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New prescription counseling (NPC) provides vital information to patients regarding newly prescribed medications to improve treatment outcomes. This evaluation's goals were to describe the implementation of teaching and assessment methods incorporated into an NPC module across two courses at Auburn University and evaluate student performance on assessments of NPC skills over five years. Assessments included self and peer evaluations of a recorded mock NPC session, NPC objective structured clinical examination (OSCE), and overall course grade. Scores were analyzed over a five-year period (2012 to 2016) to evaluate mean student performance in each of four domains (gathering information, communication, management strategies, and monitoring and follow-up) and overall for each assessment. Pearson's correlation coefficients between these scores were calculated by combining all five years of data. Seven-hundred thirty-three students were included in the analysis. No trends in mean domain and total assessment scores were noted across years. Self and peer evaluation domain and total scores were significantly, though moderately, correlated across assessments (r = 0.43–0.51), except in the communication domain (r = 0.12). Overall, NPC OSCE total scores were not correlated with NPC recording self or peer evaluation total scores (r = 0.06 and r = 0.11, respectively). Assessment total scores were all moderately correlated with overall course grades. Utilization of a scaffolding approach with class discussion, demonstration, role-play, self and peer evaluation, and OSCEs, is an effective means of building student competence in patient counseling for the NPC context. • Utilization of a scaffolding approach is an effective means of building student competence in patient counseling; • Self- and peer-evaluations of a mock counseling session are an effective assessment strategy requiring minimal faculty time; • Self and peer evaluations were correlated with one another, but were not correlated with performance on the OSCE [ABSTRACT FROM AUTHOR]

The objective of this study was to determine whether an asynchronous smartphone-based application with image-based questions would improve anesthesiology resident transesophageal echocardiography (TEE) knowledge compared with standard intraoperative teaching alone. Prospective, single-blinded, pilot, randomized controlled trial. Large university teaching hospital. Participants were anesthesiology residents on their cardiac anesthesiology rotation. EchoEducator, a TEE image–based smartphone application of learning content through questions, was developed. Content was derived from the Examination of Special Competence in Basic Perioperative Transesophageal Echocardiography and the Objective Structured Clinical Examination portion of the APPLIED Examination and focused on identification of basic TEE views, cardiac structures, and pathology. Residents were randomly assigned to receive access to either the application or to standard intraoperative teaching. Thirty residents met inclusion criteria, and 18 residents completed the study. A pre-intervention assessment was given at the beginning of the rotation, and a post-intervention assessment was given after 2 weeks. The primary outcome was the difference between the post-test score and the pre-test score. Standard bivariate statistics and the chi-square test were used for categorical variables, and the Student t test was used for continuous variables. Tests were 2-sided, and statistical significance was set at p < 0.05. The intervention group demonstrated a greater increase in score; (+19.19% [95% confidence interval 4.14%-34.24%]; p = 0.02) compared with the control group. This study supports the hypothesis that use of a smartphone-based asynchronous educational application improves TEE knowledge compared with traditional modalities alone. This supports an opportunity to improve medical education by expanding the role of web-based asynchronous learning. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: Rating scales have been described as better at assessing behaviours such as professionalism during Objective Structured Clinical Examinations (OSCEs). However, there is an increased need to train and calibrate staff on their use prior to student assessment. Material and methods: An online e‐learning package was developed and made available to all examiners at the Institute of Dentistry at the University of Aberdeen. The package included videos of three OSCE stations (medical emergency, rubber dam placement and handling a complaint) which were recorded in two different scenarios; (excellent and unsatisfactory candidate). These videos were recorded to meet a pre‐defined marking score. The examiners were required to mark the six videos using pre‐set marking criteria (checklist and rating scales). The rating scales included professionalism, general clinical ability and/or communication skills. For each video, examiners were given four possible options (unsatisfactory, borderline, satisfactory or excellent), and they were provided with a description for each domain. They were also required to complete a questionnaire to gather their views on the use of this e‐learning environment. Results: Fifteen examiners completed the task. The total scores given were very similar to the expected scores for the medical emergency and complaint stations; however, this was not the case for the rubber dam station (P‐value.017 and.036). This could be attributed to some aspects of the placement of the rubber dam being unclear as commented on in the examiners questionnaires. There was consistency in the selection of marks on the rating scales (inter‐examiner correlation ranged between 0.916 and 0.979). Conclusion: Further studies are required on the field of e‐learning training to calibrate examiners for practical assessment; however, this study provides preliminary evidence to support the use of videos as part of an online training package to calibrate OSCE examiners on the use of rating scales. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Background: One of the important goals of clinical education is to promote the level of students' clinical skills. About 50% of the midwifery education is focused on clinical education, which has a great importance in shaping the professional skills of the students. The aim of this study was to determine the ability of students in some practical skills, before internship program in the field, using objective structured clinical examination (OSCE). Materials and Methods: This research was a descriptive cross-sectional study with a single-stage, multivariate prospective design. Twenty-seven midwifery students from the Isfahan University of Medical Sciences who were in their sixth semester were selected by convenience sampling during the second semester of 2015–2016 educational year. OSCE was executed at skill laboratories in 8 stations during one day, and researcher-made checklists were used; their content and face validity were approved and their reliability was confirmed by a Cronbach's alpha coefficient of 0.97. Data analysis was performed by SPSS19. Results: Results showed that the level of students' skills at pelvic exam station was 39.97%, at bladder catheterization was 66.92%, at Leopold was 42.7%, at fetal ECG interpretation was 50.49%, at physical examination was 21.30%, at fetal resuscitation was 48.81%, at breast examination was 56.32%, and at answering the questions was 23.49%. Conclusions: Results show that students gained a score of less than 50% in most skills. Therefore, they are not efficiently skilled for these essential clinical skills. Nonetheless, these procedures need the minimum skills that are required from students after graduation and before entering the working environment in hospitals and health centers. Therefore, more attention should be paid to these skills while planning internship programs before students enter the field. Also, more attention is required while teachers teach these skills and students are supposed to regard their weaknesses in these skills.

