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The delivery of medical education has shown a significant shift from the conventional mode of training to the competency-based training. Assessments have been identified as the most significant difference between the two approaches of training. The purpose of the current review was to explore the employment of objective structured clinical examination (OSCE) tool in the delivery of medical education. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 30 articles were selected based upon the suitability with the current review objectives. It is quite obvious that during assessments, we plan to assess knowledge, skill, and affective domains, which actually gives inference about the overall learning progression. OSCE is an assessment tool that is being employed in medical training owing to its objectivity and structured nature. With the passage of time, OSCEs have been widely used in both undergraduate and postgraduate examinations. Acknowledging the fact that the OSCE can be of immense significance in monitoring the learning and its progression, it becomes quite essential to ensure its quality. In conclusion, the scope of OSCE as an assessment tool in medical education training is immense. It is the need of the hour to use the tool in an objective and structured manner to assess the level of learning in students and even monitor the progression in learning. [ABSTRACT FROM AUTHOR]

Background: Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of Ethiopia implemented a program intervention to improve the quality of non-physician anesthetists' education, which included faculty development, curricula strengthening, student support, educational resources, improved infrastructure and upgraded regulations. This study aimed to assess changes following the implementation of this program. Methods: A pre-and post-evaluation design was employed to evaluate improvement in the quality of non-physician anesthetists' education. A 10-station objective structured clinical examination (OSCE) was administered to graduating class anesthetists of 2016 (n = 104) to assess changes in competence from a baseline study performed in 2013 (n = 122). Moreover, a self-administered questionnaire was used to collect data on students' perceptions of the learning environment. Results: The overall competence score of 2016 graduates was significantly higher than the 2013 class (65.7% vs. 61.5%, mean score difference = 4.2, 95% CI = 1.24-7.22, p < 0.05). Although we found increases in competence scores for 6 out of 10 stations, the improvement was statistically significant for three tasks only (pre-operative assessment, postoperative complication, and anesthesia machine check). Moreover, the competence score in neonatal resuscitation declined significantly from baseline (from 74.4 to 68.9%, mean score difference = - 5.5, 95% CI = -10.5 to - 0.5, p < 0.05). Initial gender-based performance differences disappeared (66.3% vs. 65.3%, mean score difference = - 1.0, 95% CI = - 6.11-3.9, p > 0.05 in favor of females), and female students scored better in some stations. Student perceptions of the learning environment improved significantly for almost all items, with the largest percentage point increase in the availability of instructors from 38.5 to 70.2% (OR = 3.76, 95% CI = 2.15-6.55, p < 0.05). Conclusion: The results suggest that the quality of non-physician anesthetists' education has improved. Stagnation in competence scores of some stations and student perceptions of the simulated learning environment require specific attention. [ABSTRACT FROM AUTHOR]

Introduction: The outbreak of COVID‐19 necessitated a move to online teaching and assessment. The objective structured clinical examination (OSCE) has been an integral part of dental examinations for several decades. The COVID‐19 pandemic stopped face to face examinations around the world. An Online Virtual OSCE (VOSCE) was developed and piloted for dental undergraduate assessment. Materials and Methods: This initial report outlines the steps required to run an OSCE online. Planning and preparation required in adaptation of an OSCE for the online environment is dreported. The necessity for familiarisation sessions is addressed, and VOSCE logistics described. Results: With careful planning, the VOSCE is a useful assessment method in difficult times. Feedback from staff and students was favourable. Conclusion: Although significant organisation was required, the examination process worked well for both students and examiners. Despite limitations in relation to technical dental procedures, the VOSCE could be a viable alternative to face to face clinical examination. [ABSTRACT FROM AUTHOR]

Objective: The aim of this prospective randomised trial was to assess the impact of the team-based learning approach on basic musculoskeletal ultrasound skills in comparison to both peer-assisted and conventional teaching and to examine the influence of gender and learning style on learning outcomes. Methods: In this prospective randomised trial, we randomly assigned 88 students to 3 groups: team-based learning (n = 19), peer-assisted learning (n = 36) and conventional teaching (n = 33). Pre-existing knowledge was assessed using a multiple-choice (MC) exam. Student performance after completing the course was measured using an Objective Structured Clinical Examination (OSCE) and a second MC exam. Students were asked to complete Kolb's Learning Style Inventory and to evaluate the course. Results: There was a significant gain in theoretical knowledge for all students (p < 0.001). The team-based learning groups' performance proved to be significantly superior on the OSCE (p = 0.001). As gender had no significant effect on practical or theoretical performance, learning style was linked to differences in the practical outcome. An evaluation showed overall satisfaction with the course and with the respective teaching methods. Conclusion: Team-based learning proved to be superior to peer-assisted and conventional teaching of musculoskeletal ultrasound skills. [ABSTRACT FROM AUTHOR]

Background: Medical schools have traditionally assessed medical students using long and short cases. Objective structured clinical examination (OSCE) has been found to be more reliable. Aim: To compare OSCE and traditional method of assessment in the summative assessment of final-year medical students. Methodology: This was a retrospective cross-sectional study conducted at Enugu State University of Science and Technology College of Medicine. The Department of Internal Medicine organized clinical examinations consisting of long and short cases. The Department of Surgery organized an OSCE consisting of two parts (picture OSCE and clinical OSCE). Students' scores in both internal medicine and surgery were collated and subjected to analysis with SPSS version 23 (IBM; SPSS, Chicago, IL, USA). Pearson's correlation was used to assess the correlations, paired t-test was used to compare the mean scores, and Cronbach's alpha was used to assess the reliability. P < 0.05 was considered statistically significant. Results: Out of the 73 candidates, 41 were female and 32 were male giving a female: male ratio of 1.3:1. Using paired sample t test, there were significant differences between the mean score in long case (mean = 52.86, standard deviation [SD] = 4.315) and mean score in clinical OSCE (mean = 58.356, SD = 7.906), t (72) = −7.181, P = 0.000; mean score in short case (mean = 52.86, SD = 4.097) and mean score in picture OSCE (mean = 48.580, SD = 8.992, t (72) =4.558, P = 0.000; no significant difference between the mean total score in internal medicine clinicals (mean = 105.712, SD = 6.680) and mean total score in surgery clinicals (mean = 106.915, SD = 15.846), t (72) = −0.788, P = 0.433. The Cronbach's alpha for traditional examination and OSCE was 0.437 and 0.863, respectively. Conclusion: OSCE gives a similar mean score to traditional method, but OSCE is more reliable.

