EVALUATION OF A CUMULATIVE EXIT-FROM-DEGREE OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) IN A GULF CONTEXT

This study aimed to evaluate the psychometric properties of the 2nd iteration of an Objective Structured Clinical Examination (OSCE) for graduating pharmacy students in Qatar. A secondary objective of this study was to identify quality improvement opportunities for design, implementation, and evaluation of the OSCE. The psychometric analyses occurred as follows: Cut score determination using borderline regression method; predictive validity using regression and correlation of select course grades and assessments with OSCE scores, concurrent validity using correlation between other cumulative assessments and OSCE scores, risk of bias using correlation between assessors’ analytical and global scoring, content validity using student-feedback forms, and interrater reliability using intra-class correlation coefficients (ICCs), and internal consistency using Cronbach’s alpha. Pearson and Spearman correlation statistics were conducted at α level < 0.05. A series of two focus groups and subsequent qualitative content analysis were conducted with key stakeholders to identify strengths, weaknesses, opportunities, and challenges regarding OSCE implementation. Total cut score for the exam was 55.3%. Overall pass rate was 79.2%. OSCE scores correlated moderate-strongly with course grades of Professional Skills and Integrated Case-based Learning, and formative OSCE assessments. Course grades for medicinal chemistry were not correlated with OSCE scores. OSCE scores were moderately predicted by Professional skills course grades (52.3%) and its formative OSCE assessment (61.2%). Average correlation between analytical and global grades for all assessors was 0.52. A total of 90% of the stations were deemed to reflect practice, according to student perceptions. The average intraclass correlation coefficient for analytical checklists scores, global scores, and total scores were 0.88 (0.71 – 0.95), 0.61 (0.19 – 0.82), and 0.75 (0.45 – 0.88) respectively. Cronbach’s alpha of students’ performance in global scores across stations was 0.87, and 0.93 in terms of total scores. Focus groups confirmed content validity as a weakness yet spoke to training and assessment techniques as both strengths and areas for improvement. In sum, the 2nd iteration of a cumulative OSCE for graduating pharmacy students in Qatar was deemed valid and reliable, however refinements can be implemented in future iterations to further improve the exam as a high stakes assessment

A best evidence medical education (BEME) systematic review on the feasibility, reliability and validity of the objective structured clinical examination (OSCE) in undergraduate medical studies

Tese de doutoramento, Ciências e Tecnologias da Saúde (Educação e Comunicação em Ciências da Saúde), Universidade de Lisboa, Faculdade de Medicina, 201

Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series

<p>Abstract</p> <p>Background</p> <p>We describe how we used the framework of the U.S. Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) to develop a program to improve rates of diagnostic testing for the Human Immunodeficiency Virus (HIV). This venture was prompted by the observation by the CDC that 25% of HIV-infected patients do not know their diagnosis – a point of substantial importance to the VA, which is the largest provider of HIV care in the United States.</p> <p>Methods</p> <p>Following the QUERI steps (or process), we evaluated: 1) whether undiagnosed HIV infection is a high-risk, high-volume clinical issue within the VA, 2) whether there are evidence-based recommendations for HIV testing, 3) whether there are gaps in the performance of VA HIV testing, and 4) the barriers and facilitators to improving current practice in the VA.</p> <p>Based on our findings, we developed and initiated a QUERI step 4/phase 1 pilot project using the precepts of the Chronic Care Model. Our improvement strategy relies upon electronic clinical reminders to provide <it>decision support</it>; audit/feedback as a <it>clinical information system</it>, and appropriate changes in <it>delivery system design</it>. These activities are complemented by academic detailing and social marketing interventions to achieve <it>provider activation</it>.</p> <p>Results</p> <p>Our preliminary formative evaluation indicates the need to ensure leadership and team buy-in, address facility-specific barriers, refine the reminder, and address factors that contribute to inter-clinic variances in HIV testing rates. Preliminary unadjusted data from the first seven months of our program show 3–5 fold increases in the proportion of at-risk patients who are offered HIV testing at the VA sites (stations) where the pilot project has been undertaken; no change was seen at control stations.</p> <p>Discussion</p> <p>This project demonstrates the early success of the application of the QUERI process to the development of a program to improve HIV testing rates. Preliminary unadjusted results show that the coordinated use of audit/feedback, provider activation, and organizational change can increase HIV testing rates for at-risk patients. We are refining our program prior to extending our work to a small-scale, multi-site evaluation (QUERI step 4/phase 2). We also plan to evaluate the durability/sustainability of the intervention effect, the costs of HIV testing, and the number of newly identified HIV-infected patients. Ultimately, we will evaluate this program in other geographically dispersed stations (QUERI step 4/phases 3 and 4).</p