Abstract Background Medical students may not be able to identify the essential elements of situational awareness (SA) necessary for clinical reasoning. Recent studies suggest that students have little insight into cognitive processing and SA in clinical scenarios. Objective Structured Clinical Examinations (OSCEs) could be used to assess certain elements of situational awareness. The purpose of this paper is to review the literature with a view to identifying whether levels of SA based on Endsley’s model can be assessed utilising OSCEs during undergraduate medical training. Methods A systematic search was performed pertaining to SA and OSCEs, to identify studies published between January 1975 (first paper describing an OSCE) and February 2017, in peer reviewed international journals published in English. PUBMED, EMBASE, PsycINFO Ovid and SCOPUS were searched for papers that described the assessment of SA using OSCEs among undergraduate medical students. Key search terms included “objective structured clinical examination”, “objective structured clinical assessment” or “OSCE” and “non-technical skills”, “sense-making”, “clinical reasoning”, “perception”, “comprehension”, “projection”, “situation awareness”, “situational awareness” and “situation assessment”. Boolean operators (AND, OR) were used as conjunctions to narrow the search strategy, resulting in the limitation of papers relevant to the research interest. Areas of interest were elements of SA that can be assessed by these examinations. Results The initial search of the literature retrieved 1127 publications. Upon removal of duplicates and papers relating to nursing, paramedical disciplines, pharmacy and veterinary education by title, abstract or full text, 11 articles were eligible for inclusion as related to the assessment of elements of SA in undergraduate medical students. Discussion Review of the literature suggests that whole-task OSCEs enable the evaluation of SA associated with clinical reasoning skills. If they address the levels of SA, these OSCEs can provide supportive feedback and strengthen educational measures associated with higher diagnostic accuracy and reasoning abilities. Conclusion Based on the findings, the early exposure of medical students to SA is recommended, utilising OSCEs to evaluate and facilitate SA in dynamic environments.

Introduction: The purpose of medical education is to acquire knowledge, perspective and skills necessary for patient treatment, and focus on assessment as a tool for quality assurance in educational programs is one of the important traits of medical education. The purpose of this study was to investigate the achieving rate of learning minimums in common pediatric illnesses among medical interns of Isfahan University of Medical Sciences. Methods: This descriptive, cross-sectional study was conducted in 2014-15 academic year. Research population included the medical interns of Isfahan University of Medical Sciences who were selected through convenience sampling (census) (n=84). Data were collected using 8-station objective structured clinical examination. Views of medical education and pediatrics experts were used to confirm content and face validity. Reliability coefficient of the examination was calculated using Cronbach’s alpha of 0.86. A checklist (total score=20) was used to assess each station. Data were analyzed using descriptive statistics. Results: Mean scores of achieving rate of learning minimums in common illnesses were as follows in each station: ear checkup (13.64±1.96), common cold (16.60±2.62), diarrhea and vomiting (15.56±4.22), croup (9.28±2.07), acute seizure (15.96±2.42), history taking of seizure (14.88±2.81), interpretation of growth chart (13.60±3.17) and history taking in underweight child (8.76±3.25). Conclusion: Interns’ achieving rate of learning minimums in common pediatric illnesses was acceptable in four stations, less than expected in two stations and unacceptable in two other stations. Considering the importance of the issue, it is therefore recommended to revisit the duration and methods of ambulatory trainings in pediatrics internship programs.

Introduction: With the increasing popularity of performance-based assessments, it is necessary to employ proper indicators to ensure their quality. The present study examines the metrics of Objective Structured Clinical Examination (OSCE). Methods: In this descriptive, cross-sectional research in 10 pre-internship OSCE stations of Tehran University of Medical Sciences in 2012, the cut-off score was determined by borderline regression method and the failure rate was calculated. Root Mean Square Error (RMSE) was used to estimate error rate threshold. Internal consistency was calculated using Cronbach’s alpha and then, the Standard Error of Measurement (SEM) was determined. Alpha if item deleted, R2 coefficient, intergrade discrimination, difficulty and discrimination indices were calculated for each station. A total of 266 students participated in this exam. Results: A total of 266 students participated in this exam. The OSCE total cut-off score was 52.55 (out of 100). Four students (1.5%) failed the exam and the RMSE equaled 0.45. SEM was 4.84 and Cronbach’s alpha was calculated at 0.70 where the alpha if item deleted scores varied from 0.64 to 0.70. The R2 coefficient ranged from 0.16 to 0.85 and the intergrade discrimination ranged between 0.66 and 1.93. The ranges of difficulty and discrimination indices were 0.71-0.89 and 0.12-0.44 respectively. Conclusion: The internal consistency, SEM and threshold error rate were all acceptable. The alpha if item deleted was in the acceptable range in all stations. In two stations, the R2 value was lower than the desired range. The intergrade discrimination value was appropriate in all stations except one. The stations were not too difficult or highly discriminative which is considered favorable in criterion-referenced exams.

