU, and their public health and digital research laboratories and partners, SaNuRN represents a platform for continuous innovation, including telemedicine training and living labs with virtual and interactive professional activities. SaNuRN provides a comprehensive, personalized, 30-hour training package for health and paramedical students, addressing all 70 FNRDH competencies. The project is enhanced using artificial intelligence and natural language processing to create virtual patients and professionals for digital health care simulation. SaNuRN teaching materials are open access. It collaborates with academic institutions worldwide to develop educational material on digital health in English and multilingual formats. SaNuRN offers a practical and persuasive training approach to meet the current digital health education requirements. [ABSTRACT FROM AUTHOR]

Objectives: To describe the implementation and assess whether an objective structured clinical examination (OSCE) is a viable assessment tool for testing Antimicrobial Stewardship (AMS) principles. Methods: A three-station OSCE set in a hospital and community pharmacy was designed and mapped to the World Health Organisation's AMS intervention practical guide. This OSCE comprised 39 unique cases and was implemented across two campuses (Malaysia and Australia) at one institute. Stations were 8 min long and consisted of problem-solving and applying AMS principles to drug therapy management (Station 1), counselling on key antimicrobials (Station 2) or managing infectious diseases in primary care (Station 3). Primary outcome measure to assess viability was the proportion of students who were able to pass each case. Key findings: Other than three cases with pass rates of 50, 52.8 and 66. 7%, all cases had pass rates of 75% or more. Students were most confident with referral to medical practitioner cases and switching from intravenous to oral or empirical to directed therapy. Conclusions: An AMS-based OSCE is a viable assessment tool in pharmacy education. Further research should explore whether similar assessments can help improve students' confidence at recognising opportunities for AMS intervention in the workplace. [ABSTRACT FROM AUTHOR]

Abstract Introduction Exchange transfusion is the treatment of choice for patients with severe hyperbilirubinemia who do not respond to phototherapy. This procedure is highly complex and requires substantial expertise to perform, however it´s not done frequently enough to guarantee adequate training. Traditional learning scenarios do not have a space reserved for teaching this procedure or an instrument that fully and objectively evaluates the skills that a professional must acquire. Objectives The purpose was to construct and evaluate the INEXTUS instrument´s validity evidence relevant to internal structure, in a simulated scenario through the performance of an objective structured clinical exam (OSCE). Materials and methods The Delphi consensus methodology was utilized to design the instrument; six experts participated through three rounds using the Google Forms platform. The categories and items previously obtained were subjected to validation by nine experts through a dichotomous survey. Prior to data collection, the evaluators were trained through a pilot test with 10 medical students. Subsequently, all residents of a paediatric programme were evaluated through the OSCE methodology in a simulated scenario, with 6 stations, of a clinical case of a new-born with an explicit need for exchange transfusion. During their participation in the scenario, the residents were first evaluated with the instrument developed. Additionally, audio and video filming of all students who participated was performed with the aim of conducting a second evaluation two weeks after the first four evaluators participated. Results The final INEXTUS instrument consists of 46 subitems grouped into 23 items divided into 6 categories, demonstrating an inter-rater intraclass correlation coefficient of 0.96 (95% CI 0.94, 0.98 p-value

Background: The objective structured clinical examination (OSCE) is broadly applied to assess the clinical competence of medical students. Despite the widespread use of the OSCE, the scoring methods used in this test can be a potential source of measurement error and affect the accuracy of the scores.Objectives: This study was aimed to investigate the checklist and global rating form scoring methods in OSCE stations.Methods: In this narrative review study, the keywords “OSCE”, “Reliability”, “Validity”, “Utility”, “Global”, and “Checklist” were searched in Scopus, Web of Science, EMBASE, and Medline databases between 2010 and March 2021. After removing duplicates and considering the direct relationship of the articles to the study’s objectives, full-text articles were reviewed.Results: In total , 30 articles were retrived, of which 19 cases were finalized. The results of retrived articles were divided into five categories, including the correlation of scores, subjectivity and objectivity, validity and reliability, ease of use, and the need to train assessors, and the assessed capabilities in scoring by checklists and global rating forms.Conclusion: There is widespread disagreement on the superiority of checklist over global rating form. It is recommended that both scoring methods be used in combination to achieve maximum reliability and validity, to assess student skills based on objective criteria, to avoid applying assessor mentality, and to gain maximum validity in test results.