Purpose: To explore resident perceptions of factors contributing to pass rates on a high-stake licensing objective structured clinical exam (OSCE). Materials and Methods: A cross-sectional survey was administered to all 51 applicants of the April 2019 internal medicine Arab Board OSCE examination in Abu Dhabi, United Arab Emirates (UAE), and included questions on preparedness, stress level, and prior educational experiences. Exposures were evaluated for correlation against Arab Board pass rates using Pearson correlation and the two-tailed significance was recorded. Results: All 51 examinees completed the survey (100% response rate). Participants were primarily female n = 35 (67%) and all completed residency training in the UAE. Gender differences were noted, with higher pass rates for the male residents (13/35, 37% females vs. 8/16, 50% males, P < 0.05). Further, 65% (P < 0.001) of female examinees reported higher levels of anxiety than male residents. Examinees reported regular exposure during residency to clinical skills training (74%), standardized patients (71%), simulation (66%), and OSCEs (72%) but none of these educational modalities correlated with higher pass rates. Of multiple exam preparation modalities, only self-directed learning with deliberate practice, the intentional repetition of a task with feedback, was associated with higher pass rates. Conclusion: Clinical exam skills are vital for trainees to deliver high-quality primary healthcare services. National licensure OSCEs have become the norm in the Arab world for assessing resident clinical exam skills. Our results suggest that residency programs should encourage residents' intentional deliberate practice and mastery learning in the acquisition and retention of physical examination techniques.

In modern conditions, doctor as a specialist is faced with a large list of requirements fixed both in legal norms and in the rules of social behavior. The emergence of complex medical equipment and technologies, changes in the moral and legal conditions in the “doctor–patient” relationships led to the modernization of the medical training system. Especially it concerns the segment of practical specialist training. Simulation technologies in this sense should occupy an important place in medical education improving the quality and effectiveness of practice-oriented specialist training, reducing the risk of negative effects of the former education system in medical universities. The first experience of introducing such technologies into the training system at Yaroslavl State Medical University and in the country as a whole, along with obvious positive results, highlighted some problems. Their systematic solution is an important forward-looking task in the framework of the ongoing reform of medical education.

Abstract Background The concept of EPAs is increasingly applied to assess trainees’ workplace performance by means of entrustment ratings. OSCEs assess performance in a simulated setting, and it is unclear whether entrustment ratings can be integrated into these exams. This study explores the introduction of an entrustment rating scale into an existing OSCE. Methods A 6-point entrustment scale was added to the standard ratings in an OSCE administered prior to students’ final clerkship year in an undergraduate medical programme. Standard OSCE ratings assess clinical and communication skills. Assessors (n = 54) rated students’ performance (n = 227) on a diverse set of clinical tasks and evaluated the addition of entrustment scales to OSCEs. Descriptive and inferential statistics were calculated for analyses. Results Student performance varied across the stations, as reflected in both the standard OSCE ratings and the added entrustment ratings. Students received generally high standard OSCE ratings, whereas entrustment ratings were more widely distributed. All students passed the OSCE, and only a small proportion of students did not reach the expected pass threshold of 60% on the standard ratings in the single stations. The proportion of students who did not reach the expected entrustment level in the respective stations was noticeably higher. Both the clinical and communication skill ratings were related to the entrustment rating in most OSCE stations. A majority of the assessors positively evaluated the addition of entrustment ratings into the OSCE. Discussion The findings provide an empirical basis to broaden our understanding of the potential use of entrustment ratings in existing OSCEs. They provide directions for future, more specific studies. The ratings might be used for formative feedback on students’ readiness for workplace practice.

Abstract Background An important barrier to smoking-cessation counseling for physicians is a lack of education at the undergraduate level. Interactive methods such as peer role-play (RP) or modules utilizing standardized patients (SPs) may be effective for medical students to enhance their performance on tobacco cessation counseling. This study compared the effectiveness of a module using SPs to that of a RP module for undergraduate medical students on tobacco cessation counseling. Methods This study was conducted over a single week of the family medicine clerkship. One hundred and thirteen fourth-year medical students were randomized into either the SP group or the RP group. A RP module involved a ten-minute encounter between the student doctor and the student patient followed by five minutes of feedback from the observer student using a group developed checklist. In a SP module, each student was asked to interview a SP portraying a smoker with willingness to quit. After the encounter, the SP provided five minutes of direct oral feedback to the student. In both modules, the total intervention lasted three-and-half hours and was supervised by faculty staff. Students’ objective structured clinical examination (OSCE) scores were evaluated to determine their tobacco cessation counseling skills. Four evaluation periods were conducted at baseline, postintervention, post-clerkship, and before receiving the Korean medical licensing examination (KMLE). Students’ smoking knowledge test scores and counseling self-confidence levels at pre- and post-intervention were also compared. Results In both groups, post-intervention OSCE scores increased significantly compared to baseline (Cohen’s d 0.87, p

Abstract Background Of 37 pediatric rheumatology fellowship training programs in the United States, many have three or fewer fellows at a given time, making large-scale assessment of fellow performance difficult. An objective structured clinical examination (OSCE) is a scenario-based simulation method that assesses individual performance, thus indirectly measuring training program effectiveness. This study describes the development and implementation of two national pediatric rheumatology OSCEs and methods used for programmatic improvement. Methods OSCEs for pediatric rheumatology fellows were held in 2009 and 2011 during national rheumatology meetings using scenarios and assessment forms originally developed by a fellowship program director. The seven scenarios tested medical knowledge, physical exam and interpersonal skills. Pediatric rheumatologist evaluators assessed fellows’ performance using checklists and gave immediate feedback. Program directors were sent summaries of their fellows’ performances. Fellows evaluated the OSCE, providing organizational and scenario improvement suggestions. Programmatic changes to the 2011 OSCE were based on 2009 performance data and program evaluation feedback. Results Twenty-two fellows participated in 2009 and 19 in 2011. Performance scores in similar scenarios did not change considerably over the two iterations. In 2009, 85.7% of participants reported desire to change clinical behavior. Assessors’ 2009 program evaluation data prompted changes in rating scales and removal of invalid or unreliable assessments. Negative evaluation data about individual stations decreased from 60% in 2009 to 15.4% in 2011. Fellows’ ratings of the experience’s overall value were similar in 2009 and 2011. The average experience ratings were lower among fellows who proposed scenario-specific improvements and higher among those who recommended organizational improvements. Conclusions The 2011 examination exhibited programmatic improvement via reduction in fellows’ scenario-specific negative feedback. Fellows’ overall satisfaction did not change. Further work in scenario selection, assessment validation and inter-rater reliability will improve future pediatric rheumatology OSCEs.

