Students benefit from developing their own emergency medicine OSCE stations: a comparative study using the matched-pair method

Background: Students can improve the learning process by developing their own multiple choice questions. If a similar effect occurred when creating OSCE (objective structured clinical examination) stations by themselves it could be beneficial to involve them in the development of OSCE stations. This study investigates the effect of students developing emergency medicine OSCE stations on their test performance. Method: In the 2011/12 winter semester, an emergency medicine OSCE was held for the first time at the Faculty of Medicine at the University of Leipzig. When preparing for the OSCE, 13 students (the intervention group) developed and tested emergency medicine examination stations as a learning experience. Their subsequent OSCE performance was compared to that of 13 other students (the control group), who were parallelized in terms of age, gender, semester and level of previous knowledge using the matched-pair method. In addition, both groups were compared to 20 students who tested the OSCE prior to regular emergency medicine training (test OSCE group). Results: There were no differences between the three groups regarding age (24.3 +/- 2.6; 24.2 +/- 3.4 and 24 +/- 2.3 years) or previous knowledge (29.3 +/- 3.4; 29.3 +/- 3.2 and 28.9 +/- 4.7 points in the multiple choice {[} MC] exam in emergency medicine). Merely the gender distribution differed (8 female and 5 male students in the intervention and control group vs. 3 males and 17 females in the test OSCE group). In the exam OSCE, participants in the intervention group scored 233.4 +/- 6.3 points (mean +/- SD) compared to 223.8 +/- 9.2 points (p < 0.01) in the control group. Cohen's effect size was d = 1.24. The students of the test OSCE group scored 223.2 +/- 13.4 points. Conclusions: Students who actively develop OSCE stations when preparing for an emergency medicine OSCE achieve better exam results

Umgang mit fehlerhaften Aufgaben bei Prüfungen: Die Übertragung des Nachteilsausgleichs bei den deutschen Staatsexamina auf Aufgaben mit Teilpunkten

In the written part of German state exams, multiple choice questions which inherit a flaw are not always excluded but taken into consideration when awarding a grade to any individual candidate, if this is advantageous to the candidate. This process of elimination and compensation of disadvantage in flawed questions, as applied by the Institut für medizinische und pharmazeutische Prüfungsfragen (IMPP), can lead to different items being taken into consideration in the grading in individual cases and to the application of different pass and grade boundaries in individual cases .This procedure is applied here to examinations containing items with partial credit scoring. A simple numerical rule can be applied which can be used to decide whether a flawed item has be taken into account in the grading procedure in order to achieve a pass or a particular grade for a candidate. This rule - as in the state examinations - must take account of the individual number of scores achieved in the flawed item and, if the relative pass threshold ("automatic adjustment clause") is applied, the average score achieved in the item by all candidates. In addition, however, it also includes the grade boundaries.Sind in den schriftlichen Teilen der deutschen Staatsexamina Aufgaben enthalten, die inhaltlich oder formal fehlerhaft sind, werden diese nicht generell ausgeschlossen, sondern bei der Benotung eines einzelnen Prüfungsteilnehmers dennoch berücksichtigt, wenn dies für diesen Teilnehmer vorteilhaft ist. Dieses Verfahren von Elimination und Nachteilsausgleich bei fehlerhaften Fragen, wie es vom Institut für medizinische und pharmazeutische Prüfungsfragen (IMPP) angewandt wird, kann dazu führen, dass bei einer Prüfung individuell unterschiedliche Aufgaben in der Bewertung berücksichtigt werden sowie individuell unterschiedliche Bestehens- und Notengrenzen gelten.Dieses Vorgehen wird auf Prüfungen übertragen, die Aufgaben enthalten, bei denen Teilpunkte vergeben werden. Es lässt sich ein einfaches numerisches Kriterium angeben, mit dem entschieden werden kann, ob eine fehlerhafte Aufgabe zum Erreichen der Bestehens- oder einer Notengrenze bei einer Prüfungsteilnehmerin oder einem Prüfungsteilnehmer für die Bewertung zu berücksichtigen ist oder nicht. In dieses Kriterium geht - wie bei den Staatsexamina - die individuell erreichte Punktzahl bei der fehlerhaften Aufgabe und bei Anwendung der relativen Bestehensgrenze ("Gleitklausel") die mittlere erreichte Punktzahl aller Teilnehmer bei der Aufgabe ein. Darüber hinaus beinhaltet es aber auch noch die Notengrenzen

Interoception, body perception and awareness

Two series of studies are reported dealing with (1) psychophysical characteristics and (2) interactions of visceroceptive and somatosensoric information processing. The first studies characterized detection, graduation and localisation of visceral as compared to somatic stimuli. The second series investigated somatovisceral discrimination, masking, and summation at different levels of awareness. Methods: Distension of the sigmoid colon served as standard model. The visceral stimulus was applied by a balloon probe in the sigmoid colon, the external abdominal stimulus by a ring-shaped stimulator at two abdominal sites. A forced-choice-paradigm with two observation intervals was applied (multiple staircase) to estimate interactions between somatosensation and visceroception. Results: The visceral distension stimulus can be detected or discriminated correctly without conscious sensation. Visceral localization of stimuli requires conscious sensation. Combining visceral and somatic stimuli resulted in distinct elevation of visceral thresholds demonstrating somatosensory masking of the visceral stimulus. There are characteristic somato-visceral and viscero-somatic differences in masking and qualitative differences between implicit and explicit processing stages. Specific electrocortical reactions to visceral stimuli could be shown. Discussion: Visceroception is represented on the highest functional level as a fairly independent submodality of body perception. There are several hints that visceroception and protopathic somatic sensitivity follow the same major paths and comprise the same ontogenetic origin. Perceptual interactions are determined by modality and awareness and depend on the task. The role of implicit and explicit body perception considering the body self and its significance in the context of consiousness are discussed