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School of Medicine
Faculty of Medical and Health Sciences
Objective Structured Clinical Examination (OSCE)
Neck Examination
Inguinal Hernia
Abdominal
Examination
Trauma and
Resuscitation
Peripheral Vascular
Disease
Gallstone Disease
Year 4 Surgical OSCE
3 clinical stations involve peer physical
examination:
1. Acute abdominal pain
2. Acute leg pain
3. Neck lump
Year 4 Surgical OSCE
STUDY OBJECTIVES
• To investigate validity and reliability of OSCE grades awarded by Year 6 students during the Year 4 surgical OSCE
• To investigate the perceptions and attitudes of Year 6 students towards OSCE examining
University of AucklandMBChB Programme
YEAR
1
2
3
4
5
6
PHASE
Pre-Clinical
Clinical
OSCE Grading
History-Taking
1. Appropriate and professional manner
2. Logical progression of questions related to
presenting complaint
3. Appropriate depth and range of questioning
4. Asks about other important related areas
5. Summary and working diagnosis is succinct and
appropriate
OSCE Grading
Physical Examination
1. Appropriate and professional manner
2. Logical progression of the examination
3. Inspection
4. Palpation
5. Percussion and Auscultation
OSCE Grading
Year 4 Students are graded against expected
standards of a Final-Year Medical Student
GRADE SCORE DEFINITION
Mastery 4 Standard has been fully met
Clear Pass 3 A few minor mistakes/omissions were made
Flagged
Pass
2 Some major mistakes and/or important
omissions were made
Fail1 Many major and significant mistakes or
omissions were made
Year 4 Surgical OSCE
• Externally Valid
• Internally Reliable
Yu TC, Wheeler BR, Hill AG. “Effectiveness of standardised clerkship teaching across multiple sites.” Journal of Surgical Research, 2011;168:e17-e23.
STUDY PARTICIPANTS
• 124 x Year 4 medical students
• 28 x Year 6 medical students
• 8 x Faculty academic clinicians
Example:
Peripheral Vascular DiseaseYear 4 Surgical OSCE Evaluation Form
I enjoyed being an OSCE Examiner.
From my experience today ….
a) I learnt new clinical information
b) I reviewed my current knowledge
c) I learnt how to be a better teacher
d) I learnt how to provide feedback
e) I learnt what makes a better OSCE station
I will incorporate what I learnt today into my future clinical practice.
Participating as an OSCE Examiner has improved my confidence to teach.
As an OSCE Examiner, I gained insight into student learning processes.
I will volunteer to be an OSCE examiner in the future because ….
a) I will enjoy the opportunity to teach and provide feedback
b) Of a sense of duty to clinical teaching
c) I am likely to improve my clinical knowledge and skills
d) I will enjoy the social interactions with students and other examiners
e) Of the great food
The Clinical School values my contributions today.
My willingness to participate would increase if my contributions were acknowledged by clinical supervising consultants.
STUDY RESULTS
Internal Reliability – Cronbach’s alpha coefficients
StudentExaminers
Faculty Examiners
Acute Abdomen History-taking 0.80 0.69
Examination 0.80 0.83
PeripheralVascular Disease
History-taking 0.76 0.75
Examination 0.80 0.82
Surgical Neck Examination 0.82 0.80
STUDY RESULTS
Acute Abdomen: Student vs Faculty Exmainers
SEmean
FEmean
Paired T-test Pearson’s Correlation
History-taking(20 marks) 15.9 16.3
t= -1.49 (173)p=0.139
0.25p=0.001
Examination(20 marks) 15.8 16.1
t= -0.99 (172)p=0.323
0.24p=0.001
Total Grade(40 marks) 31.6 32.4
t= -1.43 (173)p=0.155
0.27p<0.001
STUDY RESULTS
Peripheral Vascular Disease: Student vs Faculty Examiners
SEmean
FEmean
Paired T-test Pearson’s Correlation
History-Taking(20 marks) 14.8 16.0
t= -2.77 (173)
p=0.006p=0.687
Examination(20 marks) 14.6 15.8
t= -2.62 (173)
p=0.010p=0.441
Total Grade(40 marks) 29.4 31.8
t= -2.76 (173)
p=0.006p=0.770
STUDY RESULTS
Surgical Neck Examination: Student vs Faculty Examiners
SEmean
FEmean
Paired T-test Pearson’s Correlation
Total Grade(20 marks) 15.8 15.6
t = 2.21 (173)p=0.029
0.82p<0.01
TI Perceptions and Attitudes Mean
Enjoyed being an OSCE Examiner 4.36
From today’s experience ....
a) Learnt new clinical information 3.63
b) Reviewed my current knowledge 4.33
c) Learnt how to be a better teacher 4.14
d) Learnt how to provide feedback 4.00
e) learning what makes a better OSCE station 4.14
Incorporate today’s learning into future clinical practice 4.29
Participating has improved my confidence to teach 4.14
As an OSCE examiner, I gained insight into student learning processes 4.30
In the future, I will volunteer to be an OSCE examiner because ....
a) Enjoy opportunity to teach and provide feedback 4.32
b) Sense of duty to clinical teaching 4.18
c) Am likely to improve my clinical knowledge and skills 4.32
d) Enjoy social interactions with students and other examiners 4.43
e) Of the great food 4.11
The Clinical School values my teaching and examining contributions 4.04
Willingness to participate would increase if contributions acknowledged by consultants 3.68
Strongly agree = 5, Agree = 4, Unclear = 3, Disagree = 2, Strongly disagree = 1
STUDY CONCLUSION
Validity of OSCE grades given by Year 6
student examiners varied between different OSCE stations
Year 6 student examiners find OSCE examining to be a positive learning and social experience
STUDY DISCUSSION POINTS
Possible Explanations:
Features of Individual OSCE stations
Examiner versus Patient Perspectives
Clinical Competency of Year 6 students
Performance Expectations of Year 4 students
ACKNOWLEDGEMENTS
South Auckland Clinical SchoolSchool of MedicineFaculty of Medical and Health SciencesUniversity of Auckland
Study Participants, MBChB StudentsFaculty of Medical and Health SciencesUniversity of Auckland
A Pilot Study of Final-Year Medical Students as
Surgical OSCE Examiners
Dr Tzu-Chieh Wendy Yu
Associate Professor Andrew G Hill
Department of Surgery
South Auckland Clinical School, Middlemore Hospital
Faculty of Medical and Health Sciences
University of Auckland