The coronavirus disease 2019 (COVID-19) pandemic has required educators to adapt the in-person objective structured clinical examination (OSCE) to online settings in order for it to remain a critical component of the multifaceted assessment of a student’s competency. This systematic scoping review aimed to summarize the assessment methods and validity and reliability of the measurement tools used in current online OSCE (hereafter, referred to as teleOSCE) approaches. A comprehensive literature review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Articles were eligible if they reported any form of performance assessment, in any field of healthcare, delivered in an online format. Two reviewers independently screened the results and analyzed relevant studies. Eleven articles were included in the analysis. Pre-recorded videos were used in 3 studies, while observations by remote examiners through an online platform were used in 7 studies. Acceptability as perceived by students was reported in 2 studies. This systematic scoping review identified several insights garnered from implementing teleOSCEs, the components transferable from telemedicine, and the need for systemic research to establish the ideal teleOSCE framework. TeleOSCEs may be able to improve the accessibility and reproducibility of clinical assessments and equip students with the requisite skills to effectively practice telemedicine in the future.

Background/Aims: The Objective Structured Clinical Examination (OSCE) has an established history of assessing clinical competence for medical and allied healthcare professionals. No research has investigated the use of the OSCE within speech and language therapy undergraduate education. This study aimed to evaluate undergraduate speech and language therapy students' perceptions of the OSCE and to determine if perceptions differed depending on stage of undergraduate education. Methods: An online survey was distributed to second- and final-year students in a 4-year undergraduate speech and language therapy university programme after completing an OSCE. Quantitative survey data were analysed descriptively and statistically using Fisher's exact tests. Thematic analysis was used to analyse narrative survey comments. Results: The response rate was 80%. The students perceived the OSCE to be a fair (95%) and meaningful way (97%) of assessing clinical competencies, which provided them with greater confidence for practice (91%). The OSCE was deemed to be less stressful than a written exam (65%). No significant differences were observed between second- and fourth-year students' perceptions. Five major themes included clarity of expectations, time allocated, consistency between examiners, influence on student learning, and personal impact. Discussion: The survey findings suggest that undergraduate speech and language therapy students across different stages of education and different clinical contexts perceive the OSCE as a fair and meaningful assessment approach. This study provides initial evidence that the OSCE is suitable for assessing clinical competencies specific to the profession of speech and language therapist. [ABSTRACT FROM AUTHOR]

Background: During the rapid onset of the pandemic, clinicians transitioned from traditional outpatient practice to virtual modalities for providing routine care to patient panels. Like training programs nationwide, telemedicine training and assessment had not been systematically incorporated into our residency. In response, a scheduled Internal Medicine (IM) Objective Structured Clinical Examination (OSCE) was adapted to a remote modality to become virtual care-focused learning experience for trainees and to provide valuable feedback to educators. Methods: Standardized Patients (SPs) rated residents on their communication (including information gathering, relationship development and patient education), patient activation and satisfaction, and telemedicine skills. Analyses included a comparison of domain scores for residents who participated in both the 2020 remote and 2019 in-person OSCEs, and a review of written resident comments about the virtual OSCE. Results: During 2020's video visit OSCE (VOSCE), residents (n = 23) excelled at nonverbal communication but struggled with virtual physical exams and information gathering. In debrief, residents expressed substantial interest in more opportunity to practice virtual visit skills going forward. In comparing scores of the virtual care (2020) OSCE with the in-person (2019) version, the small subset of residents who participated in both assessments (n = 9) performed similarly on communication skills, patient satisfaction and activation. Patient education scores were significantly lower during the virtual care OSCE (P =.008). Conclusion: Our reformulated OSCE accomplished 3 goals including; (1) physically distancing residents from SPs per COVID regulations, (2) providing residents with the opportunity to practice critical virtual visit skills, and (3) alerting our educators to curricular improvement areas. Our methods are useful for other institutions and have applications to the larger medical education community. [ABSTRACT FROM AUTHOR]

Background: Medical school admission procedures have the common goal to select applicants with the greatest potential of becoming successful physicians. Hamburg Medical Faculty selects medical students by grade point average (GPA) and employs a two-step selection process of a natural sciences test (HAM-Nat), in some cases followed by multiple mini-interviews (HAM-Int). Multiple mini-interviews can predict non-cognitive outcomes, while GPA has predictive validity for cognitive outcomes. The aim of our study was to explore communication skills and clinical knowledge of advanced medical students according to their respective admission procedure. Methods: In July 2019, 146 students grouped according to their admission procedure into GPA-only (19.2 %), HAM-Nat (33.6 %), HAM-Int (30.8 %), and Waiting List (16.4 %) participated in four OSCE stations which equally assessed students' communication skills (OSCE part 1) and clinical knowledge (OSCE part 2) in simulated patient encounters, rated by physicians with checklists. Additionally, psychosocial assessors ranked communication skills with a global rating scale (GR). The students also participated in a multiple choice (MC) exam testing clinical knowledge. Kruskal-Wallis analyses of variance of test performance and Spearman correlation of instruments were calculated. Results: Students from the Waiting List group performed significantly worse on the MC exam compared to GPA-only and HAM-Int (adjusted p =.029 and 0.018, respectively). No significant differences were found between the admission groups with respect to communication skills. Global Rating and OSCE part 1 (communication) correlated significantly (ρ = 0.228, p =.006) as did OSCE part 2 (clinical knowledge) and MC exam (ρ = 0.242, p =.003), indicating criterion validity. Constructs did not overlap, indicating divergent validity. Conclusions: Advanced medical students selected for undergraduate studies by multiple mini-interviews assessing psychosocial skills showed similar communication skills compared to students admitted to medical school by other entryways. It is unclear whether these similarities are due to an effective undergraduate longitudinal communication curriculum. Assessing baseline communication skills of all medical students at entry-level may aid with this question. [ABSTRACT FROM AUTHOR]

Objective: In current objective structured clinical examinations (OSCEs), simulated encounters lacking realism reduce authenticity of assessment as students can take the OSCEs with a search-and-scan approach and trained empathy. Accordingly, patient-centeredness, the fundamental goal of OSCE, is not well assessed. This study evaluated the effect of a change in the OSCE scenario and checklist with respect to detecting students' patient-centeredness.Methods: A scenario script for valid representation of a real clinical encounter was developed and defined as authenticated scenario. The OSCE scores and the measure of patient-centered communication (MPCC) scores of 79 medical students were compared between the two OSCE stations, one using the traditional scenario and another using the authenticated scenario.Results: The MPCC total score was higher in the OSCE station using the authenticated scenario than that of the traditional scenario (p < 0.001). For the OSCE scores, the patient satisfaction score and the patient-physician interaction score were higher in the station using the authenticated scenario than the traditional one (p < 0.001).Conclusion: The OSCE station using the authenticated scenario better detected medical student level of patient-centeredness.Practice Implications: Strengthening the authenticity of the OSCE scenario is critical for detecting the medical students' levels of patient-centeredness. [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.

