Search

Aim: Objective structured clinical examinations have long been used in dietetics education. This observational study aims to describe the development, deployment, feasibility and validity of assessment using an oral interview in place of traditional objective structured clinical examinations, and to determine the ability of this assessment to identify students who are either not ready for placement or may require early support and/or remediation. Methods: Student assessment data were collected over a two‐and‐a‐half‐year period and used to test the predictive ability of an oral interview to determine dietetic placement outcomes and highlight a need for early remediation. Descriptive statistics as well as a between‐group one‐way ANOVA was used to describe results. Results: A total of 169 students participated in the oral interview and subsequent medical nutrition therapy placement over the study period. Significant differences in oral interview score were seen between students who passed placement and students who passed with remediation or those who failed. Oral interview performance was able to predict placement outcome, yet required less resources than traditional objective structured clinical examinations. Conclusion: An oral interview may provide the same utility as the objective structured clinical examination in dietetics education. [ABSTRACT FROM AUTHOR]

We have evaluated the final-year Psychiatry and Addiction Medicine (PAM) summative Objective Structured Clinical Examination (OSCE) examinations in a four-year graduate medical degree program, for the previous three years as a baseline comparator, and during three years of the COVID-19 pandemic (2020–2022). A de-identified analysis of medical student summative OSCE examination performance, and comparative review for the 3 years before, and for each year of the pandemic. Internal reliability in test scores as measured by R-squared remained the same or increased following the start of the pandemic. There was a significant increase in mean test scores after the start of the pandemic compared to pre-pandemic for combined OSCE scores for all final-year disciplines, as well as for the PAM role-play OSCEs, but not for the PAM mental state examination OSCEs. Changing to online OSCEs during the pandemic was related to an increase in scores for some but not all domains of the tests. This is in line with a nascent body of literature on medical teaching and examination following the start of the pandemic. Further research is needed to optimise teaching and examination in a post-pandemic medical school environment. [ABSTRACT FROM AUTHOR]

Objective Structured Clinical Examinations (OSCE) are used to assess clinical skills. We investigated how exit OSCEs changed in Australian medical schools in response to the COVID-19 pandemic. The lead ACCLAiM assessment academic from 12 eligible Australian medical school members of the Australian Collaboration for Clinical Assessment in Medicine (ACCLAiM) received a 45-item semi-structured online questionnaire. All schools (12/12) responded. Exit OSCEs were not used by one school in 2019, and 3/11 schools in 2020. Of eight remaining schools, four reduced station numbers and testing time. The minimum OSCE testing time decreased from 64 min in 2019 to 54 min in 2020. Other modifications included: a completely online 'e-OSCE' (n = 1); hybrid delivery (n = 4); stations using: videos of patient encounters (n = 3), telephone calls (n = 2), skill completion without face-to-face patient encounters (n = 3). The proportion of stations involving physical examination reduced from 33% to 17%. Fewer examiners were required, and university faculty staff formed a higher proportion of examiners. All schools changed their OSCEs in 2020 in response to COVID-19. Modifications varied from reducing station numbers and changing delivery methods to removing OSCE and complete assessment re-structuring. Several innovative methods of OSCE delivery were implemented to preserve OSCE validity and reliability whilst balancing feasibility. [ABSTRACT FROM AUTHOR]

Introduction: The OSCE is a sociomaterial assemblage—a meshing together of human and material components producing multiple effects. Materials matter because they shape candidate performance, with potentially calamitous career consequences if materials influence performance unjustly. Although the OSCE literature refers to materials, few papers study the sociomateriality of OSCEs. Therefore, we explored OSCE stakeholders' talk about sociomaterial assemblages to better understand their importance for candidate performance. Methods: We conducted 15 focus groups with OSCE candidates (n = 42), examiners (n = 20) and simulated patients (n = 17) after an Australian postgraduate nursing OSCE. Sociomateriality informed our team‐based framework analysis of data. Results: Participants identified a multiplicity of OSCE materials (objects, technologies and spaces) thought to matter for candidate performance. Candidates' unfamiliarity with materials and missing or malfunctioning materials were reported to yield numerous negative impacts (eg cognitive overload, negative affect, time‐wasting), thereby adversely affecting candidate performance. Both examiners and candidates made micro‐adjustments to sociomaterial assemblages during the OSCE in order to make it work (eg candidates saying what they would do rather than doing it). Sometimes, such tinkering extended so far that sociomaterial assemblages were ruptured (eg examiners ignoring rubrics to help pass candidates), potentially influencing OSCE standardisation. Discussion: Our novel empirical study extends previous conceptual work by illustrating wide‐ranging sociomaterial assemblages influencing OSCE candidate performance. Further research is now needed employing sociomaterial approaches to further elucidate sociomaterial entanglements in diverse OSCEs. We encourage OSCE stakeholders to become more attuned to the productive nature of materials within all stages of OSCE design and implementation. The authors demonstrate the extent to which materials really matter in shaping candidate performance in OSCEs [ABSTRACT FROM AUTHOR]

