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