Abdulrahman Alshaya,1– 3 Shuroug Alowais,1– 3 Shmeylan Alharbi,1– 3 Abdulkareem Albekairy1– 3 1College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi ArabiaCorrespondence: Abdulrahman Alshaya Email alshayaab@gmail.comPurpose: Objective structured clinical examination (OSCE) is an effective tool for learners’ assessment that require hands-on performance. During the COVID-era, many schools decided to minimize all forms of in-person communication between faculty members and students to mitigate the risk of COVID-19 transmission. We aimed to describe our experience in conducting physical OSCEs during the COVID-19 era. We also reported students’ satisfaction during this time.Materials and Methods: Descriptive cohort study by comparing the 2019– 2020 cohort to the 2020– 2021 cohort. Descriptive framework for the feasibility of conducting physical OSCEs in the college of pharmacy at King Saudi Bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia.Results: There were no reported cases of COVID-19 transmission among students and faculty members during the OSCE assessments. Overall, the 2020– 2021 cohort reported increased satisfaction compared to their peers in the 2019– 2020 cohort; p < 0.05. We observed an increased need for coordination to ensure students’ and staff safety while adopting machine learning applications as a public measure when possible.Conclusion: Owing to the implementation of clear and strong measures, it was feasible to conduct OSCEs, and there were no reported cases of COVID-19 transmission. Other universities may adopt a similar approach so as to provide an optimal educational experience while ensuring the safety of their staff and faculty.Keywords: OSCE, education, COVID-19, simulation, teaching

Abstract 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 remote Objective Structured Clinical Examination (OSCE) is a cornerstone of medical education, enabling structured and objective assessment of clinical skills, communication, and patient-centered care. However, its widespread adoption has introduced challenges related to cost-effectiveness and efficient use of rater resources. Traditional double scoring (DS) ensures reliability but is labor-intensive and costly, especially in large-scale assessments. To address these challenges, this study introduces Targeted Double Scoring (TDS), a novel methodology that selectively applies DS to specific score ranges, particularly those near the pass/fail threshold. The study was conducted using data from a pilot remote OSCE administered to 550 clinical medicine undergraduates in China. The OSCE consisted of three stations: Clinical Reasoning (CR), Physical Examination (PE), and Fundamental Skills (FS). Each station was scored remotely by two raters, with a cut-off score of 60 out of 100. The TDS methodology was modeled based on the OSCEs DS design and fitted with scoring data. A decision-theoretic approach identified optimal Critical Score Ranges (CSRs) for targeted double scoring, balancing reliability and cost-effectiveness. The findings show that TDS significantly reduces rater workload and costs while maintaining high reliability and fairness. For instance, TDS achieved up to 70% cost savings compared to traditional DS under certain configurations. The study also highlights the flexibility of TDS, which can be tailored to different OSCE designs and scoring rubrics. These results have broad implications for medical education, especially in resource-constrained settings where optimizing assessment efficiency is critical. This study provides a practical solution to the cost-related challenges of remote OSCEs and offers a framework for adopting TDS in assessments. By focusing raters on critical score ranges, TDS maintains rigorous and fair evaluations without overburdening faculty or exceeding budgets. Future research should explore TDS scalability and its integration with emerging technologies like artificial intelligence to enhance efficiency and reliability.

Abstract Background Ultrasound education is propagated already during medical school due to its diagnostic importance. Courses are usually supervised by experienced faculty staff (FS) with patient bedside examinations or students among each other but often overbooked due to limited FS availability. To overcome this barrier, use of teaching videos may be advantageous. Likewise, peer teaching concepts solely with trained student tutors have shown to be feasible and effective. The aim was to evaluate 1) objective learning outcomes of a combined video-based, student-tutor (ViST) as compared to a FS-led course without media support, 2) acceptance and subjective learning success of the videos. Methods Two ultrasound teaching videos for basic and advanced abdominal ultrasound (AU) and transthoracic echocardiography (TTE) were produced and six students trained as tutors. Fourth-year medical students (N = 96) were randomized to either the ViST- or FS course (6 students per tutor). Learning objectives were defined equally for both courses. Acquired practical basic and advanced ultrasound skills were tested in an objective structured clinical examination (OSCE) using modified validated scoring sheets with a maximum total score of 40 points. Acceptance and subjective learning success of both videos were evaluated by questionnaires based on Kirkpatrick’s evaluation model with scale-rated closed and open questions. Results 79 of 96 medical students completed the OSCE and 77 could be finally analyzed. There was no significant difference in the mean total point score of 31.3 in the ViST (N = 42) and 32.7 in the FS course (N = 35, P = 0.31) or in any of the examined basic or advanced ultrasound skill subtasks. Of the 42 ViST participants, 29 completed the AU and 27 the TTE video questionnaire. Acceptance and subjective learning success of both videos was rated positively in 14–52% and 48–88% of the rated responses to each category, respectively. Attendance of either the student or faculty tutor was deemed necessary in addition to the videos. Conclusions A ViST versus FS teaching concept was able to effectively teach undergraduate students in AU and TTE, albeit acceptance of the teaching videos alone was limited. However, the ViST concept has the potential to increase course availability and FS resource allocation.