Examiners' judgements play a critical role in competency-based assessments such as objective structured clinical examinations (OSCEs). The standardised nature of OSCEs and their alignment with regulatory accountability assure their wide use as high-stakes assessment in medical education. Research into examiner behaviours has predominantly explored the desirable psychometric characteristics of OSCEs, or investigated examiners' judgements from a cognitive rather than a sociocultural perspective. This study applies cultural historical activity theory (CHAT) to address this gap in exploring examiners' judgements in a high-stakes OSCE. Based on the idea that OSCE examiners' judgements are socially constructed and mediated by their clinical roles, the objective was to explore the sociocultural factors that influenced examiners' judgements of student competence and use the findings to inform examiner training to enhance assessment practice. Seventeen semi-structured interviews were conducted with examiners who assessed medical student competence in progressing to the next stage of training in a large-scale OSCE at one Australian university. The initial thematic analysis provided a basis for applying CHAT iteratively to explore the sociocultural factors and, specifically, the contradictions created by interactions between different elements such as examiners and rules, thus highlighting the factors influencing examiners' judgements. The findings indicated four key factors that influenced examiners' judgements: examiners' contrasting beliefs about the purpose of the OSCE; their varying perceptions of the marking criteria; divergent expectations of student competence; and idiosyncratic judgement practices. These factors were interrelated with the activity systems of the medical school's assessment practices and the examiners' clinical work contexts. Contradictions were identified through the guiding principles of multi-voicedness and historicity. The exploration of the sociocultural factors that may influence the consistency of examiners' judgements was facilitated by applying CHAT as an analytical framework. Reflecting upon these factors at organisational and system levels generated insights for creating fit-for-purpose examiner training to enhance assessment practice., (© 2022. The Author(s).)

Purpose: To ascertain the effectiveness of the clinical, tutorial-based component of teaching and the clinical assessment method in the Bachelor of Medical Imaging Science at Curtin University of Technology (CUT), Perth, Western Australia. Materials and Methods: In mid-2006, second- and third-year students enrolled in CUT's Medical Imaging Science degree were asked to complete a questionnaire assessing the Objective Structured Clinical Examination (OSCE) evaluation program and clinical teaching. Thirty-three of 57 students answered questions about demographics and their opinions of the laboratory sessions, clinical placements and the OSCEs. Results: Seventy-six per cent of students were satisfied with their laboratory sessions and clinical placements. Sixty-four per cent of respondents indicated that the OSCE was not an objective evaluation, but 82% of students felt the OSCE was an effective test of their radiography skills and knowledge, and believed that they were able to evaluate and care for a patient during the OSCE. Conclusion: Overall, the surveyed students believed that the practical skills explored in laboratory sessions helped improve clinical training outcomes; however, only 33% of the students were satisfied that the OSCE was an appropriate assessment of their clinical training in hospitals. [ABSTRACT FROM AUTHOR]

