Analysis on the clinical competence of eight-year program medical students
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Abstract:
Objective To understand the situation and characteristic of medical students'clinical competence,and provide some guidance for the teaching reform.Methods The scores of objective structured clinical examination(OSCE) of the eight-year program medical students were analyzed.Results The mean score of the OSCE was 86.45,ranging from 70.36 to 94.07.The score of history taking (including communication),physical examination,and clinical operation was the highest,following by auxiliary examination and clinical thinking.The score of history taking was higher than that of communication skill.The excellence rate was varying among the five classes.Conclusions The students generally mastered the clinical competence,which is essential to the graduate students.Anyway,there still are some areas in need of improvement.
Key words:
Medical student; Clinical competence; Objective structured clinical examination; Examination analysisKeywords:
Excellence
Medical History
Learning of basic clinical skills is introduced in Years 1 and 2 of the MBBS Program; the Aga Khan University, Pakistan, through a structured Clinical Skills Teaching program. Acquisition of competence in performing these skills is assessed through use of the Objective Structured Clinical Examination (OSCE). Self-assessment is defined broadly as the involvement of learners in judging whether or not learner-identified standards have been met.Compared Year 2 students' self-assessment of clinical skills with examiners' assessment of performance in an OSCE using a standard rating scale.A self-assessment questionnaire was completed by all Year 2 students immediately after the OSCE. Students assessed their performance at three stations, using a performance rating scale. Examiners observed and evaluated the students during history-taking and physical examination using the same rating scale.There were significant positive correlations between examiners' assessments of performance and students' self-assessed ratings in taking consent, obtaining demographic information, history of presenting problems and summarization. Significant differences were observed in pre-procedural skills, comment on prostate, liver palpation percussion and spleen percussion.Findings highlight the strengths and weaknesses in clinical competence at the end of Year 2 and provide a direction to improve the gaps in the Clinical Skills Teaching program.
Strengths and weaknesses
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Purpose: To determine whether disclosure of scoring rubric for objective basic clinical skills can improve the scores on the objective structured clinical examination (OSCE) in medical students. Methods: Clinical performance score results of one university medical students (study group, n=345) were compared to those of another university (control group, n=1,847). Both groups took identical OSCE exam. OSCE rubric was not revealed to the study group until they were in the last 2 years of medical school. Results: There was no significant difference between before and after disclosure of rubric. However, history taking and physical examination scores of the study group were lower than those of the control group before the disclosure of rubric. After disclosure of rubric, the scores were either unchanged or slightly increased in the control group. Trend analysis of scores demonstrated that history taking and physical examination scores after the disclosure were significantly increased in the study group for 2 years. Conclusion: This study revealed that disclosure of basic clinical skills rubric to medical students could enhance their clinical performance, particularly in history taking and physical examination scores. Keywords: Objective structured clinical examination, Rubric, Clinical performance, Scoring
Rubric
Medical History
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Objective: To estimate the significance of applying objective structured clinical examination( OSCE) to medical students in evaluation of their command of clinical skills. Methods: A total of 2 181 medical students enrolled in year of 2011,2012 and 2013,respectively,in Wannan Medical College underwent OSCE at three stations on medical human analogue basis for evaluation of their clinical practice skills. In process,some of the students and judges were randomly invited to complete a previously defined questionnaire for their comments. Results: The scoring on OSCE was normally distributed in general for the total students,and students enrolled in 2013 scored significantly lower compared with those enrolled in 2011 regarding the single performance,total scores and pass rate at the three stations( P 0. 001). The questionnaire statistics showed that 85. 7% of judges and 66. 5% of students considered three-station OSCE being capable of objective and comprehensive evaluation of students in the clinical practice skills,and 93. 9% students enrolled in2012 had the opinion that such examination modality should be maintained in the future. Conclusion: OSCE has a better reliability,operability and reproducibility,and is worthy of wider application for its objective,authentic and comprehensive measurement of the clinical skills of students. In addition,OSCE may play a guiding role in orientation and improvement of clinical teaching in medical colleges.
Clinical Practice
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Objective: To explore the value of objective structured clinical examination in the general practice for medico.Methods:A total of 81 students major in three-year clinical medicine were selected as experimental group,and took objective structured clinical examination(OSCE);while 79 students at 2006 grade served as control group and took traditional theory test.The score was recorded and compared with results of occupational physician practice examination.Results:The score of OSCE and occupational physician practice examination was 80±1.41 and 84±1.69 points,respectively in experimental group,and 65±1.52 and 68±1.21 in control group.There were statistical differences between two groups(P0.05).Conclusions:OSCE is more helpful in improving score of occupational physician practice examination,and can strengthen students' clinical practice ability to become qualified physicians.
