Objectives Structured Clinical Examinations (OSCE) By: Raniah Al-jaizani, M.Sc
Objectives Structured Clinical
Examinations (OSCE)
By: Raniah Al-jaizani, M.Sc
Background
Traditional assessment methods useful for
evaluation of knowledge, but not necessarily
of skills
Clinical skills represents amalgam of clinical
knowledge and communication/interpersonal
& problem-solving skills
Performance based assessment provides
unique vehicle for measurement of clinical
skills
What is OSCE
Objective
Structured
Clinical
Examination
OSCE - Objectives
All the candidates are presented with the
same test
OSCE - Structured
The marking scheme for each station is structured
Specific skill modalities are tested at each station
History taking
Explanation
Clinical examination
Procedures
OSCE – Clinical Examination
Test of performance of clinical skills: not a
test of knowledge
The candidates have to demonstrate their
skills
Why we Need OSCE?
The desire to improve the quality of our
evaluation techniques and ever-changing
curriculum
Such a test would be very helpful & gives a
better evaluation of students therapeutic
decision-making & performance in therapeutic
courses
Realizing that skills domain is difficult to test
with either written examination format
Defining OSCE
OSCE consists of multiple short (5-20 minute) stations
Each is examined on one-to-one basis with: examiner & real/simulated patient known as standardized patients (SP)
SP are persons trained to simulate a medical condition in a standardized way, each station requires the candidate to perform a specified task/series of tasks
Stations may be active or non-active
OSCE Stations
Based on therapeutic topics we will cover it in 442 PHCL
you will be dealing with 3 active stations
For each station you will be given 10 minutes
Each station will consist of a SP which in your case will
be an actor.
Before the station you will be given a form. Which
includes a task (e.g. recommend dose adjustment in
case of..) & instructions (e.g. a physician approaches
you with questions about adjusting medication in case
of….)
OSCE Stations
You will enter the station & introduce yourself to the SP
The SP will handle the case according to a specific
training
SPs follow a certain script to play with you during the
encounter
These scripts are written in details including patient
general look, cloths, emotions, and all negative and
positive answer
In order to evaluate you the SP and/or the OSCEs
examiners will be given a checklist to fill out while
observing you
OSCE Stations
These checklists are standardized to reduce
examiners' bias
On these checklists, there are station specific points
(i.e. points to cover the case in particular) & general
performance points (i.e. points to cover general things
like introducing yourself)
SPs will reveal information when specific related
questions are asked. For example, if you don't ask
about all their medication now and in the past, they
won’t give you the list of medications they are taking
Check List (Evaluation Form)
Medical knowledge specific to this station, such us,
symptoms, signs, associated factors, risk factors,
management plan….
Data gathering skills: Your way of patient information
collection
Documentation: summarizing the findings of the
patient encounter & initial patient work-up
Communication & interpersonal skills
OSCE Test for Therapeutic II
Do I need to study for the test?
In normal circumstances the test would be part of the
course evaluation so you will need to study
Do I need to bring anything with me?
Your brains!
Your smile
A calculator
Will you provide me with anything in the station?
The station form including: Your task & instructions
Some stations require having a drug information
handbook, in such situations we will provide for you
How will I move from a station to another?
Depending on the availability of SP you will enter the
room and wait in front each station
Each station will be marked with a number including
rest stations
You will be given clear instructions on how & where to
move during the exam
How will I move from a station to another?
You will now enter the first station
After 10 minutes a bill will ring you will all come out of
the stations, & a second bill will ring which means
move to the next station but do not enter, then a third
bill will ring which means enter the station
So there will be 3 bills
What are the stations available on the day of examination?
In usual circumstances you should not know the
stations, but it depends on what you have covered
over therapeutic courses.
What are the stations available on the day of examination?
1. Diabetic patient education on how to use insulin
2. Adverse drug reactions: antihyperlipidemic
3. Adverse drug reactions: antidiabetic
4. Prevention of secondary diabetes complications
5. Type II diabetic patient with compromised kidney or
liver functions
What are the stations available on the day of examination?
6. Patient with newly diagnosed respiratory tuberculosis
7. Antibiotic dosage adjustment in meningitis &
compromised kidney function
8. Osteoporosis patients starting new treatment
9. Patient on lipid lowering drug requiring counseling
10. Switching from sliding scale to regular insulin dosing
11. Case puzzle
“I cannot say whether things will get better if we change; what I can say is they must change if they are to get
better”
Georg C. Lichtenberg