Mohammed Abdul Shafi, Mohamed Rimzy Mohamed Riza, Muhammed Shaan RiazFaculty of Medicine, St George’s Hospital Medical School, London, UKWe have read with great interest the article by Kumar et al,1 which correlates the performance of physician associates in a multiple mini-interview (MMI) to performances in objective structured clinical examinations (OSCEs). As senior medical students, we share many similarities with physician associate students as we were assessed through MMIs for entrance into medical school and are constantly assessed via OSCEs throughout our training. We would therefore like to share our perspective on the topic.Authors' responseWe thank Shafi et al for their interest in our recently published paper1 and for sharing their perspective as medical students who have gone through multiple mini-interview (MMI) and objective structured clinical examinations (OSCE). Having read their response in detail, we feel it warrants several clarifications.View the original paper by Kumar and colleagues.

Introduction: The aim of the Objective Structured Clinical Examination (OSCE) is a standardized and fair assessment of clinical skills. Observing second clinical year medical students during a summative OSCE assessing a General Practice clerkship, we noticed that information exchange with peers led to a progressively faster and overly focused management of simulations. Therefore, we established a Multiple Scenario-OSCE (MS-OSCE) where all students had to manage the same chief complaint at a station but it’s underlying scenarios being randomly changed during students’ rotation through their parcours. We wanted to ensure they fully explore differential diagnosis instead of managing their task influenced by shared information. We wanted to assess if a MS-OSCE violates the assumption of objectivity and fairness given that students are not tested with the same scenarios.Methods: We developed and piloted five OSCE stations (chest pain, abdominal pain, back pain, fatigue and acute cough) with two or three different underlying scenarios each. At each station these scenarios randomly changed from student to student. Performance was assessed with a checklist and global rating. The effect of scenarios and raters on students’ grades was assessed calculating the intraclass correlation coefficient with a fixed effect two level linear model.Results: A total of 169 students and 23 raters participated in the MS-OSCE. The internal consistency over all stations was 0.65 by Cronbach’s alpha. The difference of the mean grades between the scenarios of a given chief complaint ranged from 0.03 to 0.4 on a 1 to 5 grading scale. The effect of scenarios on the variance of the final grades at each station ranged from 4% to 9% and of raters from 20% to 50% when adjusted for students’ skills. Conclusions: The effect of different scenarios on the grades was relevant but small compared to the effect of raters on grades. Improving rater training is more important to ensure objectivity and fairness of MS-OSCE than providing the same scenario to all students.

Introduction: Soft tissue masses are commonly encountered in surgical and general medical practice. The graduating medical student should therefore be competent in the physical examination of a lump. Paucity of real patients makes it paramount that models be used for teaching and evaluation. This study purposed to describe the perception of graduating medical students to the use of a low-cost lump model for Objective Structured Clinical Examination (OSCE)., Methods: This was a cross-sectional survey of final year medical students who participated in a surgery OSCE utilizing an innovative low-cost lump model., Results: One hundred and sixty students undertook the OSCE examination while 130 (81.3%) students completed the survey questionnaire. One hundred and forty students (87.5%) passed (score 3 5) the skills assessment using the lump model. The median age of the students who completed the questionnaire was 25 (range 24-27) years. There were more males N=84 (65.6%) than females N= 44 (34.4%). Two thirds (67.2%; n=84) of the students said the model simulated a true lump. Nearly all the students agreed that the signs of site (97.6%; n=127), size (97.6%; n=127), shape (95.4%; n=124) and transillumination (95.4%; n=124) were clearly demonstrable with the model. A lower proportion of agreements were seen with signs such as tenderness (64.6%; n=82), attachment (77.7%; n=80) and warmth (58.6%; n=75) while more students disagreed with pulsatility (51.5%; n=67)., Conclusion: The medical students had a positive perception to the use of the model. However, further refinements would be needed for more signs to be demonstrable., (© Association of Resident Doctors, UCH, Ibadan.)

SaNuRN is a five-year project by the University of Rouen Normandy (URN) and the Côte d’Azur University (CAU) consortium to optimize digital health education for medical and paramedical students, professionals, and administrators. The project includes a skills framework, training modules, and teaching resources. In 2027, SaNuRN is expected to train a significant portion of the 400,000 health and paramedical professions students at the French national level. Our purpose is to give a synopsis of the SaNuRN initiative, emphasizing its novel educational methods and how they will enhance the delivery of digital health education. Our goals include showcasing SaNuRN as a comprehensive program consisting of a proficiency framework, instructional modules, and educational materials and explaining how SaNuRN is implemented in the participating academic institutions. SaNuRN is a project aimed at educating and training health-related and paramedics students in digital health. The project results from a cooperative effort between URN and CAU, covering four French departments. The project is based on the French National Referential on Digital Health (FNRDH), which defines the skills and competencies to be acquired and validated by every student in the health, paramedical, and social professions curricula. The SaNuRN team is currently adapting the existing URN and CAU syllabi to FNRDH and developing short-duration video capsules of 20 to 30 minutes to teach all the relevant material. The project aims to ensure that the largest student population earns the necessary skills, and it has developed a two-tier system involving facilitators who will enable the efficient expansion of the project’s educational outreach and support the students in learning the needed material efficiently. With a focus on real-world scenarios and innovative teaching activities integrating telemedicine devices and virtual professionals, SaNuRN is committed to enabling continuous learning for healthcare professionals in clinical practice. The SaNuRN team introduced new ways of evaluating healthcare professionals by shifting from a knowledge-based to a competencies-based evaluation, aligning with the Miller teaching pyramid and using the Objective Structured Clinical Examination and Script Concordance Test in digital health education. Drawing on the expertise of URN, CAU, and their public health and digital research laboratories and partners, the SaNuRN project represents a platform for continuous innovation, including telemedicine training and living labs with virtual and interactive professional activities. The SaNuRN project provides a comprehensive, personalized 30-hour training package for health and paramedical students, addressing all 70 FNRDH competencies. The program is enhanced using AI and NLP to create virtual patients and professionals for digital healthcare simulation. SaNuRN teaching materials are open-access. The project collaborates with academic institutions worldwide to develop educational material in digital health in English and multilingual formats. SaNuRN offers a practical and persuasive training approach to meet the current digital health education requirements., (© Julien Grosjean, Frank Dufour, Arriel Benis, Jean-Marie Januel, Pascal Staccini, Stéfan Jacques Darmoni. Originally published in JMIR Medical Education (https://mededu.jmir.org), 30.04.2024.)