Clinical Practice
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Objective:To establish an examination and evaluation system of clinical skills in clinical medicine and explore its significance. Methods:According to the clinical skills teaching of clinical medicine,the examination and evaluation system for clinical skills in clinical medicine were established and applied to teaching practice.Results:After the establishment of clinical skills examination and evaluation system,the grades of 2000,2001,2002 and 2003 clinical medical students' clinical skills examination was carried out and evaluated.The test results of 2003 grade students were higher than the grade of 2002:2002 was higher than 2001,and 2001 was higher than the 2000(F=64.22,q=3.67-19.13,P0.05,0.01).There was significance of the results of the history taking,basic technical operations,examination results analysis and clinical case analysis among the different grades(F =34.96-134.22,q=3.74-25.36,P0.01).The test results of 2003 students physical examination were higher than those of the 2002,2001 and 2000 students(F=6.79,q=4.29-6.28,P0.01).Conclusion:The examination and evaluation system of clinical skills has an important significance on cultivating medical students' innovative thinking,innovative ability and the adaptability.
Clinical Practice
Clinical Significance
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The objective structured clinical examination has been considered a modern type of examination for assessment of clinical skills within nursing education. The aim of the study was to compare between the performance of students regarding to their scores and grads by using objective structured clinical examination (OSCE) and traditional clinical examination (TCE) and to investigate student's perception about OSCE. A quasi-experimental study was used 100 student's scores and grads firstly as a control group (TCE) then as a study group(OSCE) at nursing college in Princess Nora Bint Abdul Rahman University then the OSCE feedback questionnaire was completed by the student immediately after OSCE exam. The results of the study indicate that there were statistically significant differences between two groups for the practical examination score with accepted normal distribution curve for the student's grads. OSCE was considered as a fair examination method by 65% students and 69%of them felt it provides a true measure of essential clinical skills. Students preferred OSCE as method of assessing clinical competences and considered it a more valid and reliable method of examination. The study recommended that OSCE as a tool should be applied to evaluate clinical competence among nursing students.
Final examination
Educational measurement
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Objective To explore the methods for examination and assessment of clinical practice ability of medical students. Methods Based on the three-station clinical skill examination,a nine-station objective structured clinical examination(OSCE)was established,and used in 740 medical students for examination and assessment of their ability in clinical work,and,at the same time,aquestionnaire survey was conducted in 740 medical students for their appraisal of OSCE. Results The OSCE scores of 7-year program medical students were higher than that of 5-year program medical students(t=7.860,P0.01).The losing rate was 11%-28%in each test station,history taking,clinical basic skills and case analysis being the highest in the loss.More than 95% of the students thought OSCE was objective and fair,which could reflect the clinical practice ability of medical students.The OSCE was regarded as having a higher practicality and manipuility. Conclusion OSCE can objectively reflect the clinical practice ability of medical students.
Clinical Practice
Medical History
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Objective To evaluate the graduation clinical skill examination based on objective structured clinical examination(OSCE) for college nursing undergraduates.Methods Classic OSCE was simplified and taken as references for nursing undergraduate graduation clinical skill examination including nursing evaluation,nursing dignosis,nursing intervention and health education for stations.Self-made questionnaire was conducted among students.Examination scores and the questionnaire results were statistically analyzed by SPSS 16.0 software.Measurement data and categorical data were shown as ((x)±s) and ％ respectively.T test was used in comparison between the groups according to the inspection level of α =0.05,P ＜ 0.05 means significant difference.Results Simplified OSCE was composed of 4 stations and the mean score was (80.38 ± 4.22) with mean scoring rate of the 4 stations varied from 72.2％ to 88.0％.More than 93％ students thought that OSCE score can or basically can evaluate comprehensive clinical nursing competence,clinical thinking,communicating and adaptability.Conclusions Simplified OSCE is designed properly for the objective evaluation of nursing students' clinical competence and students are mostly satisfied with its design and organization,quality and efficiency.
Key words:
Objective structured clinical examination; Nursing; Clinical competence
Graduation (instrument)
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Background: Medical student learn how to perform eye examinations since beginning in clinical skills laboratory. Objective Structured Clinical Examination (OSCE) was used to assess students’ clinical skills performance every year and to indicate students’ progress. To evaluate medical students’ clinical skills progress, and to evaluate OSCE of eye examination skills. Methods: A cohort study, involving first and third year OSCE results in Clinical Skills Laboratory, Faculty of Medicine Gadjah Mada University from medical students batch 2010 (n:185). The scores of OSCE Year 1 compared to Year 3 using Mann whitney test to explore the progress of students clinical skills performance. To correlate between OSCE scores with clinical cases used in OSCE (such as: visual aquity, visual field, segment anterior and posterior examination) using Pearsoncorrelation to evaluate the assessment process. Result: OSCE results show that medical studens give significant progress on their eye examination performance (median OSCE year 1=66, year 3=80; p=0.00). There is strong correlation between clinical cases during OSCE with students score (p=0.005) that show inequality of difficulty level of cases, particularly for first year OSCE that used more detail check list instrument. Conclusion: Medical students show significant progress on their eye examination skills performance. OSCE process need to be improved, especially on developing clinical cases and check list as a scoring instrument. Keywords: medical students, eye examination, OSCE score
Eye examination
Final examination
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