Do You Know OSCE ?

Alaa Mosbah

A Prof. OBS & GYN, Manchester Programme Director Deputy, Faculty of

Medicine, Mansoura University, Egypt,2015

OSCE

Introduction

Objectives of OSCE

Advantages & Disadvantages of OSCE

The basic steps in modeling an OSCE

Example

Bad surprises in OSCE

Some precautions

OSCE

Introduction

Objective Structured Clinical Examination

Introduced as a mode of students’ assessment in

medical school in 1975, by Haden and Gleeson (

Harden R, Stevenson M, Downie WW, Wilson GM. Br Med J 1975;1:447-51).

Originally described as a timed examination

OSCE

Objective Structured Clinical Examination

objective - all students are assessed using

exactly the same stations with the same

marking scheme.

structured - stations in OSCEs have a very

specific task include parts from all elements of

the curriculum as well as a wide range of skills

clinical examination - the OSCE is designed

to applied clinical and theoretical knowledge

OSCE

In the UK, USA, Canada and indeed

most reputable colleges of medicine

the OSCE is the standard mode of

assessment of competency and

clinical skills

In Mansoura Manchester

Programme for Medical Education

(Egypt), OSPE or OSCE is 8 years

old.

Clinical Sems – Exams & Marks

MarksItem

60Midterm MCQs (2 or 3)

70SSC/Presentation & Active

Attendence

200Final MCQs/EMQs

200Final OSCE

120Final Short Essay

650Total

OSCE

Different stations -

each testing a specific

clinical skill in a set

time

OSCE

One examiner observes and assess each student at each

station whilst remaining at the same station for the whole

cycle

Circuit- The passage of the candidates through the

carousel of the number of stations

Cycle is the number of times the examination is run on

OSCE

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OSCE

OSCE

OSCE Objectives

Evaluate the students skills.

Evaluate the students’ attitude, conduct, and

behaviour & communication skills

Evaluate performance skills in history taking and

clinical examination

Proper data extraction and interpretation

Advantages of OSCE

1. Uniform scenarios for all candidates2. Availability3. Safety, no danger of injury to patients4. No risk of litigation5. Feedback from Actors (simulators)6. Allows for Recall7. Stations can be tailored to level of skills to be assessed8. Allows for teaching audit9. Allows for demonstration of emergency skills

Disadvantages of OSCE

1. Organizational training

2. The idealized ‘textbook’ scenarios may not mimic

real-life situations

3. Expensive !!!!! Quebec Medical College, for example, spends

$1,080 to assess the performance of each student in a comprehensive

OSCE

The Basic Steps ……OSCE

OSCE team.

Skills to be assessed (OSCE Stations).

Objective marking schemes

Recruitment and training of the standardized

patients ( "real" or "simulated" patients).

Logistics of the examination process.

OSCE... Requirements

Consider the curriculum and assessment

objectives

Instructions for :

- Site organisers

- Students & examiners

- Role Player

Write marking criteria

OSCE…. Requirements

• Suitable venue

• Adjoining rooms

• Big hall with partitions (enough space

&privacy)

• Room for students to gather before exam

• Room to brief examiners

• Rest room for patients

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OSCE…. Requirements

Admin to supervise students waiting

Admin to check examiners all present

Admin to look after patients

Helpers for ‘emergencies’

Marshals &Timekeepers

A reserve examiner

Refreshments

Station

Number

Code(admin. use

only)

Description Required logistics

1 OHx History taking(Role player) Desk, 3 seats

2 OEx Clinical Examination Bed, 2 seats, bed sheet, hand cleaning gel

3 OJ Jar Desk, 2 seats & Jar

4 OD Data interpretation Desk, 2 seats &partogram

5 OP procedureModel, speculum, cotton tipped swab, table&2

seats

6 PHx History taking((Role player) Desk, 3 seats

7 PEx Clinical Examination Bed, 2 seats, bed sheet, hand cleaning gel

8 PI Instrument Desk, 2 seats

9 PPh Photographic material Desk, 2 seats, PC or laptop (windows operated,

MS office)

10 PP Procedure Desk, 2 seats & inhaller

How the station works

Students read the instructions

They have 60 seconds to read them

– Confirm their identity

– Let them start immediately

• Let them leave as soon as the bell goes

OSCE station 1History Taking

Instructions to Students

This is an 8-minute station.

The patient is G3P2 pregnant 9 weeks

You are asked to take a focused history trying to answer

these questions to the examiner:

•What is the patient's complaint?

•What is the menstrual history of the patient?

•What are the investigations done and their results?

You will also be asked to answer:

•Any further questions raised by the patient & any further

questions raised by the examiner.

OSCEstation 1…..History Taking

Instructions to Role player

Personal data:

Your name is Mona Aly

You are 26 years old, G3P2 (2 normal labors)

You are married 6 years ago and have 2 children.

Your problem:

-Recurrent Bleeding (mild) during pregnancy

-Severe vomiting

Your menstrual history:

Your menstrual cycles started at the age of 13 years.

Periods were regular.

Your period's duration is 5-7 days,

The amount of the menstrual flow was average.

L.M.P: 15-10-2013

Ask the student this question at the end of the interview:

What is the next step to diagnose my condition?

The examiner will ask the student to mention the differential diagnosis management of this condition.

OSCE station 1….. History Taking

Instructions to the Examiner Gentle handling with the patient 2 marks

Asks about the main complaint (bleeding in early pregnancy) 2 marks

Asks about details of menstrual history 4 marks

Asks about LMP and knows that she is pregnant 9 weeks.

Asks about investigation done and their results. 2 marks

USS showing snow honey comb appearence

Further investigations to diagnose this case (serum B hCG). 2 marks

Answer the examiner's question about D.D of such case 4 marks

(DD of bleeding in early pregnancy)

Answer the examiner's question about management of this case. 4 marks.

(Suction evacuation and follow up).

Total /20 marks.

OSCE station 1….. History Taking

Marking Sheet

Student's name :

Student's number :

Gentle handling with the patient 2 marks

Asks about the main complaints 2 marks

Asks about Details of menstrual history 4 marks

Asks about investigation done and their results. 2 marks

Further investigations to diagnose this case. 2 marks

Answer correctly the D.D of such case. 4 marks

Answer the examiner's question about management of this case. 4 marks.

Total /20 marks.

Examiner's name Examiner's signature

Comments

OSCE... Bad surprises !!

• Examiners late or absent

• Patients ill or absent

• Too hot room

• Too much noise

• Candidate getting distressed

OSCE... Bad surprises !!

• Examiners late or absent

• Patients ill or absent

• Too hot room

• Too much noise

• Candidate getting distressed

Be Fair The students should be unknown to you

Judge them on how they perform today

Do not be influenced by your previous

knowledge of their skills (good or bad)

Be FairDo not compare students with each

other

Judge the student against the marking

scheme

All could pass, all could fail at your

station

Remember……..

No student will fail because they have

failed one station

It is their overall performance across the

exam which counts

Do…?.............Do not ?

Treat candidates

politely , pleasantly&

fairly

Let them start and

finish on time

Turn it into a teaching

session

Give candidates

verbal feedback as

to how they are

doing (good/bad)

Yes No

I LOVE OSCE

Thank You

DR

ALAA MOSBAHA. PROF. OF OBS & GYN

Manchester Programme Director DeputyMANSOURA FACULTY OF MEDICINE ,Egypt

dralaamosbah.blogspot.com

2015