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. [ABSTRACT FROM AUTHOR]

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.

Introduction Child neurology has unique challenges in communication due to complex disorders with a wide array of prognoses and treatments. Effective communication is teachable through deliberate practice and coaching. Objective structured clinical exams (OSCEs) are one method of providing practice while assessing communication skills. Yet OSCEs have not been reported for child neurology residents. Methods We developed simulated clinical cases centering on communication skills for child neurology residents, all with challenging clinical scenarios (e.g., disclosure of a medical error, psychogenic nonepileptic events). Standardized patients (SPs) portrayed the parents of pediatric patients and, in some scenarios, an adolescent patient. We used a modified Gap-Kalamazoo Communication Skills Assessment Form to assess communication skills. The assessment was completed by faculty, SPs, and the resident, and we measured agreement among raters. Residents were surveyed afterward regarding their experience. Results Nine cases were developed and piloted. A total of 27 unique resident-case encounters with 16 individual trainees occurred over three annual implementations. Scores on the 360-degree assessment of communication skills showed that residents overwhelmingly underassessed their skills compared to other rater groups. Among 18 responses on the post-OSCE survey, the majority (77%) found the experience useful to their education and felt that the feedback from the SPs was helpful (61%) and the case portrayals were realistic (89%). Discussion We implemented simulated cases for assessment and formative feedback on communication skills for child neurology residents. We provide a blueprint to develop this educational activity in other programs.

Introduction Residents have been known to report a lack of self-efficacy in their ability to provide care for limited English proficiency (LEP) patients. Interpreters must be utilized to help navigate these patient encounters, but many institutions do not have a curriculum focused on utilizing interpreters effectively. Methods We created a 3-hour workshop for physician learners working with the pediatric population. It included a panel discussion, best-practices presentation, video demonstration, observing scenarios, and pre- and postworkshop objective structured clinical exams (OSCEs). The first OSCE introduced learners to a scenario (4-day-old with jaundice with an LEP parent) where interpreter use was imperative. The second OSCE allowed learners to perform another case (12-year-old with an abscess with an LEP parent) and practice newly obtained skills from the workshop. Both OSCEs were scored using a 16-item yes/no checklist. All pediatric residents filled out an eight-item survey to evaluate the workshop; a subset of that group performed the pre- and postworkshop OSCEs. Results Forty pediatric residents attended the workshop and completed the survey. The workshop was well received, with the majority of residents stating they would change their current interpreter usage practices. Ten pediatric residents performed the pre- and postworkshop OSCEs; all improved their scores. Discussion The workshop was effective in improving how residents navigated LEP encounters. It is applicable to learners of all levels who want to improve their communication skills to provide better care for LEP patients and can be tailored to fit the needs of a specific institution.

Objective: To use 360-degree evaluations within an Observed Structured Clinical Examination (OSCE) to assess medical student comfort level and communication skills with intimate partner violence (IPV) patients.Methods: We assessed a cohort of fourth year medical students’ performance using an IPV standardized patient (SP) encounter in an OSCE. Blinded pre- and post-tests determined the students’ knowledge and comfort level with core IPV assessment. Students, SPs and investigators completed a 360-degree evaluation that focused on each student’s communication and competency skills. We computed frequencies, means and correlations.Results: Forty-one students participated in the SP exercise during three separate evaluation periods. Results noted insignificant increase in students’ comfort level pre-test (2.7) and post-test (2.9). Although 88% of students screened for IPV and 98% asked about the injury, only 39% asked about verbal abuse, 17% asked if the patient had a safety plan, and 13% communicated to the patient that IPV is illegal. Using Likert scoring on the competency and overall evaluation (1, very poor and 5, very good), the mean score for each evaluator was 4.1 (competency) and 3.7 (overall). The correlations between trainee comfort level and the specific competencies of patient care, communication skill and professionalism were positive and significant (p