The use of simulation as a tool for assessment in medical examinations is expanding. We describe 12 practical tips for the implementation of simulation based critical evaluation for the Objective Structured Clinical Examination (OSCE). The material in this article is a combination of personal experience and the available literature. Three themes are discussed encompassing simulation theory for the OSCE, practical features of simulation for the clinical examination and contingency planning. As clinical assessment evolves, the utility for simulation-based practice will advance alongside. An improved understanding of the processes for incorporating simulation into the OSCE will be of benefit to both the medical educator and the student. [ABSTRACT FROM AUTHOR]

Background: First-day neonate death has the highest rate in infant mortality. Using modern educational methods such as simulation and competency can be effective in improving learners' performance and subsequently their confidence. Material and Method: This study was a quasi-experimental intervention on 80 midwifery students of semester 3, 4, and 5 undergraduate degrees. Eighty-six students registered after the researcher's explanations. The learners were randomly assigned into two groups while they were receiving routine midwifery education according to the midwifery curriculum. The learners in the intervention group (in seven groups) received a 7-hour session about neonate resuscitation. The theory session was conducted using PowerPoint presentation, lecture, video, and pictures. The practical session was conducted using simulation with manikins of skill laboratory. The skill practice continued until the learners achieved competency (performing 90% of resuscitation steps). The learners were assessed before, immediately, and 6 weeks after training using questionnaires and a checklist. The data were analyzed using SPSS, descriptive, and inferential statistics. Results: The knowledge, skill, and self-confidence scores increased significantly immediately after the training (P < 0.001), from 5.05 ± 2.07 (out of 12) to 10.17 ± 1.31, 18.90 ± 3.14 to 68.45 ± 2.05, and 1.50 ± 0.55 to 2.02 ± 0.57, respectively. The changes were retained 6 weeks after the training. These changes were not observed in the control group. Conclusion: Competency-based, simulation-based, and objective structured clinical examination (OSCE) were effective in students learning to manage initial neonatal resuscitation in the skills' lab, and this increase was retained 6 weeks after the training. [ABSTRACT FROM AUTHOR]

Background: Interpersonal and communication skills (ICS) are important core competencies in medical education and certification. In this study, we identified self- and simulated patient (SP)-reported ratings of US first-year medical students' ICS and the influence of age and gender on performance appraisal during the Objective-Structured Clinical Examination (OSCE). Methods: OSCE participants, including 172 first-year medical students and 15 SPs were asked to evaluate the students' ICS using the American Board of Internal Medicine–Patient-Satisfaction Questionnaire (ABIM–PSQ), electronically and via paper, respectively. Self- and SP-reported ratings of students' ICS were presented as the median on a 5-point Likert-scale and as three categories defined as "good," "very good," and "inadequate." Results: SPs assessed all 172 students in the OSCE, while 43.6% of students assessed their own performance. The majority of students and SPs evaluated the students' ICS as very good. 23.3% of SPs and 5.3% of students rated the medical students' ability to encourage patient question-asking and answer questions as inadequate (P < 0.002). Neither age nor gender influenced the medical students' self-assessment of ICS. Female SPs assigned lower scores to students in regard to respecting patients and encouraging patient question-asking and answering. Older SPs was more likely to assign lower scores on all survey questions. Conclusions: In the present study, self- and SP-reported ratings of first-year medical students' ICS were mainly "very good" with no influence of students' age or gender. Older age and female gender among the SPs were associated with a reduction in SP-reported ratings of students' ICS. [ABSTRACT FROM AUTHOR]

What Was the Educational Challenge?: The objective structured clinical examination (OSCE) is used extensively in health and medical education to assess clinical competence. While OSCEs are not primarily designed for individual feedback, they provide an opportunity to generate meaningful and constructive feedback that students can use to reflect on areas of weakness (and strength). The most timely and effective way to incorporate individual feedback following a summative OSCE continues to be explored., What Was the Solution?: This paper describes a novel OSCE feedback model which uses readily available summative assessment data to calculate 10% index scores. This provides information about relative station difficulty and relative individual student performance., How Was the Solution Implemented?: An individualised feedback report was provided to every student after the OSCEs. This enables identification of stronger and weaker performance areas and composite skills, which can be utilised by all students to direct future learning., What Lessons Were Learned That Are Relevant to a Wider Global Audience?: Providing timely, individual actionable feedback to every student following a summative OSCE is possible without impacting the examination process or examiner burden., What Are the Next Steps?: A study is planned to determine the utilisation of this feedback by students and it's impact as a qualitative self-assessment exercise.

Unlabelled: A significant component of Canadian medical education is the development of clinical skills. The medical educational curriculum assesses these skills through an objective structured clinical examination (OSCE). This OSCE assesses skills imperative to good clinical practice, such as patient communication, clinical decision-making, and medical knowledge. Despite the widespread implementation of this examination across all academic settings, few preparatory resources exist that cater specifically to Canadian medical students. MonkeyJacket is a novel, open-access, web-based application, built with the goal of providing medical students with an accessible and representative tool for clinical skill development for the OSCE and clinical settings. This viewpoint paper presents the development of the MonkeyJacket application and its potential to assist medical students in preparation for clinical examinations and practical settings. Limited resources exist that are web-based; accessible in terms of cost; specific to the Medical Council of Canada (MCC); and, most importantly, scalable in nature. The goal of this research study was to thoroughly describe the potential utility of the application, particularly its capacity to provide practice and scalable formative feedback to medical students. MonkeyJacket was developed to provide Canadian medical students with the opportunity to practice their clinical examination skills and receive peer feedback by using a centralized platform. The OSCE cases included in the application were developed by using the MCC guidelines to ensure their applicability to a Canadian setting. There are currently 75 cases covering 5 specialties, including cardiology, respirology, gastroenterology, neurology, and psychiatry. The MonkeyJacket application is a web-based platform that allows medical students to practice clinical decision-making skills in real time with their peers through a synchronous platform. Through this application, students can practice patient interviewing, clinical reasoning, developing differential diagnoses, and formulating a management plan, and they can receive both qualitative feedback and quantitative feedback. Each clinical case is associated with an assessment checklist that is accessible to students after practice sessions are complete; the checklist promotes personal improvement through peer feedback. This tool provides students with relevant case stems, follow-up questions that probe for differential diagnoses and management plans, assessment checklists, and the ability to review the trend in their performance. The MonkeyJacket application provides medical students with a valuable tool that promotes clinical skill development for OSCEs and clinical settings. MonkeyJacket introduces a way for medical learners to receive feedback regarding patient interviewing and clinical reasoning skills that is both formative and scalable in nature, in addition to promoting interinstitutional learning. The widespread use of this application can increase the practice of and feedback on clinical skills among medical learners. This will not only benefit the learner; more importantly, it can provide downstream benefits for the most valuable stakeholder in medicine-the patient., (© Ayma Aqib, Faiha Fareez, Elnaz Assadpour, Tubba Babar, Andrew Kokavec, Edward Wang, Thomas Lo, Jean-Paul Lam, Christopher Smith. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