A case study to evaluate the introduction of Objective Structured Clinical Examination (OSCE) within a School of Pharmacy

Healthcare education is continually evolving to reflect therapeutic advances in patient management. Society demands assurances regarding the ongoing competence of HCPs including pharmacists. The use of OSCEs to evaluate competence of medical staff as well as nurses is well documented in the literature however evidence of its use with undergraduate pharmacy students is still sparse.Royal Victoria HospitalCraigavon HospitalNorthern Ireland Centre for Postgraduate Learning and Development (NICPLD

Trialing project-based learning in a new EAP ESP course: A collaborative reflective practice of three college English teachers

Currently in many Chinese universities, the traditional College English course is facing the risk of being ‘marginalized’, replaced or even removed, and many hours previously allocated to the course are now being taken by EAP or ESP. At X University in northern China, a curriculum reform as such is taking place, as a result of which a new course has been created called ‘xue ke’ English. Despite the fact that ‘xue ke’ means subject literally, the course designer has made it clear that subject content is not the target, nor is the course the same as EAP or ESP. This curriculum initiative, while possibly having been justified with a rationale of some kind (e.g. to meet with changing social and/or academic needs of students and/or institutions), this is posing a great challenge for, as well as considerable pressure on, a number of College English teachers who have taught this single course for almost their entire teaching career. In such a context, three teachers formed a peer support group in Semester One this year, to work collaboratively co-tackling the challenge, and they chose Project-Based Learning (PBL) for the new course. This presentation will report on the implementation of this project, including the overall designing, operational procedure, and the teachers’ reflections. Based on discussion, pre-agreement was reached on the purpose and manner of collaboration as offering peer support for more effective teaching and learning and fulfilling and pleasant professional development. A WeChat group was set up as the chief platform for messaging, idea-sharing, and resource-exchanging. Physical meetings were supplementary, with sound agenda but flexible time, and venues. Mosoteach cloud class (lan mo yun ban ke) was established as a tool for virtual learning, employed both in and after class. Discussions were held at the beginning of the semester which determined only brief outlines for PBL implementation and allowed space for everyone to autonomously explore in their own way. Constant further discussions followed, which generated a great deal of opportunities for peer learning and lesson plan modifications. A reflective journal, in a greater or lesser detailed manner, was also kept by each teacher to record the journey of the collaboration. At the end of the semester, it was commonly recognized that, although challenges existed, the collaboration was overall a success and they were all willing to continue with it and endeavor to refine it to be a more professional and productive approach

Workshop 08. Professional Delivery of Clinical Reasoning in Medicine

Objectives To consider the specific challenges for students in developing clinical reasoning skills in contemporary systems-based curricula. To consider case vignettes portraying specific student cognitive-processing difficulties in diagnostic reasoning and design a teaching approach to address these difficulties. To share best practice with colleagues. To watch and discuss one example of teaching and learning practice demonstrated in the authors’ DVD recording of an innovative teaching session .Workshop Summary A brief presentation will explore recent evidence in current literature regarding clinical teaching in this area. The delegates will work in small groups on real case vignettes bringing these specific student cognitive difficulties to life. This will enable delegates, in collaboration, to generate suitable teaching and learning approaches for consideration by the whole group. Watching the authors’ own demonstration DVD depicting an innovative teaching approach will stimulate further discussion and reflection on incorporating novel approaches in delegates` own teaching. There will be time for Questions/Answers and sharing best practice with other delegates

P33. Optimising student experience: an innovative and integrated tutor support and development programme

Background The curriculum of the five year MBBS course at HYMS is integrated and student–centred with regular clinical skills sessions throughout the first two years. The clinical skills tutors are practising clinicians who deliver their teaching role alongside everyday clinical practice. The essential features of our successful support system have evolved during our first eight years, creating a vibrant integrated and innovative Community of Practice. Our support system includes:• Peer observation • Regular online student-tutor feedback • Regular tutor training sessions • Regular Action Learning Sets • New tutor mentoring • Annual Performance Review 65 • Tutor commitment to completing a Postgraduate Certificate in Medical Education • Core staff in key roles facilitating inclusion of tutors in all aspects of the medical school. • Involvement in student assessment.Our tutors benefit and learn from each other’s experiences whilst developing professionally as educators embedded within medical school life. The Community of Practice ensures that tutors deliver consistently high quality student learning experience. The evaluation includes:• Students complete online, anonymous evaluation of tutors • We performed an evaluation of one session by observing all tutors • Informal evaluation that problems are now frequently managed by the tutor group rather than by faculty