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OSCE

OSCE. Dr Omar Al- Hussaini , MBChB,CNN,DipMedEd , CBS. Background about OSCE Definition of OSCE Harden ’ s12 tips for organizing OSCE Advantages. Disadvantages Examples of OSCE Station profile Reflections Summary . Abbasid era in Baghdad in 931 AD

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OSCE

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  1. OSCE Dr Omar Al-Hussaini, MBChB,CNN,DipMedEd, CBS

  2. Background about OSCE Definition of OSCE Harden’s12 tips for organizing OSCE Advantages Disadvantages Examples of OSCE Station profile Reflections Summary

  3. Abbasid era in Baghdad in 931 AD • Caliph Al-Muqtadir, ordered his chief physicianto examine all healers • Licensing Boards • The chief physician • License for practicing

  4. Miller’s Pyramid of Clinical Competence

  5. What is OSCE? The candidates rotate through a series of stations at which they are asked to carry out a (usually clinical) task

  6. Background about OSCE • Started in 1972 Dundee, Scotland by R. Harden and F.Glesson • First literature about OSCE 1975, BMJ • Used in undergraduate as well as postgraduate • Formative & summative • Used in many disciplines

  7. MODIFICATION OF OSCE OSLER:objective structured long examination record OSPE: objective structured practical examination OSVE: objective structured video examination OSTE: objective structured teaching evaluation OSPRE: objective structured performance-related examination OSSE: objective structured selection exam.

  8. Characteristics of the OSCE • It is an assessment approach primarily used to measure clinical competence • Should be planned or structured (predetermined clinical competences) • Examination format or framework • Different types of test method can be incorporated into it

  9. Characteristics of the OSCE (Cont.) • In most stations students are observed (by one or more examiners) • Scored as they carry out the task or interpret clinical materials (e.g.laboratory data, X-rays), write notes or answer question

  10. What is to be assessed? Duration of station Number of stations Use of examiners Range of approaches New stations Harden’s 12 Tips for Organizing an OSCE

  11. Harden’s 12 Tips for Organizing an OSCE (Cont.) • Organization of the examination • Assigning priority • Resource requirements • Plan of the examination • Change signal • Records

  12. Exam Venue

  13. Changing Stations

  14. Advantages of the OSCE • Valid examination • The examiners can control the complexities of the examination • Used as summative as well formative • Can be used with larger number of students • Reproducible

  15. Advantages of the OSCE (cont) • The variable of the examiner and the patient are to a large extent removed • Fun activity within the department or college, which promotes team work

  16. Disadvantages of the OSCE • Knowledge and skills are tested in compartments • The OSCE may be demanding for both examiners and patients • More time in setting it up • Shortage of examiners • Might be quite distressing to the student

  17. A student from Newcastle, UK New meanings for OSCE: • Obligatory sweepingly crushing experience • Obnoxiously stupefying celebration of the evil • A collection of “ overwhelmingly significant clinical errors”

  18. OSCE stations-Dec 2002

  19. Simulated Patient (Hx taking)

  20. Simulated Patient(examination)

  21. Video station

  22. Post graduate surgical OSCE

  23. OSCE in Peadiatrics

  24. OSPE in Pharmacology (Nepal) (I): Spotter section: A student identifies a drug among the choices displayed for a particular condition and then answers one or two questions related to the drug. (II): communication skills: A student communicates with and prescribes a drug for a simulated patient.

  25. Station Profile A) Instruction to students:. Mr.Mohammed is a 22-year-old working in Thumrith base, presented to our clinic with headaches, generalized loss of interest in life, poor social performance, chest discomfort. .

  26. Station Profile (cont) A) Instruction to students:(cont) • You have 8 minutes to assess the affective state of this patient, by taking the proper and relevant history • An observer, using a checklist, will assess your performance while you interact with the patient

  27. Station Profile (cont) B) Briefing to the Observer: • The student is required to assess the affective state of Mr. Salim, by taking the proper and relevant history. • Observe your students using the following checklist, without any probing or interference from you.

  28. Station Profile (cont) C) Briefing to the patient: • Don not give more information than asked for. • Try to answer the questions as clearly as possible. • Try to be consistent with all the students as the interview you.

  29. Student greeted the patient Introduced her/himself Asked the patient’s name Mood state Duration of mood disturbance Interest & enjoyment of life Diurnal swings of mood Recent change in sleep pattern Change in appetite Suicidal thoughts/& or attempts Checklist

  30. Anecdotes •Using the whistle •Tuning the video! •Shortage of patients •Staff as SP’s •Preparing the equipment •Choosing the number of stations

  31. Key Points Staff development Dynamic process Stimulation Bank Videos & simulators Enjoyable Feedback

  32. Feedback from Students (positive) • To assess our performance in action • To detect our weaknesses • To assess our abilities in solving clinical problems • To assess our clinical skills, skills in communication and approaching patients

  33. Feedback from Students (positive) • The student is made to organize his/her thoughts • Increases self confidence • Fair to all students • Clinically oriented • To train the students because OSCE is an international examination

  34. Feedback from Students (negative) • Might be exhausting for the real patient • It’s humiliating to patients • Needs extra preparation time • burden on the student • Only 10 stations!!! • No need for the presence of an observer • Some stations require more time than the others

  35. Examiners after the OSCE

  36. When used correctly, the OSCE can be highly successful as an instrument to assess competence in medicine Ronald Harden

  37. THANK YOU

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