Objective Structured Clinical Examinations (OSCEs) are routinely used in healthcare education programs. Traditionally, students undertake OSCEs as face-to-face interactions to assess competency in soft skills. Due to physical distancing restrictions during COVID-19, alternative methods were required. This study utilized a mixed-method design (online survey and interviews) to evaluate second-year pharmacy students' and examiners' experiences of their first virtual OSCEs in Australia. A total of 196 students completed their first virtual OSCE in June 2020 of which 190 students completed the online survey. However, out of the 190 students, only 88% (n = 167) consented to the use of the data from their online survey. A further 10 students and 12 examiners were interviewed. Fifty-five students (33%) who participated in the online survey strongly agreed or agreed that they preferred the virtual experience to face-to-face OSCEs while 44% (n = 73) neither agreed nor disagreed. Only 20% (n = 33) felt more anxious with the virtual OSCEs. Additionally, thematic analysis found non-verbal communication as a barrier during the OSCE. Positive aspects about virtual OSCEs included flexibility, decreased levels of anxiety and relevance with emerging telehealth practice. The need for remote online delivery of assessments saw innovative ways of undertaking OSCEs and an opportunity to mimic telehealth. While students and examiners embraced the virtual OSCE process, face-to-face OSCEs were still considered important and irreplaceable. Future opportunities for OSCEs to be delivered both face-to-face and virtually should be considered. [ABSTRACT FROM AUTHOR]

Background: The Australian Collaboration for Clinical Assessment in Medicine (ACCLAiM) is a voluntary assessment consortium, involving medical schools nationwide. The aims of ACCLAiM are to benchmark student clinical assessment outcomes and to provide quality assurance (QA) of exit-level Objective Structured Clinical Exams (OSCEs). This study aimed to evaluate the impact of the ACCLAiM QA process for optimising OSCE delivery standards at the member schools using a Community of Practice (CoP) framework., Methods: A mixed methods sequential explanatory design, involving an online questionnaire and subsequent focus group discussions, was utilised. Questionnaire responses were analysed using descriptive statistics, while thematic analysis was employed for the qualitative data., Results: Data analysis revealed that school-specific OSCE practices had evolved based on QA feedback, as well as a collaborative sharing of expertise consistent with a CoP model. Extending beyond a QA working group for accountability and demonstration of minimum standards, participation in ACCLAiM QA processes is creating a sustainable socio-academic network focused on quality improvement., Conclusion: Collaborative QA in clinical assessment creates opportunities for optimising standards in OSCE processes and sharing of resources for OSCE assessments. It also allows for professional development and scholarly engagement in assessment research. These benefits contribute to the existence of an emergent CoP model.

Objective. To examine the effects of student demographics, prior academic performance, course engagement, and time management on pharmacy students' performance on course examinations and objective structured clinical examinations (OSCEs). Methods. Study participants were one cohort of pharmacy students enrolled in a five-year combined Bachelor and Master of Pharmacy degree program at one institution. Variables included student demographics, baseline factors (language assessment and situational judgement test scores), prior academic performance (high school admission rank), course engagement, and student time management of pre-class online activities. Data were collected from course, learning management system, and institutional databases. Data were analyzed for univariate, bivariate, and multivariate associations (four linear regression models) between explanatory factors and outcome variables. Results. Three years of data on 159 pharmacy students were obtained and entered in the dataset. Significant positive predictors of OSCE communication performance included domestic (ie, Australian) student designation, higher baseline written English proficiency, and pre-class online activity completion. Positive predictors of OSCE problem-solving included workshop attendance and low empathy as measured by a baseline situational judgment test (SJT). Positive predictors of performance on year 2 end-of-course examinations included the Australian Tertiary Academic Rank, completing pre-class online activities prior to lectures, and high integrity as measured by an SJT. Conclusion. Several explanatory factors predicted pharmacy students' examination and OSCE performance in the regression models. Future research should continue to study additional contexts, explanatory factors, and outcome variables., (© 2020 American Association of Colleges of Pharmacy.)