Objective: To update the description of current objective structured clinical examination (OSCE) practices within pharmacy schools in the United States and identify barriers to OSCE implementation and expansion., Methods: A survey was deployed to all accredited Doctor of Pharmacy programs within the United States. The survey was designed to collect information regarding the curricular mapping of OSCEs, OSCE design, OSCE delivery, assessment of OSCE performance, and barriers to OSCE implementation and expansion., Results: Of the 135 US-accredited programs identified, 109 (81%) programs completed the survey. In total, 93 (85%) programs reported using OSCEs to assess students; however, implementation throughout the curriculum and current practices varied by institution. Most programs place OSCEs within specific courses (96%), with the applied skills coursework being the most used (80%). The most common number of OSCEs that occur throughout a curriculum is 6 (18%), however, 20 (22%) programs execute 10 or more OSCEs throughout their curriculum. Forty (43%) programs use OSCEs as high-stakes assessments where poor performance could prevent a student from progressing to advanced pharmacy practice experiences. Of the responding programs, over half (56%) use teaching objective structured examinations to enhance learning. Common barriers to OSCE expansion exist and are related to resource utilization., Conclusion: Significant expansion of OSCE development and implementation has occurred over the last decade. There is substantial variability in implementation and utilization among programs. Although standards of best practice for OSCEs exist for other health professions, best practices in pharmacy education have not been widely accepted or adopted., Competing Interests: Declaration of Competing Interest Kylie Barnes receives speaking and lecture fees from the American College of Clinical Pharmacy. The remaining authors have no competing interests to declare., (Copyright © 2024 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Interprofessional education (IPE) is required in the advanced nursing practice curriculum to promote collaboration between health care professionals. Time constraints, accessibility, and geographical locations are common barriers to overcome when considering implementing IPE experiences. Utilizing virtual modalities to develop these experiences can increase IPE opportunities. An innovative approach was taken to incorporate a telehealth Objective Structured Clinical Examination involving family nurse practitioner and pharmacy students from different academic institutions for an IPE virtual simulation. Faculty evaluated student performance based on competencies. Faculty and student feedback regarding the IPE experience was positive. [ABSTRACT FROM AUTHOR]

Patients want empathetic physicians who listen and understand. How do you teach and measure empathy? Medical educators, including those inspired by Alan Alda, have turned to theater to teach skills in empathetic communication. Improvisation-informedcurriculum (medical improv) draws upon foundational actors training: deep listening, emotional understanding, connections, authenticity. Arating scale to measure the impact of medical improv on empathetic and clear communication does not exist. Objective: To develop aframework and instrument, the Empathy and Clarity Rating Scale (ECRS), for measuring communication elements used by actors and physicians, and pilot ECRS to test effectiveness of medical improv on first-yearstudents' communication skills. Design: Four medical schools collaborated. USMLE Step 2 Communication and Interpersonal Skills (CIS) domains were used as framework for discussion among three focus groups, each with clinicians, actors, communication experts, and community members with patient experience. Audiotaped discussions were transcribed; open coding procedures located emerging themes. The initial coding scheme was compared with the Consultation and Relational Empathy (CARE) measure. ECRS content was aligned with CARE, CIS and focus group themes. Modified nominal processes were conducted to finalize the scale. We implemented procedures to establish content validity and interrater reliability. Final ECRS was used to study student performance across three levels of experience with medical improv. Results: The final ECRS was comprised of seven five-pointscale items. Narrative comments precede behaviorally anchored ratings: 5=desired, 1=ineffective, 2–4=developing based upon adjustment needed. Rater agreement across all items was 84%. There was asmall correlation between the ECRS and another measure interviewing (r=0.262, p=0.003). Students with advanced medical improv training outperformed those without (F=3.51, p=.042). Conclusion: Acommunication scale enlightened by experiences of actors, clinicians, scholars and patients has been developed. The ECRS has potential to detect the impact of medical improv on development of empathetic and clear communication. [ABSTRACT FROM AUTHOR]