Pregnancy diagnosis in the bitch is routinely performed using ultrasound and is therefore an important skill for veterinarians to have been exposed to during undergraduate training. Proficiency of this skill is difficult to achieve, due to limited exposure to suitable live patients, and animal welfare considerations limiting repeated performance on the same bitch. Models have been beneficial in allowing undergraduates to perform a range of ultrasound techniques without the use of live animals. Using clinical veterinarians and a model created at the University of Surrey, cognitive task analysis (CTA) was used to construct a list of instructional steps required to perform ultrasound pregnancy diagnosis. Experts were asked to evaluate the existing model then video recorded while demonstrating the skill on the model as if teaching a novice student. Anonymized and muted video footage along with transcribed audio files were used to create a draft teaching protocol. A group consensus for the final teaching protocol was developed following a semi-structured interview. The final teaching protocol had 23 steps to guide a novice to perform this skill, broken down into three stages: setup and preparation, pregnancy identification, and estimation of gestational age. Not all steps were both performed and verbalized by all of the experts, hence the need for a panel discussion to confirm a final teaching protocol. This study demonstrated that CTA is useful in compiling a comprehensive list of steps, for a teaching protocol, including those which may have been missed if demonstrated through a lone subject matter expert.

Introduction The ability to utilize the electronic health record (EHR) without compromising the doctor-patient relationship (DPR) is an essential skill of all physicians and trainees, yet little time is spent on educating or assessing learners on needed techniques. To address this gap, we developed a conventional OSCE station coupled with a simulated patient chart within the Epic program in order to assess our students' skills utilizing the EHR during a patient encounter. Methods Of third-year medical students, 119 were given full access to the patient's simulated chart 24 hours in advance of their OSCE to review clinical data. During an in-person OSCE with a standardized patient (SP), students performed a focused history and physical, using the EHR to verify allergies and medications. Students completed an electronic patient note graded by faculty. SPs evaluated the students on communication and interpersonal skills with specific rubric elements. Faculty graded the students' notes to evaluate their expression of clinical reasoning in the assessment and plan. Results Training SPs and faculty to assess students on EHR skills was feasible. After implementation of a comprehensive curriculum focused on EHR and DPR, there was a significant difference on EHR-related communication skills (M = 76.4, SD = 17.6) versus (M = 37, SD = 28.9) before curriculum enhancement t (117.9) = −12.4, p

Background and Objective: Previous studies had examined the effect of learning in young adults with generally worse results in cases with the delayed sleep-wake phase disorder. In this study, the relationship between circadian rhythm preferences and objective structured clinical examination (OSCE) results was examined in medical students. Materials and Methods: This study was conducted during the OSCE for clinical license in medical students who were graduation candidates. The reduced form of the Horne and Ostberg Morningness-Eveningness Questionnaire was used to estimate their circadian chronotype. The OSCE consisted of 12 stations, which evaluated different clinical skills, as well as participant’s medical knowledge. The effect of morningness-eveningness preference of each participant on score was evaluated within each station of OSCE. Results: In total, 78 students participated out of a total of 114 clinically competent candidates (aged 25-34 years) were evaluated. In terms of sex, 56% of the students were girl, who obtained significantly higher grades in three stations (P < 0.05). The grades of students with delayed sleep-wake chronotypes were higher in most of the stations; however, the difference was statistically significant in only one station (P = 0.045), which was the most difficult station of the exam. Nevertheless, the delayed sleep-wake chronotype was associated with excessive daytime sleepiness (P = 0.002). Conclusion: Contrary to other similar studies in medical students, normal circadian chronotype was associated with poorer outcome in the OSCE; which may be explained by unusual student training hours during shifts, and the resultant available time for undisturbed study .

Background: Lesotho has been experiencing health challenges as indicated by its high maternal mortality ratio of 620 per 100 000 live births for the year 2010, which has been linked to its limited human resources. Objectives: The knowledge and skills of final-year student nurse-midwives related to the active management of the third stage of labour were determined. Method: A quantitative, descriptive survey design was used to conduct this study with 99 final-year midwifery students at four nursing schools in Lesotho using stratified sampling. The structured questionnaire collected data on the knowledge and self-reported competency. Subsequently, the controlled cord traction marks, extracted from the objective structured clinical examination (OSCE), were compared to the self-reported competency of these midwifery students using R software version 3.4.0. Results: The mean score for knowledge and the OSCE was 73.8% (n = 99) and 77.2% (n = 99), respectively. The majority of respondents (95.2%, n = 99) rated themselves highly in terms of the active management of the third stage of labour competency. There was no correlation between the self-reported competency and knowledge (r = 0.08, p = 0.4402), and self-reported competency and OSCE scores (r = −0.004, p = 0.01). Conclusion: The high mean scores for the knowledge and the OSCE indicate that the theoretical component of the curriculum on the active management of the third stage of labour was effective in equipping final-year midwifery students with knowledge and skills to carry out this competency.

Background: Traditional clinical examination is perceived to be biased and to overcome this, objective structured clinical examination (OSCE) was introduced. Aims: The aim was to assess the students' exposure and perception of OSCE as well as its strengths and weaknesses in comparison to conventional clinical examination. Subjects and Methods: A cross-sectional study of students who had surgical OSCE was conducted from July 2018 to October 2018 in Ahmadu Bello University, Zaria. Using a structured questionnaire, exposure and perception of OSCE as well its strength and weaknesses in comparison to the conventional clinical examination were assessed with dichotomous questions and a 5-point Likert scale. Data were analyzed with SPSS Version 20. Results: One hundred and thirty-four students responded, mean aged 24.1 ± 4.3 years, with a male-to-female ratio of 2.5:1. Although 64.7% of them strongly agreed that OSCE is the standard mode of examination, only 36.1% strongly agreed that it was easier to pass. More than half of the students perceived that the content of the OSCE was appropriate, wide-scoped, unbiased, and brought out specific areas of weakness. Some students (38.1%), however, felt that there was a need for improvement in the OSCE process, especially in time allocation, but most of them (89.5%) prefer it and agree that it was superior to conventional clinical examination. Conclusions: The perception of the process and structure of OSCE among the medical students was good. Compared to conventional clinical examination, students found OSCE was easier and fairer, had a better examination of structure and level of coordination, and induced lesser anxiety and fatigue. However, the entire process of OSCE can be improved.

