E_ATP2013 Communication Skills Medical Students Dr Thomas Kropmans, Thursday 5 - 6

The Use of OSCEs to Assess

Communication Skills in

Undergraduate Medical Students Dr Thomas JB Kropmans

Communication skills (CS) high impact upon

quality of health care.

Labour intense paper based process during last

30 years

30 % errors in educational decision making

process

Communication Skills in Medicine

3

Systematic review Records identified through

database searches (n=1998)

Records after duplicate removal (n=1358)

Records after filtering (n=1290)

Exclusion by applying Boolean logic

• NOT dentist* (n=10)

• NOT veterinary (n=7)

• NOT pharmac* (n=51)

Potentially relevant studies (n=87)

Reasons for exclusion

• Irrelevant topic (n=613)

• Not an undergraduate OSCE (n=557)

• Duplicates (n=20)

• Non English articles (n=13)

Reasons for exclusion

• Not an OSCE (n=48)

• No validity / reliability (n=5)

Critically reviewed studies (n=34)

Automated duplicate removal (n=640)

Heterogeneity of measurement instruments limits

comparability

Comparison of student competence across

institutions and assessment (OSCE) settings is

required

Universal adoption of a standardized

Communication Skills measurement instrument is

recommended (Academic Medicine September

2013)

Communication Skills in Medicine

Objective Structured Clinical

Examinations e.g. OSCE

Station 4

Station 1 Station 2 Station 3

ExaminerPatient Student

Waiting Area –

To be Examined

Student

Station 5Station 6Station 7Waiting Area -

Examined

Secretary

Desk

StudentStudentStudent

Student

StudentStudentPatient Student Patient Student

Patient StudentPatient StudentPatient StudentPatient Student

Student Examiner Patient Secretary Flow of Students

Examiner Examiner

Examiner Examiner Examiner Examiner

Tablet/PDA

Web Server/Database

Web Server/Central

Database

100 students X 10 stations = 1000 forms

30% pass/fail decisions based upon error!

Three weeks of administration time

Station 4

Station 1 Station 2 Station 3

ExaminerPatient Student

Waiting Area –

To be Examined

Student

Station 5Station 6Station 7Waiting Area -

Examined

Secretary

Desk

StudentStudentStudent

Student

StudentStudentPatient Student Patient Student

Patient StudentPatient StudentPatient StudentPatient Student

Student Examiner Patient Secretary Flow of Students

Examiner Examiner

Examiner Examiner Examiner Examiner

Tablet/PDA

Web Server/Database

Web Server/Central

Database

Of 1000 forms 300 contains errors

Low Cronbach’s Alpha (< 0.8 poor)

Pass mark of 50%?

Qpercom Ltd ‘Better assessment of

better doctors’ since 2008

30 % based upon error

Current partners e.g. clients

Unique software solution

Internal Consistency Stations

Internal Consistency Stations

Improved pass/fail decisions

Improved pass/fail decisions

OSCE Management Information System

30 % reduction of error

70% reduction in administration time

Better doctors due to improved & automated

educational decision making process

30 yrs old assessment problem solved &

presented at E-ATP2013