Title: Discuss how an Objective Structured Clinical Examination (OSCE) within medical examinations can support learning, teaching and preparation for practice.
References:
Harden R.M Stevenson M Downie W.W. Wilson, G.M 1975. Assessment of clinical competence using objective structured examination. Br Med J 1, 447-451
Include the following sections.
Introduction (suggested word count: approx. 500 words)
Describe your context
Brief introduction to what an OSCE examination is- the general concept of how it works and the advantages of using it as an assessment tool.
To create a mock OSCE examination which assesses a wide variety of skills that all medical students should know prior to completing medical school.
In the case, design a OSCE station which is made up of 3 stations that assess three core skills required by all medical school graduates.
Each station provides a learning opportunity to support learning of students,for example, each student is able to keep a copy of the mark scheme following the mock test.
This way students can look back at the mark scheme on a later date and revise over the key concepts and salient points which needs to be covered in the future to pass exams.
They also prove to be a useful resource for teachers to use as a guide when assessing students. This is because the mark schemes provide a general structure for teaching that can easily be followed and privdes information for the teacher to then pass on to students.
OSCE examinations can support preparation for practice by… any papers to back this up?
Give a very brief overview of the example you have selected, with supporting references
As above
Describe why you have chosen the example, and how you believe it can benefit your context
Purposes of assessment (suggested word count: approx. 1,500 words)
Discuss your goals in selecting the example, drawing on material discussed in the course
Purpose of the assessment is to ensure medical students are assessed in core skills such as communication, practical skills and
Consider the purposes of assessment when evaluating the example, considering the example’s advantages and disadvantages, and how it might relate to a wider programme of assessment
Advantages of OSCE – anything in the literature?
Disadvantages: Simulated patients/ scenarios are unrealistic? Pressure of exam can mean some students don’t perform as well as they would usually, usually in real life doctors have a longer time to assess/communicate with patients (for example when breaking bad news, usually a senior is always present and you’re not expected to deliver bad news by yourself.
Try wherever possible to critically evaluate established literature when highlighting points, alongside your own practice and experiences
Be selective – there isn’t enough space to include all frameworks, or comprehensively address every point
Design choices (suggested word count: approx. 1,000 words)
Discuss design choices that are important when evaluating the quality of the example assessment
These may include the length of the test, the selection of examiners, training, standard setting, resit opportunities, ethical issues, the application of feedback, the use of post-hoc review process, or any other relevant choice
Focus is on selection of examiners and application of feedback:
Examiners will be current junior doctors who will be recruited as volunteers.
Although there may be a disadvantage of using junior doctors as they have less experience,this OSCE to be a learning experience not just for the students but the examiners themselves. This way everyone involved has a learning opportunity. (Any studies/ literature to back up this point? Any reviews which looks into the experience of OSCE examiners in this setting?)
Another reason as to why you wanted this “junior doctors teaching students approach” is that it supports peer-peer teaching. Students will less likely to feel pressure perhaps- again any literature on this point to back it up?
Furthermore, recruitment will be easier as the number of juniors is higher than specialist doctors. Any studies or relevant points to add?
Also juniors are able to gain some more teaching experience- doctors should be teachers too as well as clinical.
Feedback will be given in the form of written feedback, and completion of the mark schemes. Each station will be given additional time of 2 minutes for a brief feedback.
Due to space constraints you will need to be selective: pick issues that you consider to be especially important, and explain the logic in those choices
Also feedback is arguably the time in which most learning occurs. — back this up with relevant literature research.(Although actively doing the exam is also a learning opportunity we can only progress or become better after feedback). OSCE’s allow students to be assessed directly by another more senior person. Hence good opportunity to get quality feedback from- usually as medical wards are busy juniors never have time to be watched and get feedback.
Draw on established literature to discuss design choices as well as your own experience
Excellent papers in Assessment, Examination and Standard Setting will usually…
Describe the local context, including the type of programme, length of study, and the nation in which the programme is based
Explain the goal of the new assessment explicitly with reference to the old system
Synthesise the literature, summarizing the overall quality of the evidence and especially by explaining apparent contradictions between individual papers
Selectively highlight only the most relevant terms and concepts and orient explanations to the goals of the new assessment: in this case 3 themes:
How can OSCE’s support learning (mark schemes for students)
How can OSCE’s support teaching (teachers learning from students)
How can OSCE’s support preparation for practice (OSCE’s stations being set up in a way that “mimiks real life” can be an good introduction for new doctors. ?? any relevant literature
Discuss the most important design features
Reflect on the strengths and weaknesses of the chosen approach
Clarify what happens when a student fails the new assessment
Consider how your approach might contribute to fairness or unfairness in assessment
Review how the quality of the new assessment will be evaluated over time
Conclude with a paragraph summing up the whole paper without introducing any new information.
Ensure you complete the following 5 areas:
Demonstration of skills in reflecting assessment design
Demonstrates a critical understanding of key assessment issues through a balanced argument.
Demonstrate skills in reflecting upon and critically analyzing the purposes, processes, tensions and practicalities of assessment design.
2) Understanding and application of key concepts from the course material
Demonstrates critical understanding of key concepts from the course. Considers complex interaction between factors that impact on successful assessment.
3) Understanding and use of relevant literature
Demonstrates further reading and critical appraisal of the literature related to the subject area and assessment design. Appropriate sources chosen which support discussions.
4) Structure, clarity and referencing
Written with a structure, style and authorial voice consistent with the clinical education literature. Excellent referencing practice
5) Reflection on participation in, and relevance of, the course to their own learning / context.
Demonstrates appropriate reflexivity in relation to their learning from this course and the application of insights gained to individual work context and future practice.