Background: Ultrasound education is propagated already during medical school due to its diagnostic importance. Courses are usually supervised by experienced faculty staff (FS) with patient bedside examinations or students among each other but often overbooked due to limited FS availability. To overcome this barrier, use of teaching videos may be advantageous. Likewise, peer teaching concepts solely with trained student tutors have shown to be feasible and effective. The aim was to evaluate 1) objective learning outcomes of a combined video-based, student-tutor (ViST) as compared to a FS-led course without media support, 2) acceptance and subjective learning success of the videos. Methods: Two ultrasound teaching videos for basic and advanced abdominal ultrasound (AU) and transthoracic echocardiography (TTE) were produced and six students trained as tutors. Fourth-year medical students (N = 96) were randomized to either the ViST- or FS course (6 students per tutor). Learning objectives were defined equally for both courses. Acquired practical basic and advanced ultrasound skills were tested in an objective structured clinical examination (OSCE) using modified validated scoring sheets with a maximum total score of 40 points. Acceptance and subjective learning success of both videos were evaluated by questionnaires based on Kirkpatrick's evaluation model with scale-rated closed and open questions. Results: 79 of 96 medical students completed the OSCE and 77 could be finally analyzed. There was no significant difference in the mean total point score of 31.3 in the ViST (N = 42) and 32.7 in the FS course (N = 35, P = 0.31) or in any of the examined basic or advanced ultrasound skill subtasks. Of the 42 ViST participants, 29 completed the AU and 27 the TTE video questionnaire. Acceptance and subjective learning success of both videos was rated positively in 14–52% and 48–88% of the rated responses to each category, respectively. Attendance of either the student or faculty tutor was deemed necessary in addition to the videos. Conclusions: A ViST versus FS teaching concept was able to effectively teach undergraduate students in AU and TTE, albeit acceptance of the teaching videos alone was limited. However, the ViST concept has the potential to increase course availability and FS resource allocation. [ABSTRACT FROM AUTHOR]

ObjectiveTo assess the effectiveness of an experimental curriculum on teaching first-year medical students the musculoskeletal exam as compared to a traditional curriculum.BackgroundMusculoskeletal complaints are common in the primary care setting. Practitioners are often deficient in examination skills and knowledge regarding musculoskeletal diseases. There is a lack of uniformity regarding how to teach the musculoskeletal examination among sub-specialists. We propose a novel web-based approach to teaching the musculoskeletal exam that is enhanced by peer practice with pathophysiology-focused cases. We sought to assess the effectiveness of an innovative musculoskeletal curriculum on the knowledge and skills of first-year medical students related to musculoskeletal physical diagnosis as compared to a traditional curriculum. The secondary purpose of this study was to assess satisfaction of students and preceptors exposed to this teaching method.MethodsThis quasi-experimental study was conducted at a single LCME-accredited medical school and included a convenience sample from 2 consecutive classes of medical students during the musculoskeletal portion of their physical diagnosis class. We conducted a needs assessment of the traditional curriculum used to teach musculoskeletal examination. The needs assessment informed the development of an experimental curriculum. One class (control group) received the traditional curriculum while the second class (experimental group) received the experimental curriculum, consisting of a web-based musculoskeletal tutorial, pathophysiology-focused cases, and facilitator preparation. We used multiple-choice questions and musculoskeletal OSCE scores to assess differences between knowledge and skills in the 2 groups.ResultsThe sample consisted of 140 students in each medical school class. There were no statistically significant differences between the 2 groups. One hundred seven students from the control group and 120 students from the experimental group took the multiple-choice examination. The average score was 66% (95% CI= 59.7-72.3) for the control group and 66% (95% CI = 60.5-71.5) for the experimental group. There was no difference between the median musculoskeletal OSCE scores between the 2 groups. The experimental group was satisfied with the new teaching method and gained the additional benefit of a persistent resource.ConclusionsThis web-based experimental curriculum was as effective as the traditional curriculum for teaching the musculoskeletal exam. Additionally, users were satisfied with the web-based training and benefited from a persistent resource.

