Do You Know OSCE ? Alaa Mosbah A Prof. OBS & GYN, Manchester Programme Director Deputy, Faculty of Medicine, Mansoura University, Egypt,2015
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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
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