Objective structured clinical examination versus traditional written examinations: a prospective observational study

BACKGROUND

Recently, Objective Structured Clinical Examinations (OSCE) became an official evaluation modality for 6-year medical students in France. Before, standard examination modalities were: written progressive clinical cases (PCC), written critical reading of scientific articles (CRA), and internship evaluation (IE). The aim of this study was to assess the performances of 6-year medical students in their final faculty tests by comparing OSCE-exams with standard examination modalities.

METHODS

This was a prospective observational study. We included all 6-year medical students in our university from 2020 to 2021. The endpoints were the scores obtained at the following final faculty tests during the 6^th year of medical studies: OSCE-training, OSCE-exams, written PCC, written CRA, and IE. All scores were compared in a paired-analysis.

RESULTS

A total of 400 students were included in the study. No student was excluded in the final analysis. The mean scores obtained at the OSCE-exams were significantly different from those obtained at OSCE-training, PCC, CRA, and IE (12.6 ± 1.7, 11.7 ± 1.7, 13.4 ± 1.4, 13.2 ± 1.5, 14.7 ± 0.9, respectively; p < 0.001). OSCE-exams scores were moderately and significantly correlated with OSCE-training and PCC (Spearman rho coefficient = 0.4, p < 0.001); OSCE examination scores were lowly but significantly correlated with CRA and IE (Spearman rho coefficient = 0.3, p < 0.001). OSCE-scores significantly increased after an OSCE training session.

CONCLUSION

In our faculty, 6-year medical students obtained lower scores at OSCE exams compared to other standard evaluation modalities. The correlation was weak to moderate but significant. These results suggest that OSCE are not redundant with the other evaluation modalities. Interestingly, a single OSCE training session led to an improvement in OSCE scores underlining the importance of a specific training.

Effect of absenteeism on the performance of medical sciences students: gender differences

The effects of the learning environment on academic performance can be investigated according to a broad range of factors using a diversity of approaches. Many differences in academic performance have been associated with the sex of the student. Objectives: This study aims to understand the impact of absenteeism on the final grades earned by full-time medical laboratory sciences undergraduate students and whether this is affected by sex. Academic performance was analyzed using students' final grades from two consecutive semesters (January to April and September to December 2019). The differences between male (n = 43) and female (n = 72) students were evaluated by Pearson's correlation. During the semester, all teaching and assessment methods were standardized across both course sections to avoid confounding effects derived from the teaching method. Academic performance was assessed both objectively (multiple-choice questions) and subjectively (short essay questions). The mean scores of male and female students during two semesters were significantly different (p = 0.0180). To correlate marks with absenteeism, the correlation coefficient (r) was negative, which indicates an inverse correlation between absence rate and scores. Interestingly, a statistically significant correlation between absenteeism and final grades was found in the male sample population (p = 0.0011 for the first semester; p = 0.0255 for the second semester) that was not observed for their female counterparts (p = 0.2041; p = 0.1537). The results indicate that academic performance among women is not solely dependent on class attendance but likely involves other factors such as self-learning, and group discussion. The mean scores of female medical sciences students were significantly higher than the male students for two consecutive semesters. Male overall scores seem to be conditional on the instructor's explanation. This sex-based variation in academic performance revealed by taking absenteeism rate into account warrant further investigation.

Teaching Effective Informed Consent Communication Skills in the Virtual Surgical Clerkship

BACKGROUND

The disruption by the COVID-19 pandemic on undergraduate medical education allowed for assessment of virtual curricular innovations. One of the difficulties encountered in the virtual curriculum is the teaching of clinical competencies that would traditionally require students to undergo in-person simulations and patient encounters. We implemented a novel informed consent activity module, with standardized patients, to improve self-efficacy in communication within our core surgery clerkship.

STUDY DESIGN

All medical students who participated in the virtual surgery clerkship were recruited to participate in a retrospective survey study regarding the novel informed consent module. These questions evaluated their perceived competence in 4 domains relating to informed consent: identifying the key elements, describing common challenges, applying the New Mexico Clinical Communication Scale (NMCCS), and documenting.

RESULTS

Thirty-four of 90 students participated in the study (38% of the cohort). Respondents to the survey reported that their self-efficacy in communication skills related to informed consent improved as a result of their participation in the activity in each of the 4 domains surveyed (p < 0.01), with the majority of students identifying as satisfactory or above in each domain post-module. Students generally viewed the virtual informed consent activity positively, but noted that it was not the same as an in-person clinical experience.

CONCLUSIONS

A virtual module of communication skills training, using standardized patients and faculty, improved students' belief in their self-efficacy in obtaining informed consent. This communication module can be useful in a virtual or mixed curricular structure for both current and future medical students.

Evolving to Objective Structured Clinical Exams (OSCE): Transitional experience in an undergraduate pharmacy program in Kuwait

BACKGROUND

Objective Structured Clinical Exams (OSCEs) can assess professional competencies in a structured manner and facilitate objective evaluation of clinical performance. With limited data from the Eastern Mediterranean region, this study aims to describe the development, implementation, and evaluation of OSCEs for final year pharmacy students in Kuwait. The study also aims to compare students' performance in two academic years (2015-2016 and 2016-2017).

METHODS

The design, implementation, and evaluation of the competency-based OSCE followed a 3-phase systematic evidence-based approach. The development phase involved establishing an OSCE working group to develop a blueprint and scoring rubrics and to organise assessors and standardised patient/physician training. The implementation phase involved conducting formative and summative OSCEs. The evaluation phase involved undertaking student and staff perception surveys.

RESULTS

The overall students' OSCE scores for the academic years 2015-2016 and 2016-2017 were (median (interquartile range)) (71.6%, 32.2) and (60.0% (30.7)) and respectively (p < 0.0001). The average students' performance score was high in stations covering 'patient consultation and diagnosis' competency (71.4% (95% CI: 66.7-73.3)) and lower in stations covering 'monitoring of medicine therapy' competency (50.0% (95% CI: 33.3-66.7)). Students perceived stations covering 'monitoring medicines therapy' and 'assessment of medicine' as difficult. However, staff perceived stations related to 'patient consultation and diagnosis' competency as the easiest. Students reported that the OSCE was a positive experience as it provided them an opportunity to practice real life scenarios in a safe learning environment.

CONCLUSION

The OSCE helped to identify the level of competency of students prior to graduation and areas to improve in the curriculum.