Shayaan Akhtar, Musab Hasan, Haseeb Iqbal Faculty of Medicine, Department of Medicine, Imperial College School of Medicine, London, UKCorrespondence: Shayaan AkhtarFaculty of Medicine, Imperial College London, Sir Alexander Fleming Building, Imperial College Road, London, SW7 2AZ, UKEmail shayaan.akhtar16@imperial.ac.uk View the original paper by Dr Ganesananthan and colleagues

آزمون بالینی با ساختار عینی(OSCE)، یکی از بهترین روش های سنجش می باشد که می‌تواند جنبه‌های مهارت بالینی دانشجو را به صورت ساختار یافته بررسی کند. این مطالعه به منظور ارزیابی دیدگاه کلی دانشجویان درباره یOSCE ، تخمین میزان پذیرش فرایند از طرف دانشجویان و ایجاد بازخورد در جهت بهتر شدن ارزیابی های آتی انجام شد. این مطالعه ی توصیفی-تحلیلی از نوع مقطعی روی دانشجویان (21نفر) سال چهارم دندانپزشکی قزوین در سال تحصیلی 92-91در دو نیمسال انجام شد.امتحان شامل 8 ایستگاه بود که مهارت هایی از جمله تشخیص لام-های میکروسکوپی، توصیف نمای هیستوپاتولوژی، استفاده از تصاویر رایانه ای هیستوپاتولوژیک، معرفی مورد جهت تشخیص افتراقی و طرح درمان را در برمی گرفت. طی یک روز در هرنیمسال با نظارت دو نفر از اعضای هیأت علمی با رعایت اصول ارزیابی آزمون آسکی در بخش آسیب شناسی فک و صورت دانشکده ی دندانپزشکی قزوین انجام گرفت. نمرات دانشجویان توسط نرم افزار SPSS- 16جمع آوری و به کمک میانگین و درصد فراوانی تجزیه و تحلیل گردید. برای مقایسه ی نمرات دانشجویان در دو آزمون از روش تی تست استفاده گردید.(p

Introduction The ethical skills fundamental to medical practice encompass a large portion of the Accreditation Council for Graduate Medical Education (ACGME) professionalism milestones. Yet many ethical practices are difficult to reduce to milestone frameworks given the variety of traditions of moral reasoning that clinician-trainees and their colleagues might properly employ. Methods We developed an observed standardized clinical examination (OSCE) simulation with standardized patients to assess the ethical skills captured in professionalism milestones in pediatrics. The OSCE included four vignettes based on actual cases that presented problems without a correct answer. Residents discussed ethically challenging issues with standardized patients and were evaluated on specific ethical tenets contained in the professionalism milestones. Our assessment guide for preceptors offered content for debriefing and assessment. We piloted this OSCE with seven preceptors and 17 pediatric residents in two different medical settings. Results Residents all agreed that the four cases were realistic. All but two residents agreed that OSCEs like this one are an appropriate or objective way of assessing the ACGME professionalism milestones. All preceptors reported that they strongly agreed the assessment improved their ability to assess the professionalism milestones. Discussion This OSCE offers a structured method to assess professionalism milestones and a forum to discuss ethical problem solving. It can also be used solely as a training exercise in ethical decision making and having difficult conversations.

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.

Introduction Common variable immunodeficiency (CVID) is the most common symptomatic antibody deficiency, with a prevalence of 0.6-6.9 depending on the population studied. In contrast to other primary immunodeficiency diseases (PIDDs), symptoms may not appear until the third decade of life. Lack of recognition of CVID is a persistent problem. Myriad confounding clinical phenotypes and frequent infections, including autoimmunity, malignancy, chronic lung disease, granulomatous disease, and gastrointestinal disease, complicate the diagnosis. Often it is years before a diagnosis is made, leading to irreversible morbidities and mortality. Methods Second-year medical students are introduced to CVID during their session on PIDDs that occurs during the immunology/rheumatology course. To assess students’ recognition of CVID, a 15-minute OSCE encounter was created that included a simulation of lung sounds (rhonchi), physical exam cards (clubbing, otitis media with effusion), and moulage of skin (petechiae). A standardized patient (SP) portrayed a patient requesting antibiotics for a sinus infection. Students were tasked to both interview the patient and perform a hypothesis-driven physical exam. A postencounter exercise queried the students on their differential diagnosis and their rationale. Results Item analysis of the case showed high levels of difficulty and strong discrimination between high- and low-performing students in both communication skills and clinical reasoning in CVID. Discussion This SP encounter can be used in both formative and summative assessments to measure the recognition of CVID.