Despite the fact that one fifth of Americans live with disability, caring for these patients is not routinely part of the undergraduate medical student curriculum. An innovative session addressing care of patients with spinal cord injury was developed for medical students and led by physiatrists, faculty experts in communications, and individuals with spinal cord injury. A mixed-method design was used in evaluating students' knowledge, skills, and attitudes following this curriculum. Quantitative evaluation was performed with a written essay question and checklist items from an objective structured clinical examination station. The session was given to 296 students from 2016 to 2018. On the objective structured clinical examination, 94% asked about sexual function, 85% asked about activities of daily living, 77% asked about instrumental activities of daily living, and 47% of students evaluated skin health. Students demonstrated respectful (99%) and nonjudgmental (99%) attitudes with spinal cord injury standardized patients and 91% interacted with the standardized patients caretaker appropriately. Themes emerged from the student survey including the following: the value of having real patients present during the session, exposure to physical medicine and rehabilitation as a specialty, and the advantage of a small group format. This session provided students with tools necessary to care for patients with spinal cord injury. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of online videos along with traditional teaching on learning pharmacotherapeutic skills. Materials and Methods: Eight videos illustrating skills required for drug administration by parenteral and inhalational routes were developed and uploaded along with additional resource materials on a dedicated website. Following an online pretest, two practicals on routes of drug administration were conducted for 181 II MBBS students. They were then allowed to voluntarily watch the videos. Video usage, change in knowledge (pre- and post-video observation test score), and performance (Objective Structured Clinical Examination [OSCE] scores of two internal assessments) and perceptions (using prevalidated questionnaire) were recorded. Results: The average number of videos watched/student was 7.50 ± 1.30, whereas the average number of times each video watched was 1.50 ± 0.094. Only 39 students watched the videos before the first internal assessment were found to have statistically higher OSCE score compared to others who failed to watch (P = 0.006). The latter group watched the videos subsequently and showed improvement in their OSCE scores in the second internal assessment as compared to the first one (14.28 ± 3.26; P = 0.001). Students (93.10%) perceived the online videos as useful teaching tools, which helped them to understand and retain the sequence of procedural steps of the skills better. Conclusion: Drug administration skills when taught using a blend of traditional teaching methods and online videos, improved the performance with added reinforcement. Student acceptability was high indicating online videos can serve as a supplementary tool. [ABSTRACT FROM AUTHOR]

Objective: The main objective was to explore the perceptions of undergraduate nursing students on OSCE as a method of clinical evaluation in mental health nursing clinical examination and to compare the scores of written clinical examination and OSCE in mental health nursing. Method: A quantitative research using descriptive survey design was done among Baccalaureate Nursing students enrolled for Mental Health Nursing Clinical Course, NURS 3017 in the spring 2018. Pierre et al's (2004) OSCE evaluation questionnaire was used to assess student's perception about OSCE. Results: A paired t test was conducted to compare the scores of OSCE and final written clinical examination. There was a significant difference in the mean scores of OSCE (Mean=31.03, SD=3.05) and written clinical examination (Mean=29.67, SD=3.35); t=2.24, p=.031. These results suggests that students scored better in OSCE as compared to written clinical examination. The perception of the students towards OSCE as a clinical examination method shows that 51% of the students prefer OSCE over clinical written examination. Conclusions: It is a mandatory requirement for nurse educators today to have a patient safety curriculum. OSCE gives a fair chance to all the students to go through same process of evaluation and examiners can make sure every student has learned necessary skills appropriately to provide comprehensive care in the respective field. Hence OSCE should be integrated with other method of clinical evaluation in mental health nursing education in Oman. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Background: Objective structured clinical examinations (OSCEs) have been used globally in medical education and touted as the "gold standard" for competence-based assessments. However, the value of OSCEs in nursing education has not been extensively evaluated. Purposes: This review aims to report the global trends in nursing OSCEs; evaluate their validity, reliability, acceptability, and costs; and present the characteristics of validated nursing OSCEs. Methods: This is a scoping review involving a systematic search in 7 electronic databases. Results: A total of 204 studies, published between 1982 and 2018, were included in the review. We found that nursing OSCEs were extensively used across various nursing specialties in 33 countries and confirmed their validity, reliability, and acceptability in nursing education. Conclusions: This review confirms the value of OSCEs in nursing education and presents the underlying characteristics of validated nursing OSCE designs. [ABSTRACT FROM AUTHOR]

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 < 0.001 in SP group; d 0.77, p < 0.001 in RP group). However, there were no differences between the two groups. Students achieved the highest OSCE score for smoking-cessation counseling before the KMLE. After training, student self-confidence and smoking-knowledge test scores increased significantly, regardless of the type of module. Self-confidence was higher in the SP group compared with the RP group (d 0.37, p = 0.01). Conclusions: Peer role-play may be equivalent to the SP method with regard to knowledge and skills reported during smoking-cessation counseling and SP method may be better in self-confidence. Cost and student self-confidence may be important factors when choosing among the teaching methods for smoking-cessation counseling. [ABSTRACT FROM AUTHOR]

Medical education faces challenges concerning job burnout and emotional labor among junior physicians, which poses a potential threat to the quality of medical care. Although studies have investigated job burnout and emotional labor among physicians, empirical research on the association between job burnout, emotional labor, and clinical performance is lacking. This study investigated the effects of job burnout and emotional labor on clinical performance by using the objective structured clinical examination (OSCE) scores of interns and residents. Specifically, this cross-sectional study utilized the Maslach Burnout Inventory and the Emotional Labor Questionnaire as measurement instruments. A total of 225 interns and residents in central Taiwan answered structured questionnaires before beginning their OSCE. The major statistical analysis method employed was logistic regression. After adjustment for covariates, first-year residents were less likely than other residents to obtain high OSCE scores. The odds of high OSCE performance among interns and residents with high interaction component scores in emotional labor were significantly higher than those with low interaction scores. A high score in the interaction dimension of emotional labor was associated with strong clinical performance. The findings suggest that interventions which motivate positive attitudes and increase interpersonal interaction skills among physicians should receive higher priority. [ABSTRACT FROM AUTHOR]