The practical part of the state final certification implies an assessment of skills.The objective of our study was the approbation of the Station of Subarachnoid Space Puncture as a part of the objective structured clinical examination.Subjects and methods. 26 students of the second year of the clinical residency were included in the study; they all were taking the practical part of the final exam in Anesthesiology and Reanimatology. A phantom-simulator was used for the manipulation, which allowed authentic simulating of a lumbar puncture. Two trainers evaluated the manual skills, independently of each other.Results. 25 (96%) residents passed the station successfully. The total time required to pass the station made 3.1 (2.58, 3.45) min. In 1 (4%) case, the student failed to gain the required number of points for the successful passage of this station. The most common mistakes during the manipulation were associated with improper control of the patient's state after the drug administration into subarachnoid space, there were 14 (54%) such cases; and in 10 (38%) cases, several attempts were required to obtain cerebrospinal fluid. The monitoring of the check-list filling incompletion demonstrated that different trainers at the station could use it. The difference in the filled check-lists was less than 5%.Conclusions. The developed check-list allows performing an objective assessment of the practical skills of graduates from the clinical residency.

Abstract Background To prevent the problems of traditional clinical evaluation, the “Objective Structured Clinical Examination (OSCE)” was presented by Harden as a more valid and reliable assessment instrument. However, an essential condition to guarantee a high-quality and effective OSCE is the assurance of evidence to support the validity of its scores. This study examines the psychometric properties of OSCE scores, with an emphasis on consequential and internal structure validity evidence. Methods Fifty-three first year medical students took part in a summative OSCE at the Lebanese American University-School of Medicine. Evidence to support consequential validity was gathered by using criterion-based standard setting methods. Internal structure validity evidence was gathered by examining various psychometric measures both at the station level and across the complete OSCE. Results Compared to our actual method of computing results, the introduction of standard setting resulted in lower students’ average grades and a higher cut score. Across stations, Cronbach’s alpha was moderately low. Conclusion Gathering consequential and internal structure validity evidence by multiple metrics provides support for or against the quality of an OSCE. It is critical that this analysis be performed routinely on local iterations of given tests, and the results used to enhance the quality of assessment.

Objectives Our school introduced a new curriculum based on faculty-directed, intensive, small-group teaching of clinical skills in the third-year medical students. To examine its effects, we compared the mean scores on an OSCE between the third- and fourth-year medical students. Methods Third- and fourth-year students did rotations at the same five OSCE stations. They then completed a brief self-reporting questionnaire survey to examine the degree of satisfaction with new curriculum in the third-year students and clinical practice in the fourth-year students, as well as their perception of confidence and preparedness. We analyzed the OSCE data obtained from 158 students, 133 of whom also completed the questionnaire. Results Mean OSCE scores on the breast examination and wet smear stations were significantly higher in the third-year group (P < 0.001). But mean OSCE scores of motor-sensory examination and lumbar puncture were significantly higher in the fourth-year group (P < 0.05). The mean OSCE scores had no significant correlation with satisfaction. In addition, the self-ratings of confidence had a high degree of correlation with satisfaction with new curriculum (r = 0.673) and clinical practice (r = 0.692). Furthermore, there was a moderate degree of correlation between satisfaction and preparedness in both groups (r = 0.403 and 0.449). Conclusions There is no significant difference in the effect on the degree of clinical performance and confidence between an intensive-small group teaching and a 1-year clinical practice. If combined, intensive small group teaching and clinical practice would be useful to improve the degree of ability and confidence in medical students.

Abstract Background High stress levels amongst undergraduates (particularly in relation to assessment) and efforts to improve mental wellbeing have been increasingly reported in the veterinary educational literature. However reports to date have primarily focused on the experiences of students of veterinary medicine, rather than veterinary nursing students. Methods The purpose of this mixed method sequential explanatory study was to establish the “Big-five” personality traits and quantify the level of test anxiety associated with objective structured clinical examinations (OSCEs) amongst a cohort of 23 final year veterinary nursing students at an Irish third level college. The 12 item Brief FRIEDBEN Test Anxiety Scale (B-FTAS) and the 20 item mini International Personality Item Pool (mini-IPIP) were used to identify test anxiety levels and personality traits in this cohort. Focus groups were then employed to examine the effectiveness of a coaching intervention in ameliorating this test anxiety. Results The initial, quantitative, phase found these students to have higher levels of test anxiety than previously reported for undergraduates sitting written examinations. No association was found between test anxiety and neurotic personality traits in this student cohort. In the qualitative follow up phase the coaching intervention was reported to have been helpful in equipping the students to better manage test anxiety. The OSCE stressors identified in this study closely resembled those previously reported by nursing and midwifery students. Conclusions The shared experience of the coaching intervention and formative OSCE was reported to have been helpful in empowering the students to manage assessment-associated anxiety. Implications and recommendations for educators were identified.

Abstract Background Task-specific checklists, holistic rubrics, and analytic rubrics are often used for performance assessments. We examined what factors evaluators consider important in holistic scoring of clinical performance assessment, and compared the usefulness of applying holistic and analytic rubrics respectively, and analytic rubrics in addition to task-specific checklists based on traditional standards. Methods We compared the usefulness of a holistic rubric versus an analytic rubric in effectively measuring the clinical skill performances of 126 third-year medical students who participated in a clinical performance assessment conducted by Pusan National University School of Medicine. We conducted a questionnaire survey of 37 evaluators who used all three evaluation methods—holistic rubric, analytic rubric, and task-specific checklist—for each student. The relationship between the scores on the three evaluation methods was analyzed using Pearson’s correlation. Inter-rater agreement was analyzed by Kappa index. The effect of holistic and analytic rubric scores on the task-specific checklist score was analyzed using multiple regression analysis. Results Evaluators perceived accuracy and proficiency to be major factors in objective structured clinical examinations evaluation, and history taking and physical examination to be major factors in clinical performance examinations evaluation. Holistic rubric scores were highly related to the scores of the task-specific checklist and analytic rubric. Relatively low agreement was found in clinical performance examinations compared to objective structured clinical examinations. Meanwhile, the holistic and analytic rubric scores explained 59.1% of the task-specific checklist score in objective structured clinical examinations and 51.6% in clinical performance examinations. Conclusion The results show the usefulness of holistic and analytic rubrics in clinical performance assessment, which can be used in conjunction with task-specific checklists for more efficient evaluation.