Introduction As the number of patients with limited English proficiency grows, there is increasing awareness in the medical community about disparities in health outcomes for this population. The proper use of professional medical interpreters improves communication between physicians and patients with limited English proficiency. Typically, however, little curricular time in medical training is devoted to this competency. Methods We developed a two-station objective structured clinical examination (OSCE) in which learners worked with interpreters to conduct medical interviews with Spanish-speaking standardized patients (SPs). Cases were designed for use with residents from any medical specialty and to have personal and emotional richness in keeping with the real-life circumstances of many patients. Twelve residents from six medical specialties completed a session evaluation and were assessed by faculty, SPs, and interpreters using existing validated instruments and case-specific checklists. Results All residents reported that the cases mimicked real patient encounters. The checklists were well received and easy to use. While scores varied between residents, deficiencies were identified in basic communication skills for interacting with a non-English-speaking SP through an interpreter, including maintaining proper eye contact and open body posture with patients and introducing and clearly articulating the role of the interpreter. Discussion A two-station OSCE utilizing professional medical interpreters and Spanish-speaking SPs was well received by all participants. Residents’ scores helped identify common skill gaps in their work with interpreters. Based on the success of the pilot deployment, we plan to target educational interventions at these common deficiencies and offer the OSCE to more trainees.

Introduction To assess communication and professionalism, as well as technical skills related to patient care, the American Board of Anesthesiology (ABA) has begun administering an Objective Structured Clinical Examination (OSCE) portion of the APPLIED Examination in addition to the Standard Oral Examination component. Methods We created video modules and a curriculum for anesthesiology resident OSCE preparation for the Interpretation of Monitors and Interpretation of Echocardiography components. The modules can be used individually by trainees or included as part of an OSCE workshop led by faculty educators with seven individual stations matching the content of the actual ABA examination. These modules are recommended for all levels of anesthesiology trainees so that they can gain exposure to the format and the fast pace of the examination. Results Sixty-six junior and senior anesthesiology residents, fellows, and junior faculty successfully participated in these modules. Seventy-three percent of the participants agreed that after completing these modules, they now had a good understanding of the Interpretation of Monitors and Interpretation of Echocardiography technical skills stations. More than 90% of participants reported that the modules were useful, and more than 70% reported that they now felt prepared for these stations of the OSCE. Discussion Developing technical skills stations for deliberate practice and preparation for the ABA OSCE is resource intensive. Finding time and faculty to facilitate OSCE preparation is also challenging. With the video modules and scripts included in this publication, residents can practice independently or as part of larger preparation course.

Aim: Objective structured clinical examinations (OSCEs) are used extensively in medical education to prepare students for the clinical setting. Their use in dietetic education is still relatively new, and relationships to placement outcomes are unknown. The aim of this study was to explore 11 years of OSCE and placement data to answer the following questions: Does the OSCE predict dietetic placement outcome? and, What are the student perceptions of the benefits of OSCE in preparation for practice? Methods: Data were collected retrospectively from 328 students between 2006 and 2017 who had completed their final year OSCE and placement. Aggregate OSCE marks and mean marks obtained in active and passive OSCE stations were compared with placement outcome. Evaluation questionnaires completed by students at the end of the OSCE were collated. Results: Aggregate marks achieved in OSCE stations were significantly different for students who passed (mean = 63.24, SD = 7.94), struggled (mean = 58.25, SD = 8.82) or failed (mean = 57.31, SD = 8.28) placement, P < 0.001. Majority of students perceived the OSCE as a meaningful and fair assessment (92%) that helped to prepare them for practice (82%). Conclusions: The OSCE provides a meaningful assessment of dietetic student skills in preparation for practice. Aggregate OSCE marks provide a consistent indicator of students who are likely to struggle in practice. [ABSTRACT FROM AUTHOR]

Literature demonstrates that the primary concerns for entry-level graduates relate to standards covering professional competencies and outcome expectations; knowledge, skills, attitudes, and values; and pharmacy practice experiences. Implementing patient interviewing team simulation assessments (PITSA) into the curriculum is an option to address these concerns. PITSA are formative or summative assessment tools that can measure student's ability to communicate with a healthcare provider in addition to evaluating the student's clinical knowledge and skills during scheduled class time. At the University of Texas at Tyler Fisch College of Pharmacy, PITSA were implemented into an OSCE remediation course as an alternative strategy to allow students to review past content and practice counseling and interviewing techniques. Students identified the PITSA as a strength of the OSCE remediation course. Students reported the PITSA allowed them to improve their pharmacy practice skills. In addition, students stated the PITSA were beneficial to have prior to starting advanced pharmacy practice experiences. Although PITSA have some limitations, it can be a cost-effective instrument to prepare students for capstone OSCE assessments as well as advanced pharmacy practice experiences. [ABSTRACT FROM AUTHOR]