Background: Acquiring medical competencies alone does not necessarily lead to the delivery of quality clinical care. Many UK training programs are soon to be based on the curricula of entrustable professional capabilities (EPCs). These are tasks carried out in practice requiring proficiency in several competencies for quality practice. Assessments to evaluate EPCs for independent practice are needed. Comprehensive geriatric assessment (CGA) is an EPC in geriatric medicine. We describe the development of an assessment of CGA as an example of examining EPCs. Methods: A CGA station was introduced in the Diploma in Geriatric Medicine clinical examination. Candidates rotate through four stations: three single competency‑based stations (history, communication/ethics and physical examination) and an EPC‑based station in CGA. Results: One hundred and seventy‑eight (female: 96 [53.9%]) candidates took it. There was a weak but significantly positive correlation between the score at CGA and the total score in the other stations (r = 0.46; P < 0.001). Most candidates passing the station passed the examination. Correlation with other stations similarly showed weak significant correlations (Station 1: r = 0.38; P < 0.001, Station 3: r = 0.28; P < 0.001, and Station 4: r = 0.37; P < 0.001). There was 61.4% (kappa: 0.61; P = 0.000) agreement between examiners whether a candidate passed or failed. Agreement was higher for the other stations, i.e. Station 1 (kappa: 0.85; P < 0.001), Station 3 (kappa: 0.72; P < 0.001), and Station 4 (kappa: 0.85; P < 0.001). Discussion: Performance on the station correlated positively with overall performance, suggesting that it has discriminatory value in differentiating candidates with varying ability and the more able candidates pass the examination [ABSTRACT FROM AUTHOR]

Although reviewing dental students' clinical competency assessments is an important aspect of instruction, finding time to give individual feedback to each student poses a challenge for faculty members, and some students may prefer to receive feedback from a peer. The aim of this study was to explore dental students' perceived value of feedback on their performance in a simulated patient care activity from either a faculty member or a peer. Participants were third‐ and fourth‐year dental students who had completed two years of interprofessional instruction and a videotaped objective structured clinical examination (OSCE) with standardized patients. Participants in two cohorts were randomly assigned to a faculty or peer feedback group. Cohort one (2015‐16) consisted of 66 students: 21 in faculty‐led groups, and 45 in peer‐led groups. Cohort two (2017) consisted of 60 students: 17 in faculty‐led groups, and 43 in peer‐led groups. In both types of pairings, the protocol consisted of jointly observing a video recording of student performance in the simulated patient encounter and discussing questions about the student's performance in non‐technical competencies such as communication, patient safety, scope of practice, and conflict resolution. For cohort two, prior to the feedback sessions, students in the peer feedback groups received a 60‐minute training on providing constructive feedback. All 126 students in the two cohorts completed an evaluation questionnaire after the experience. The results showed that students in both types of feedback sessions perceived value in the feedback and believed it enhanced their skills. However, students rated faculty feedback significantly higher (p<0.05) than peer feedback on nearly all dimensions. Perceived value did not differ by age, gender, class year, or OSCE performance. These results provide support for the value of peer feedback on nontechnical clinical competency assessments, though not as a substitute for faculty feedback. [ABSTRACT FROM AUTHOR]

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

The American Board of Anesthesiology's Objective Structured Clinical Examination (OSCE), as a component of its initial certification process, had been administered in-person in a dedicated assessment center since its launch in 2018 until March 2020. Due to the COVID-19 pandemic, a virtual format of the exam was piloted in December 2020 and was administered in 2021. This study aimed to compare candidate performance, examiner grading severity, and scenario difficulty between these two formats of the OSCE. The Many-Facet Rasch Model was utilized to estimate candidate performance, examiner grading severity, and scenario difficulty for the in-person and virtual OSCEs separately. The virtual OSCE was equated to the in-person OSCE by common examiners and common scenarios. Independent-samples t -test was used to compare candidate performance, and partially overlapping samples t -tests were applied to compare examiner grading severity and scenario difficulty between the in-person and virtual OSCEs. The in-person (n = 3235) and virtual (n = 2934) first-time candidates were comparable in age, sex, race/ethnicity, and whether U.S. medical school graduates. The virtual scenarios (n = 35, mean [0.21] ± SD [0.38] in logits) were more difficult than the in-person scenarios (n = 93, 0.00 ± 0.69, Welch's partially overlapping samples t -test, p = 0.01); there were no statistically significant differences in examiner severity (n = 390, −0.01 ± 0.82 vs. n = 304, −0.02 ± 0.93, Welch's partially overlapping samples t-test, p = 0.81) or candidate performance (2.19 ± 0.93 vs. 2.18 ± 0.92, Welch's independent samples t-test, p = 0.83) between the in-person and virtual OSCEs. Our retrospective analyses of first-time OSCEs found comparable candidate performance and examiner grading severity between the in-person and virtual formats, despite the virtual scenarios being more difficult than the in-person scenarios. These results provided assurance that the virtual OSCE functioned reasonably well in a high-stakes setting. • The virtual Objective Structured Clinical Examination functioned reasonably well. • The virtual scenarios were moderately more difficult than the in-person scenarios. • Virtual & in-person examinees performed similarly in large-scale, high-stakes setting. • Examiner grading severity was comparable between the in-person and virtual exams. • A deliberate de novo design may be required for long-term virtual performance exam. [ABSTRACT FROM AUTHOR]

