OSCEs Who, What, When, Where, How, and Why

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OSCEs! Who, What, When, Where, How, and Why ?

• Dorian Williams
• June 7, 2006

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Objectives

• By the end of this talk you should be familiar
  with
• the structure of an OSCE
• the types of competencies that can be assessed
  using an OSCE
• some of the issues involved in case development
  and implementation

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Objectives contd

• In addition, you will have an opportunity to
  share ideas of how to incorporate an OSCE into
  your situation

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OSCE?

• Objective Structured Clinical Examination
• Objective Structured Clinical Experience
• Not the Organization for Security and
  Co-operation in Europe(OSCE.org)!! Google finds
  everything!

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OSCE history

• First described 1975 in the British Medical
  Journal by Harden RM
• Br Med J. 1975 Feb 221(5955)447-51

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Just what is an OSCE?

• Means of assessing skills/competencies through
  direct observation in a structured/standardized
  way.

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OSCE Format

• Students rotate through a series of stations each
  with a defined task.

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Why use an OSCE?

• Allows students to self-assess clinical
  proficiency.
• Allows students to practice an OSCE exam in a
  lower stakes setting, given the
  NBME/USMLEs implementation of Step II CS, a
  clinical skills exam as part of the Step II
  licensure exam.

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Why use an OSCE?

• Allows assessment of clinical skills across a
  broad range of topics.
• Allows educators to establish standardized
  clinical evaluation tools using controlled
  grading criteria.

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Does
Shows How
Knows How
Knows
Assessment Model
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Guide for Selecting a Testing Method(AMost
efficient/BSecondary utility)
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Issues to Consider

• What skill(s) do you want to assess?
• The Case Template
• Recruiting and Training Standardized Patients
• Examination Logistics
• Cost!

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Skills assessed PDCI2 OSCE

• Medical History
• Physical Examination
• Communication Skills
• Recognizing Health Issues

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Skills assessed Senior CPX

• History
• Physical Exam
• Communication
• Diagnosis
• Management

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Other things that can be assessed

• Professionalism
• Technical or procedural skills
• Patient Education
• Limited only by ones imagination.

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The Template (Minimum)

• A case summary including the task to be performed
• Standardized patient training materials
• The evaluation form
• Clear student instructions and examiner
  instructions (if applicable)
• A list of requirements (equipment, scripts etc)

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Standardized Patients

• Real vs Simulated
• Paid vs Volunteer
• Recruiting (Be Careful!)
• Training
• Who grades?

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Caution!

• Keep grading simple and objective

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Standardized Patients

• Michael!

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Logistics

• Get Help (Lots of it!)
• Start early (Years??)
• Location
• Exam Security
• Organization/Orientation
• Manage stress

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Cost!

• Calculate a realistic budget
• INCLUDE
• Supplies
• Paid Patients
• Support Staff
• Faculty Time

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OSCE in Pictures
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OSCE in Pictures
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OSCE in Pictures
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OSCE in Pictures
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OSCE in Pictures
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OSCE in Pictures
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OSCE in Pictures
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OSCE in Pictures
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OSCE in Pictures

• I dont have a picture pulling out my hair
  grading!

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Summary

• On OSCE is an effective assessment method
• Organization is essential
• Keep the evaluation simple
• Be aware of budget issues
• Watch your learners!!!

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Discussion/share ideas