Practical teaching and assessment of learned skills are essential components of any veterinary nursing course to ensure students can carry out RCVS Day One Skills safely. In addition, passing the objective structured clinical examinations (OSCEs) is also required for professional registration with the RCVS. OSCE examinations have been used for a long time to assess competence and thus safe practice due to their reliability to test each student on the same task. However, it is understood by many educators in this industry, and others, that OSCEs elicit anxiety and stress. Many students will worry about OSCEs long before they are due to sit the exams. Therefore, it is essential that we work together to guide students towards these exams to minimise the effects of this. One way we can achieve this is by offering clarity of the process of the exams. This article aims to assist clinical coaches, educators and students in their approach to the OSCEs, as well as offering explanation as to why we do them, how they work and what can be done to try to reduce the effects of stress and anxiety leading up to them. [ABSTRACT FROM AUTHOR]

Background: Extended Focused Assessment Sonography for Trauma (EFAST) is an important bedside tool for the management of multiple trauma patients. We aimed to evaluate the assessment of our EFAST education in the Emergency Medicine Clerkship (EMC) for final year medical students and the correlations of EFAST marks with other practical skill stations and the final multiple choice question (MCQ) exam marks. Methods: Fifty-four final year medical students were trained on performing EFAST on human models during their 4-week clerkship. Students received an hour of didactic lecture, 4-hours practical sessions on human models, and completed a minimum of three EFAST examinations on trauma patients. Finally, the EFAST performance was evaluated on human models using a standard evaluation form during an Objective Structured Clinical Examination (OSCE). The marks of 51 students who completed the final exam were analyzed. Results: The overall passing rate of the EFAST station was 88% (n: 45). EFAST station mark had significant weak correlations with other OSCE stations marks (p = 0.027, rho = 0.31), and with the final EMC mark (p = 0.032, rho = 0.3), but not with the final MCQ exam. Conclusions: Final year medical students demonstrated effective EFAST learning as measured by their examination performance. One hour EFAST training and 4 -hours practice provide an acceptable level of skill for medical students. The EFAST final marks showed significant weak correlation with other OSCE station marks and final clerkship marks, but not with the final MCQ exam mark which assesses a different cognitive learning domain. [ABSTRACT FROM AUTHOR]

Background The 360 Degree Evaluation Model is one means to provide a comprehensive view of clinical competency and readiness for progression in an online nursing program. Objectives This pilot project aimed to evaluate the effectiveness of implementing a 360 Degree Evaluation of clinical competency of graduate advanced practice nursing students. Design The 360 Degree Evaluation, adapted from corporate industry, encompasses assessment of student knowledge, skills, behaviors and attitudes and validates student's progression from novice to competent. Settings Cohort of advanced practice nursing students in four progressive clinical semesters. Participants Graduate advanced practice nursing students ( N  = 54). Methods Descriptive statistics and Jonckheere's Trend Test were used to evaluate OSCE's scores from graded rubric, standardized patient survey scores, student reflection and preceptor evaluation. Results We identified all students passed the four OSCEs during a first attempt or second attempt. Scaffolding OSCE's over time allowed faculty to identify cohort weakness and create subsequent learning opportunities. Standardized patients' evaluation of the students' performance in the domains of knowledge, skills and attitudes, showed high scores of 96% in all OSCEs. Students' self-reflection comments were a mix of strengths and weaknesses in their self-evaluation, demonstrating themes as students progressed. Preceptor evaluation scores revealed the largest increase in knowledge and learning skills (NONPF domain 1), from an aggregate average of 90% in the first clinical course, to an average of 95%. Conclusions The 360 Degree Evaluation Model provided a comprehensive evaluation of the student and critical information for the faculty ensuring individual student and cohort data and ability to analyze cohort themes. [ABSTRACT FROM AUTHOR]

Background The objective structured clinical examination is a critical simulation tool used as the gold standard for assessing graduate health students' ability to perform clinically. Often these simulations use assessment/evaluation methods that can be subjective. Methods To minimize subjectivity, one graduate nursing program is triangulating student performance assessment by using case-specific quizzes, standardized patient feedback, and structured observation rubrics. Results Initial evidence finds this composite evaluation provides equitable feedback across cohorts, identifies students struggling didactically and adds precision to remediation. Conclusions Initial findings are suggesting that this approach offers an all-encompassing reflection of clinical and academic performance. [ABSTRACT FROM AUTHOR]