Introduction: Passing the Objective Structured Clinical Examination (OSCE) is currently a requirement for the vast majority (not all) of candidates to gain American Board of Anesthesiology (ABA) initial certification. Many publications from the ABA have attempted to justify its introduction, conduct and value. However, the ABA has never attempted to understand the views of the residents. Methods: A total of 4237 residents at various training levels from 132 programs were surveyed by asking to fill a Google questionnaire prospectively between March 8th, 2021 and April 10th, 2021. Every potential participant was sent an original email followed by 2 reminders. Results: The overall response rate was 17.26% (710 responses to 4112 invitations). On a 5-point Likert scale with 1 as "very inaccurate" and 5 as "very accurate," the mean accuracy of objective structured clinical examination (OSCE) in assessing communication skills and professionalism was 2.3 and 2.1 respectively. In terms of the usefulness of OSCE training for improving physicians' clinical practice, avoiding lawsuits, teaching effective communication with patients and teaching effective communication with other providers, the means on a 5-point Likert scale with 1 as "Not at all useful" and 5 as "Very useful" were 1.86, 1.69, 1.79, and 1.82 respectively. Residents unanimously thought that factors such as culture, race/ethnicity, religion and language adversely influence the assessment of communication skills. On a 5-point Likert scale with 1 as "not at all affected" and 5 as "very affected," the corresponding scores were 3.45, 3.19, 3.89, and 3.18 respectively. Interestingly, nationality and political affiliation were also thought to influence this assessment, however, to a lesser extent. In addition, residents believed it is inappropriate to test non-cardiac anesthesiologists for TEE skills (2.39), but felt it was appropriate to test non-regional anesthesiologists in Ultrasound skills (3.29). Lastly, nearly 80% of the residents think that money was the primary motivating factor behind ABA's introduction of the OSCE. Over 96% residents think that OSCE should be stalled, either permanently scrapped (60.8%) or paused (35.8%). Conclusions: Anesthesiology residents in the United States overwhelmingly indicated that the OSCE does not serve any useful purpose and should be immediately halted. [ABSTRACT FROM AUTHOR]

Objective: Good physician communication skills increase patient satisfaction and improve healing processes. Although physicians and patients appear to value communicative competencies differently, students are often evaluated solely by physicians. This study examines whether additional assessment of students by 'standardized patients' (SPs) is useful.Methods: During their Objective Structured Clinical Examination (OSCE) 238 medical students were additionally rated by SPs at 9 stations according to two items that defined the 'physician-patient relationship' and 'communication'. SPs were informed that their assessment was for research purposes only, with no impact on the assessment of the students. SPs also had the opportunity to comment on their rating of the students.Results: The SPs rated the communicative competencies of students differently than physicians. The two parts of the SP rating are closely related. Inclusion of SP rating in the OSCE would provide higher measurement precision, with more students failing. SPs considered five factors relevant in their rating: 'human connection', 'information flow', 'professionalism', 'competence', and 'exam situation'.Conclusion: Our study suggests inclusion of SP rating as additional assessment of student communication skills.Practice Implications: Addition of SP rating in assessments is worthwhile, as it appears to complete the picture of the student performance in their OSCEs. [ABSTRACT FROM AUTHOR]

Objectives: We compared the effect of different didactic formats - e - learning and role-playing - on medical students' knowledge and counselling skills in smoking cessation training. Methods: At a German medical school, 145 third-year students were randomly allocated to attend an online course with video examples or an attendance course with role-playing. Students were trained in smoking cessation counselling according to the 5A's (ask, advise, assess, assist, arrange) for approximately 90 minutes. Practical skills were measured in an objective structured clinical examination (OSCE) and represent the primary endpoint of this prospective comparative study. Additionally, changes in theoretic knowledge were assessed by pre - and post - interventional questionnaires and a final written exam. Results: In the OSCE, overall scores were higher in the attendance group (Mdn=70.8 % vs. 62.8 %; U=119; p=.087, n=36), but a statistical advantage was only found in one single counselling sequence (“Assist”: Mdn=66.7 % vs. 51.4 %; p = .049) and the rating of the standardised patients (M=4.7 vs. 4.2 out of 5 points, t(27.836)=2.0, p=.028). Students’ results (n=130) from self-assessment and written exams suggest that both approaches are equally well suited to increase theoretical knowledge. The online course was more time efficient (90 vs. 73 minutes). Conclusions: Seminar and web-based training seem equally well suited for transferring knowledge and skills on tobacco cessation counselling. Considering their particular strengths, these two teaching approaches could be combined. [ABSTRACT FROM AUTHOR]

An objective structured clinical examination (OSCE) is a performance-based examination in which students rotate through a series of stations where they are expected to perform specified tasks to demonstrate competency. This paper reports on student satisfaction with the OSCE administered at the end of a Doctor of Optometry professional program. Students were very positive about the interactions with standardized patients and the organization of the examination. They felt the examination used realistic scenarios. They had a mixed response to the use of simulators for skills assessment and the length of time available in each station to perform those tasks. Overall, the optometry students were very positive about the opportunity to participate in the OSCE prior to sitting for the entry-to-practice Optometry Examining Board of Canada examinations, which also use OSCEs. [ABSTRACT FROM AUTHOR]

Purpose: It aimed to compare the use of the tele-objective structured clinical examination (teleOSCE) with in-person assessment in high-stakes clinical examination so as to determine the impact of the teleOSCE on the assessment undertaken. Discussion follows regarding what skills and domains can effectively be assessed in a teleOSCE. Methods: This study is a retrospective observational analysis. It compares the results achieved by final year medical students in their clinical examination, assessed using the teleOSCE in 2020 (n=285), with those who were examined using the traditional in-person format in 2019 (n=280). The study was undertaken at the University of New South Wales, Australia. Results: In the domain of physical examination, students in 2020 scored 0.277 points higher than those in 2019 (mean difference=-- 0.277, P<0.001, effect size=0.332). Across all other domains, there was no significant difference in mean scores between 2019 and 2020. Conclusion: The teleOSCE does not negatively impact assessment in clinical examination in all domains except physical examination. If the teleOSCE is the future of clinical skills examination, assessment of physical examination will require concomitant workplace- based assessment. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic has required educators to adapt the in-person objective structured clinical examination (OSCE) to online settings in order for it to remain a critical component of the multifaceted assessment of a student's competency. This systematic scoping review aimed to summarize the assessment methods and validity and reliability of the measurement tools used in current online OSCE (hereafter, referred to as teleOSCE) approaches. A comprehensive literature review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Articles were eligible if they reported any form of performance assessment, in any field of healthcare, delivered in an online format. Two reviewers independently screened the results and analyzed relevant studies. Eleven articles were included in the analysis. Pre-recorded videos were used in 3 studies, while observations by remote examiners through an online platform were used in 7 studies. Acceptability as perceived by students was reported in 2 studies. This systematic scoping review identified several insights garnered from implementing teleOSCEs, the components transferable from telemedicine, and the need for systemic research to establish the ideal teleOSCE framework. TeleOSCEs may be able to improve the accessibility and reproducibility of clinical assessments and equip students with the requisite skills to effectively practice telemedicine in the future. [ABSTRACT FROM AUTHOR]

