Creative Applications of Objective Structured Clinical Examination (OSCE) in Health Professional Education With thanks to the HEA for their support towards funding and organising this workshop

1
Creative Applications of Objective Structured
Clinical Examination (OSCE) in Health
Professional EducationWith thanks to the HEA
for their support towards funding and organising
this workshop

• Kathy Curtis
• November 2006

2
What is an OSCE? An examination of students
clinical skills

• OSCEs
• are used in both formative and summative
  assessment within health professional education
• identify objective performance criteria for the
  skill being examined
• structure the performance criteria in a checklist
  to facilitate identification of desired clinical
  skills
• use a set structure to encourage parity between
  students
• use Stations designed to assess a specific
  skill or component of health professional
  clinical practice
• Conventionally, students move between multiple
  OSCE stations, each one focussing on a
  different skill, so students demonstrate the
  breadth of skills required for clinical practice
  expected at their stage of learning and
  development

3
Examples of OSCE Stations1. resuscitation of a
child2. consultation skills3. physical
examination skills
1
3
2
4
The value of OSCEs

• OSCEs
• have been extensively researched and found to
  have academic rigour for summative assessment in
  health professional education, if they are
  conducted using robust processes (number of
  stations, preparation of simulated
  patients/examiners, global judgement alongside
  checklist)
• are a requirement for accreditation in many
  health professional programmes
• encourage a collaborative approach between HEI
  and practice in the creation of health
  professionals who are fit for purpose
• are adaptable across professions, clinical skills
  and academic levels
• have potential for peer feedback and assessment
• promote development of functioning knowledge
  (Biggs 2006)
• have scope for application outside the health
  arena Objective Structured Professional
  Examination (OSPE)

5
Creative Applications of OSCE at UniS

• UniS OSCEs are primarily used in the education of
  nurses, midwives, and ODPs and some allied health
  professionals such as Emergency Care
  Practitioners, and Dieticians
• OSCEs are applicable to testing skills at any
  academic level and are used from level 1 with
  pre-registration students to Masters level in
  both formative and summative assessment
• The creative approaches to OSCE are adaptable
  between health professions and outside the health
  professional education arena, as the principles
  can be applied irrespective of clinical content
• The creative approaches used and under
  development at EIHMS include the long-case OSCE,
  the Masters level OSCE with a knowledge for
  skills viva to test expertise for advanced
  practice, the use of formative OSCE to develop
  learning, and peer assessment at the formative
  OSCE stage to enhance student learning

6
The Long Case OSCE

• A single clinical case with the OSCE checklist
  structured with subsections to assess a variety
  of skills
• Ideal for assessing professional-client
  interaction such as history taking leading to
  collaborative management planning
• the case specificity may reduce reliability of
  assessing performance across cases, but may gain
  validity through increased realism and depth
• If performance criteria are set to assess generic
  skills, irrespective of case specificity, then
  loss of case breadth has less impact on
  reliability of assessing student skill
• Students need to be active participants in
  authentic real-life tasks to develop skills and
  prepare for practice (Bryan Clegg 2006)

7
OSCE plus Viva for testing skills at Masters Level

• Identifying the performance criteria for advanced
  practice skills or expertise can be challenging
• Experts as examiners must be liberated to assess
  using global judgement alongside set performance
  criteria
• Knowledge associated with specific advanced
  practice skills can be assessed within a viva
  subsection of the OSCE checklist
• Important to differentiate between academic
  levels in OSCE, not just in the advanced skills
  performance required but in the higher challenge
  for, and expectations of, these students
• Teachers, examiners and students feedback on
  the Masters Level OSCE is very positive

8
Using peer assessment in formative OSCE

• There is substantial evidence to support the use
  of peers in feedback and assessment (Topping
  2005)
• Peer involvement is beneficial to the students by
  promoting deeper learning as they increase their
  effort knowing peers will be evaluating their
  work (Brown et al 2003) and by making students
  rethink their understanding of the skill in order
  to be able to provide appropriate feedback
• Providing peer feedback prepares students for
  professional practice where assessment of peers
  and students is expected (NMC 2004)
• Peer assessment using formative OSCE provides the
  student with a clear understanding of the
  performance criteria required for clinical
  practice
• Peer involvement in teaching and learning helps
  teachers, both by improving the success of
  student learning and by empowering students to
  progress through feedback

9
This workshop therefore aims to

• Encourage constructive dialogue between health
  professional educators in the use of OSCE for
  student learning and assessment, to develop best
  practice
• Share experiences of the less conventional UniS
  approach to developing OSCE
• Encourage creativity to developing student
  learning and assessment using OSCE
• Encourage a liberation of minds, to meet the
  challenges of developing and assessing skills in
  health professional education for the 21st
  century

10

• References
• Biggs, JC. 2003 Teaching for Quality Learning at
  University, 2nd edition. Open University Press,
  Berkshire.
• Brown, E, Gibbs, G, Glover, C. 2003 Evaluation
  tools for assessing the impact of assessment
  regimes on student learning. http//bio.ltsn.ac.u
  k/journal/vol2/beej-2-5.htm Accessed 26.10.06
• Bryan, C and Clegg, K 2006 Innovative Assessment
  in Higher Education. Routledge, London
• Nursing and Midwifery Council 2004 The Code of
  Professional Conduct standards for conduct,
  performance and ethics. NMC, London.
• Topping, KJ. 2005 Trends in Peer Learning.
  Educational Psychology, 25 (6), 631-645.

11
Plan for the day 0930-1010     Plenary
Session Welcome , Introduction to the day and
group timetables/rotation
plan, with coffee/tea  1010-1030     OSCE
session One OS1      1030-1050     OSCE
session Two OS2      1050-1110     OSCE
session ThreeOS3      1110-1130     OSCE
session FourOS4      1130-1150     OSCE
session FiveOS5      1150-1210     OSCE
session SixOS6      1210-1310     Networking
Lunch 1310-1340 Plenary session Three
Kings actors talk and demonstration
with coffee 1340-1400     OSCE
session SevenOS7 1400-1420   OSCE session
EightOS8      1420-1500     Plenary Session
Panel questions and Discussion 1500  
End of day      All plenary sessions and the
lunch will be in 01DK02 All OSCE sessions will be
in the skills labs on the ground floor
12
Delegates will be divided into 8 groups
A,B,C,D,E,F,G H and rotate around 7 OSCE
stations in set sessions Station sessions are
20 mins except the Masters Level station which is
40 mins  
Rotation plan for groups