Traditional examination has inherent deficiencies. Objective Structured Clinical Examination (OSCE) is considered as a method of assessment that may overcome many such deficits. OSCE is being increasingly used worldwide in various medical specialities for formative and summative assessment. Although it is being used in various disciplines in our country as well, its use in the stream of general surgery is scarce. We report our experience of assessment of undergraduate students appearing in their pre-professional examination in the subject of general surgery by conducting OSCE. In our experience, OSCE was considered a better assessment tool as compared to the traditional method of examination by both faculty and students and is acceptable to students and faculty alike. Conducting OSCE is feasible for assessment of students of general surgery. [ABSTRACT FROM AUTHOR]

Abstract Introduction Communication with patients and among colleagues is critical to effective clinical care. A group observed structured clinical encounter (GOSCE) is an effective and resource-saving tool for teaching communication skills to medical students. While objective structured clinical exams (OSCEs) are a well-established assessment tool for communication skills, a GOSCE allows for formal observation of communication skills while also providing an opportunity for peer observation and feedback. Additionally, a GOSCE costs less and requires fewer faculty per learner than a traditional OSCE. Methods This is a four-station GOSCE to teach advanced communication skills to medical students. The stations are smoking cessation, difficult doctor-patient encounter, shared decision making, and delivering bad news. A group is made up of four to six students and one faculty member. At each station, one student takes the lead in the patient interview, followed by a group interview and ending with feedback by all participants. Results In the pilot phase, a total of 44 students were administered the GOSCE and were surveyed about their experience. Students felt the GOSCE was an enjoyable and educational experience. The GOSCE has subsequently been administered to more than 600 students, and 25 internal medicine faculty have participated. Discussion Our work demonstrates that the GOSCE is a feasible curricular enhancement for formative assessment of communication skills during the internal medicine clerkship. It is easy to implement and has been well received by all participants, with minimal impact on limited medical school and faculty resources.

Abstract Introduction Objective structured clinical examinations (OSCEs) have traditionally been used by medical schools and residency training programs to assess baseline knowledge. Most OSCEs include complex stations and the use of standardized patients. Our objective was to create a medical knowledge assessment tool for pediatric residency training programs that could be easily implemented without the need for a simulation center, ancillary staff, or the use of expensive or technical equipment. Methods This PL-3 (or PGY-3) modified OSCE for consists of a 15-station, 59-question written exam that includes free-text responses to brief clinical scenarios, interpretation of X-rays and other visual images, and one interactive station. The format is case based, highlighting the importance of clinical application of theoretical knowledge. Results More than 300 PL-3 residents have completed the examination in the 16 years since initiation. Surveys of residents have revealed that the exercise is extremely educational and that the subsequent discussions foster a positive learning environment. Discussion This modified OSCE adds to the body of literature on OSCEs and related assessment tools by providing educators with an assessment tool that is easily adaptable and effectively addresses one of the critique of OSCEs, that they are traditionally resource intensive.

Abstract Introduction A vital element of health care practice is evidence-based medicine, the explicit and judicious use of current, best-available evidence in making decisions about the individualized care of patients. With the use of evidence-based medicine continually increasing in clinical practice, medical schools are charged with ensuring graduates are prepared to appropriately access, appraise, and utilize clinical evidence, highlighting the need for a corresponding assessment tool. However, assessing evidence-based practice remains a challenging endeavor for medical educators. Few assessment tools capture students' ability to apply information resources in order to answer a targeted question during a medical encounter. Methods We describe a triple-jump assessment design where students access evidence, appraise information at hand, and apply it to formulate a treatment plan during an observed structured clinical encounter (OSCE). Results One hundred and five clerkship students participated in one of two OSCE scenarios. Data from this exercise underwent descriptive statistical analysis, including mean performance scores and confidence scores, and showed that accuracy and confidence in providing evidence-based care improved after the search and appraisal period. Discussion The addition of a modified triple-jump assessment to the end of the OSCE experience not only creates a more authentic experience but also allows for assessment and development of student metacognitive skills within the domain of knowledge gap assessment. The ease of integrating this assessment into the structure of an already-developed OSCE allows for different types of assessment to be achieved without writing entirely new OSCE cases, but rather by modifying existing scenarios.