To develop and validate a set of OSCEs for use as a nationally applicable final exam of undergraduate nursing students' clinical and professional competencies. Tertiary recommendations for nursing registration require student achievement of a prerequisite level of both nursing knowledge and skill. Assessment of nursing skills prior to provision of nursing registration is an increasingly important focus of university nursing education. Objective Structured Clinical Examinations (OSCEs) are an appropriate tool for assessing the competencies of nursing students, but the mode and content of OSCEs varies widely. Thus, for nationally-based registration, development of a standardized set of OSCEs to determine the clinical competence of nursing students is important. A modified Delphi study, informed by a systematic scoping review of relevant literature. A two-phase study was conducted. Initially, a scoping review was conducted to establish internationally agreed competences for graduating nursing students. These were included in an online questionnaire send to national experts to develop a validated and accepted nursing competency framework and associated implementation strategies. This was round 1 of a three-round modified Delphi study. A Content Validity Index (CVI) was calculated and thematic analysis was used to analyze the experts' opinions. Details of a set of OSCEs for final exam of undergraduate nursing students were developed and validated. These OSCEs included nine competencies addressed in eight 10-minute stations. A 'best-practice' OSCE evaluation system, designed from both international literature and the opinions of nation-wide experts was achieved. This well-designed OSCE was shown to be a reliable and valid method for assessing the clinical competence of nursing students. It reflected global procedures as well as the local conditions and Iranian expectations. The results of this study can be used by nursing schools across the country. They can also be used to model equivalent development of locally relevant OSCEs in countries around the world. • Standardised assessment of competence in graduating nursing students is critical. • Development of nationally recognized assessments of competence is challenging. • This study used a two-phase Delphi process to select and validate OSCE scenarios. [ABSTRACT FROM AUTHOR]

Introduction: The primary objective of this study was to explore student and faculty perception of the objective structured clinical examination (OSCE) to assess the clinical competence of 5th year medical students. Methods: Two validated tools were used to survey students' and faculty perception of the OSCE as an assessment tool. The questionnaires were self-administered and handed to the students immediately after the OSCE was conducted. Subjects were 29 female students who had completed their 3-week Internal Medicine rotation and 15 faculty members who had participated in evaluating the students. The response rate was 100%. The OSCE comprised of 21 active stations involving skills like history taking standardized patients were used, physical examination, and data interpretation for which real patients were used. Results: Majority of students, 63.2% indicated that the OSCE assessed their skills fairly. This was also true for 80% thought the OSCE was a fair method of assessing students' skills as well as a better assessment tool than the traditional long/short case exams. Conclusion: The OSCE was positively perceived by 5th year medical students and faculty members as a tool that can fairly assess students' clinical skills.

INTRODUCTION: Clinical teaching at outpatient settings is an essential part of undergraduate medical students' training. The increasing number of students in many medical schools and short hospital stays makes inpatient teaching alone insufficient to provide students with the required clinical skills. To make up this shortfall, outpatient clinical teaching has been implemented by our Department of Obstetrics and Gynecology, King Khalid University, KSA, throughout the academic year 2015–2016. The aim of this study was to evaluate the impact of clinical teaching at outpatient settings on the academic performance of our students. MATERIALS AND METHODS: In this comparative retrospective study, the effects of outpatient clinical teaching of obstetrics and gynecology on the academic performance of student was assessed through an objective structured clinical examination (OSCE). During their course on obstetrics and gynecology, 58 students had their clinical teaching both at inpatient and outpatient settings and constituted “study group”. The remaining 52 students had clinical teaching only at inpatient settings and were considered “control group”. Students in both groups sat for OSCE at the end of week 8 of the gynecology course. Students in both groups sat for OSCE at the end of week 8 of the gynecology course. Four stations were used for assessment: obstetric history, gynecological history, obstetric physical examination of pregnant women, and gynecological procedure station. Twenty marks were allocated for each station giving a total score of 80. The OSCE scores for study group were compared with those of the control group using Student's t-test; p < 0.05 was considered statistically significant. RESULTS: The total mean OSCE score was statistically significantly higher in the study group (62.36 vs. 47.94, p < 0.001). The study group participants showed significantly higher scores in the gynecological procedure station (16.74 vs. 11.62, p < 0.0001) and obstetric examination station (16.72 vs. 10.79, p < 0.0001). CONCLUSION: Clinical teaching at outpatient settings leads to an improvement in students' performance in OSCE. There is evidence of remarkable improvement in the mastery of clinical skills as manifested in the students' scores in physical examination and procedures stations. These results will encourage us to have clinical teaching in other disciplines at outpatient settings.

Purpose: To determine whether disclosure of scoring rubric for objective basic clinical skills can improve the scores on the objective structured clinical examination (OSCE) in medical students. Methods: Clinical performance score results of one university medical students (study group, n=345) were compared to those of another university (control group, n=1,847). Both groups took identical OSCE exam. OSCE rubric was not revealed to the study group until they were in the last 2 years of medical school. Results: There was no significant difference between before and after disclosure of rubric. However, history taking and physical examination scores of the study group were lower than those of the control group before the disclosure of rubric. After disclosure of rubric, the scores were either unchanged or slightly increased in the control group. Trend analysis of scores demonstrated that history taking and physical examination scores after the disclosure were significantly increased in the study group for 2 years. Conclusion: This study revealed that disclosure of basic clinical skills rubric to medical students could enhance their clinical performance, particularly in history taking and physical examination scores.

The authors propose a method "Reverse OSCE" which is built upon the principles of OSCE. It is a step forward to conventional OSCE wherein the role of tutor and student is reversed. Reverse OSCE as an assessment tool can assess the observational skill of a student along with knowledge and understanding of various procedural skills. It retains the obvious advantages of conventional OSCE in terms of objectivity, reproducibility, and easy recall along with the added benefit of versatility and ever broadening scope.