Copyright of Bagcilar Medical Bulletin / Bağcılar Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Transition to clerkship courses bridge the curricular gap between preclinical and clinical medical education. However, despite the use of simulation-based teaching techniques in other aspects of medical training, these techniques have not been adequately described in transition courses. We describe the development, structure and evaluation of a simulation-based transition to clerkship course. Approach: Beginning in 2012, our institution embarked upon an extensive curricular transformation geared toward competency-based education. As part of this effort, a group of 12 educators designed, developed and implemented a simulation-based transition course. The course curriculum involved seven goals, centered around the 13 Association of American Medical Colleges Core Entrustable Professional Activities for entering residency. Instructional techniques included high-fidelity simulation, and small and large group didactics. Student competency was determined through a simulation-based inpatient-outpatient objective structured clinical examination, with real-time feedback and remediation. The effectiveness of the course was assessed through a mixed methods approach involving pre- and post-course surveys and a focus group. Evaluation: Of 166 students, 152 (91.6%) completed both pre- and post-course surveys, and nine students participated in the focus group. Students reported significant improvements in 21 out of 22 course objectives. Qualitative analysis revealed three key themes: learning environment, faculty engagement and collegiality. The main challenge to executing the course was procuring adequate faculty, material and facility resources. Reflection: This simulation-based, resource-heavy transition course achieved its educational objectives and provided a safe, supportive learning environment for practicing and refining clinical skills. [ABSTRACT FROM AUTHOR]

Test anxiety is well studied in higher education, but studies primarily concern traditional assessments, such as written examinations. As use of objective structured clinical examination (OSCE) in pharmacy education increases, a closer examination of non-cognitive factors such as test anxiety is warranted. The purpose of this review was to determine the association between OSCE-associated test anxiety with OSCE performance in health professional students. A literature search was conducted to identify peer-reviewed literature concerning test anxiety in health professional students associated with OSCE. Investigators searched for a combination of OSCE-related terms with anxiety-related terms using PubMed. Articles were included if they assessed OSCE-related anxiety by quantitative or qualitative methods. Data extracted from eligible articles included demographic data, type of the anxiety survey, associations between OSCE-related anxiety and performance, and other student-factors associated with OSCE-related anxiety. The literature search yielded 339 articles. Nine articles met eligibility criteria and were included in the review. Results included students from medical, pharmacy, dental, and nursing professional programs. Anxiety was assessed via multiple scales. Six out of the eight studies assessing the relationship OSCE-related anxiety and OSCE performance found no association between the two measures. Contrary to literature concerning test anxiety in higher education, female gender was not associated with OSCE-related anxiety. OSCE-related anxiety appears to have minimal to no influence on student performance. Future studies should utilize standardized anxiety assessments and should seek to understand anxiety's effects on student wellbeing and burnout. • As use of OSCE expands, educators must consider the consequences of OSCE-related performance and test anxiety. • Although health profession students experience anxiety during OSCE, this appears to have little to no impact on performance. • However, test anxiety is higher with OSCE compared to other assessments and should be considered in the context of student wellness. [ABSTRACT FROM AUTHOR]

Objective To analyze the effect of specialized training of Traditional Chinese Medicine (TCM) nursing in Nanjing, in order to improve the quality of TCM nursing training in Nanjing and cultivate practice-based nurse specialists in TCM. Methods According to the inclusion and exclusion criteria, The first batch of trainees specialized in TCM nursing from several hospitals in Nanjing municipal were selected. Delphi method was used to construct the training system and training module, and the training was carried out from April 2019 to November 2019. Results A total of 31 trainees specialized in TCM nursing were included in this study. The goal of improving the implementation of TCM nursing techniques was accomplished with a highest increase rate (67.74%). The score of assessment about TCM theory was (51.19 ± 11. 91) before training and (84.19 ± 6. 90) after training, with a significant difference (P <0. 05). The score of objective structured clinical examination was (83.90 ±10. 70). There was a remarkable increase in number of researches held by trainees and number of TCM nursing technology carried out by trainees. Conclusion Through the systematic implementation of the training, scientific training courses, strict selection criteria and practical implementation of target management, the nurses' specialty in TCM nursing can be effectively improved. [ABSTRACT FROM AUTHOR]

Aim: Objective structured clinical examination (OSCE) has become an important assessment method in medicine which is more reliable than traditional exams. Faculty members make an opinion about the students during their clerkship. We aimed to investigate whether their judgments affect the scoring in the OSCE application. Material and Methods: The study was planned prospectively. 4th-year students participating in the OSCE was identified as the working group. At the end of the clerkship, the faculty members gave a performance assessment (PA) score including the professional attitude of the students. PA and OSCE scores were compared. Two other faculty members participated all OSCE stations as external evaluators. Results: There was a difference between OSCE and PA scores. Fewer students were successful at OSCE than PA (p=0.002). While the mean PA scores of three of the five faculty members were statistically similar, other two were different. The scores given by the responsible faculty members and the external evaluators from the faculty of internal medicine were similar (p>0.05). The evaluators from the surgical faculty gave lower scores statistically different from both groups (p<0.05). There was a strong relationship between the scores given by the faculty members responsible for the OSCE application and the faculty members from the surgical faculty (r=0.936; p<0.001) and those from the internal medicine faculty (r=0.947; p<0.001). Conclusion: PA scores of the faculty members did not affect the OSCE scores which were supported by the external observers. The OSCE assessment was not influenced by the PA, and was found to be reliable. [ABSTRACT FROM AUTHOR]

Objective structured clinical examinations (OSCEs) allow for holistic evaluation of clinical competence, but integration of reflective practices on OSCE performance has not been well-studied. To develop metacognitive skills, second-year pharmacy students completed a self-reflection assignment on a mock medication therapy management OSCE in an introductory pharmacy practice experience course. Students who completed the course during the prior year (no self-reflection assignment) served as the control. The study assessed the correlation of students' reflections of their OCSE abilities to OSCE performance and evaluated if student demographics influenced the correlation. There were 107 students in the control group and 95 students in the intervention group. A higher proportion of students passed the overall OSCE in the control group (67.4%) compared to the intervention group (58.9%), but this was not statistically significant. Neither gender, age, nor Pharmacy College Admissions Test score had an effect on OSCE pass rates. Grade point average did have a significant effect on OSCE pass rates (P =.019). Overall, no statistically significant association was seen in summative OSCE performance between students who used structured, guided questions to reflect on their formative OSCE performance and those who did not (P >.05). Despite this study's results, faculty continue to embrace the concept of reflective practice. Further research is needed to assess the value and role of reflective practice in pharmacy education. • Reflections can serve as an integral metacognitive practice to improve performance • Pharmacy students participated in reflection activities with the goal to improve performance an objective simulated clinical examination (OSCE) • The study demonstrated the importance of addressing numerous factors that can impact performance [ABSTRACT FROM AUTHOR]

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)