Introduction: Near-peer learning, where peers from more senior year levels teach more junior peers is a popular teaching strategy in healthcare education. There is an emerging trend to utilise this teaching strategy in preparing students for Objective Structured Clinical Examinations (OSCEs) in the form of near-peer led formative OSCEs (NP-OSCE). However, there is little exploration of this teaching strategy in medical imaging education, nor how students perceive NP-OSCEs as beneficial to their learning. This study addresses this gap., Methods: Using a students as partners inquiry approach, 47 near-peer learners' (NPLs) and 6 near-peer teachers' (NPTs) perceptions of participating in a NP-OSCE were examined using an anonymous self-report questionnaire., Results: NPLs reported that participating in the immersive NP-OSCE helped their performance in the summative OSCE by helping with their preparedness; including understanding expectations, experiencing emotions and being able to identify gaps in their knowledge and skills, which they then used to direct their revision in a manner that demonstrated the development of skills in evaluative judgement. There were mixed findings regarding the impact the NP-OSCE had on NPLs' levels of anxiety. NPTs also found the NP-OSCE beneficial for identifying gaps in their own knowledge and skills, yet found taking on the role of an examiner challenging., Conclusion: Students perceive NP-OSCEs as a valuable learning activity that helps them prepare for their OSCEs by providing a student perspective of an authentic immersive learning experience. NP-OSCEs enable students to focus their revision and develop skills in evaluative judgement., Implications for Practice: Educators should consider including NP-OSCEs in their medical imaging curriculum as students perceive it as a valuable learning experience that assists them to prepare for their OSCE., (Copyright © 2019 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.)

Over the last two decades, Objective Structured Clinical Examination (OSCE) has become an increasingly important part of psychiatry education and assessment in the Australian context. A reappraisal of the evidence base regarding the use of OSCE in psychiatry is therefore timely. This paper reviews the literature regarding the use of OSCE as an assessment tool in both undergraduate and postgraduate psychiatry training settings. Suitable articles were identified using the search terms 'psychiatry AND OSCE' in the ERIC (educational) and PubMed (healthcare) databases and grouped according to their predominant focus: (1) the validity of OSCEs in psychiatry; (2) candidate preparation and other factors impacting on performance; and (3) special topics. The literature suggests that the OSCE has been widely adopted in psychiatry education, as a valid and reliable method of assessing psychiatric competencies that is acceptable to both learners and teachers alike. The limited evidence base regarding its validity for postgraduate psychiatry examinations suggests that more research is needed in this domain. Despite any shortcomings, OSCEs are currently ubiquitous in all areas of undergraduate and postgraduate medicine and proposing a better alternative for competency-based assessment is difficult. A critical question is whether OSCE is sufficient on its own to assess high-level consultancy skills, and aspects of professionalism and ethical practice, that are essential for effective specialist practice, or whether it needs to be supplemented by additional testing modalities.

Background: Objective Structured Clinical Examinations (OSCEs) are widely used in health professional education and should be based on sound pedagogical foundations., Objectives: The aim of this study is to evaluate the feasibility and utility of using Best Practice Guidelines (BPGs) within an OSCE format in a broad range of tertiary education settings with under-graduate and post-graduate nursing and midwifery students. We evaluated how feasible it was to apply the BPGs to modify OSCEs in a course; students' perspective of the OSCE; and finally, if the BPG-revised OSCEs better prepared students for clinical practice when compared with the original OSCEs., Design: A mixed method with surveys, focus groups and semi-structured interviews evaluated the BPGs within an OSCE., Settings: Four maximally different contexts across four sites in Australia were used., Participants: Participants included lecturers and undergraduate nursing students in high and low fidelity simulation settings; under-graduate midwifery students; and post-graduate rural and remote area nursing students., Results: 691 students participated in revised OSCEs. Surveys were completed by 557 students; 91 students gave further feedback through focus groups and 14 lecturers participated in interviews. At all sites the BPGs were successfully used to modify and implement OSCEs. Students valued the realistic nature of the modified OSCEs which contributed to students' confidence and preparation for clinical practice. The lecturers considered the revised OSCEs enhanced student preparedness for their clinical placements., Discussion and Conclusions: The BPGs have a broad applicability to OSCEs in a wide range of educational contexts with improved student outcomes. Students and lecturers identified the revised OSCEs enhanced student preparation for clinical practice. Subsequent examination of the BPGs saw further refinement to a set of eight BPGs that provide a sequential guide to their application in a way that is consistent with best practice curriculum design principles., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The implementation framework outlined in this paper has been developed from feedback of a trial across three different nursing and midwifery programmes and is designed to assist educators to incorporate OSCEs within their curricula. There is value in flagging the pedagogical principles embodied in the framework and alerting educators to their importance for more meaningful student learning. For each step practical advice is provided contributing to the utility of this approach. Considerations are systematic ensuring that the use of OSCEs in health care curricula assures judicious use of resources to achieve desired student outcomes.