Introduction: Implementation of skills evaluation in the laboratory is necessary to see how far the ability has been achieved. Objective structured clinical examination (OSCE) becomes one of the evaluation techniques used. the purpose of this study is to know prevalence of the anxiety and the factors that cause anxiety before following the OSCE in first-degree nursing students. Methodology: This research is a descriptive research, as many as 89 respondents selected by using simple random sampling. The questionnaire used was Nursing Skills Anxiety Scale Test (NSTAS). Results: 65 respondents (73%) experienced anxiety with most of the sexes were women (89,9%), and 56 respondents (62.9%) were 18 years old. Factor’s related to anxiety included environment (50,5%), exam it self (44,9%) and observer (44,9%). Discussion: there is a need for further research on the impact of anxiety before taking the OSCE examination with graduation rates on each skill performed

Introduction Medical educators need to demonstrate that their trainees meet expected competency levels when progressing through medical education. This study aimed to develop competency-based pass/fail cut-scores for a graduation required Objective Structured Clinical Examination (OSCE), and examine validity evidence for new standards. Methods Six clinicians used the modified Angoff method to determine the cut-scores for an 8-station OSCE. The clinicians estimated the percentage of minimally competent students who would answer each checklist item correctly. Inter-rater reliability, differences in other academic achievements between pass/fail groups, educational impact, and response process were examined. Results One hundred seventy-four rising 4th-year medical students participated in the OSCE. The cut-scores determined for the OSCE resulted in a substantially lower failure rate (5% vs. 29% of the previous year). The inter-rater reliability across domains and cases was .98 (95% CI = .97 - .99). The pass/fail groups significantly differed in six of the eight measures of academic achievements included in the study. Discussion The impact of the standards setting was substantial as it significantly reduced the failure rate and burdens of remediation for both students and faculty. The very high inter-rater reliability indicates that the modified Angoff method produced reliable cut-scores. The significant differences between the pass/fail groups in other measures support external validity of the standards and ensure no false passes. The study also supports response process validity by including discussion among judges and check of previous student performances, as well as recruiting and training multiple clinician educators experienced in medical student teaching. Conclusion Findings of the study provide strong evidence supporting validity of the new cut-scores from a wide spectrum of validity metrics, including response process, internal structure, relations to other variables, and consequences. The study also added to the literature the value of the modified Angoff method in determining competency-based standards for OSCEs.

Purpose The biases that may influence objective structured clinical examination (OSCE) scoring are well understood, and recent research has attempted to establish the magnitude of their impact. However, the influence of examiner experience, clinical seniority, and occupation on communication and physical examination scores in OSCEs has not yet been clearly established. Methods We compared the mean scores awarded for generic and clinical communication and physical examination skills in 2 undergraduate medicine OSCEs in relation to examiner characteristics (gender, examining experience, occupation, seniority, and speciality). The statistical significance of the differences was calculated using the 2-tailed independent t-test and analysis of variance. Results Five hundred and seventeen students were examined by 237 examiners at the University of New South Wales in 2014 and 2016. Examiner gender, occupation (academic, clinician, or clinical tutor), and job type (specialist or generalist) did not significantly impact scores. Junior doctors gave consistently higher scores than senior doctors in all domains, and this difference was statistically significant for generic and clinical communication scores. Examiner experience was significantly inversely correlated with generic communication scores. Conclusion We suggest that the assessment of examination skills may be less susceptible to bias because this process is fairly prescriptive, affording greater scoring objectivity. We recommend training to define the marking criteria, teaching curriculum, and expected level of performance in communication skills to reduce bias in OSCE assessment.

Objectives: The adaptation of the educational programmes of European faculties of medicine to the European Higher Education Area guidelines has focused curricula design on competence acquisition. Competencies are defined as the achievements of a predetermined level of efficacy in real-world scenarios. Our objective was to assess whether performance on a common competence evaluation test, the Objective Structured Clinical Examination (OSCE), resulted in different scores for second-year students after a practical medical training course took place in a primary health centre (PHC) or in a hospital. Design: A descriptive study was conducted during the 2010–2014 academic year of the OSCE test scores obtained by all second-year students. Location: Faculty of Medicine at the University of Lleida (Catalonia, Spain). Main measurements: We performed a correlation analysis between students who completed their practical medical training at the PHC and hospitals utilising Student's t-test for comparison of means. Results: 423 students who completed internships at the PHC and at hospitals obtained OSCE mean scores of 7.32 (SD; IC) (0.82; 7.18–7.47) points and 7.17 (0.83; 6.07–7.26) points, respectively (p = 0.07). Conclusions: Second-year medical students acquired similar competency levels in the two analysed training scenarios. The two areas both serve their teaching purpose.

Background: Communication is a process that allows us to interact with other people. Medical professionals need to possess good communication skills for history taking, diagnosis, and treatment. Communicative skills are hardly taught in medical schools of India. The students are expected to learn them on their own. To address this issue, we introduced communicative skills training (CST) for medical interns. Objective: Primary – To determine the effectiveness of CST in improving history taking on sensitive issues by medical interns. Secondary – To improve patients' satisfaction through improved communicative skills. Materials and Methods: This was a randomized control study carried out on medical interns at Jamnagar. The interns were randomized to either Group A or Group B. Intervention in the form of CST was given to Group A while Group B was control. The topic of CST was “eliciting sexual history.” Assessment of participants was done by pre- and post-intervention objective structured clinical examination. For ethical reasons, Group B was also given CST by experts after completion of our study but their results were not included for analysis. Results: Although mean scores increased in both the groups, (from 6.4 to 13.4 in the intervention group and from 6.5 to 7.5 in controls), the percent increase was much larger in the intervention group than controls (109% vs. 15%). Students gave a positive feedback to CST. Opinion of teachers was favoring CST. Among the patients allotted to intervention group, 83% were satisfied. Conclusion: CST imparted to medical interns helps in improving doctor–patient relationship.