D’Souza, Karen

Heal, Clare

Malau-Aduli, Bunmi S.

Smith, Jane W

Turner, Richard

English

Background: The Australian Collaboration for Clinical Assessment in Medicine (ACCLAIM) consortium comprises 15 out of a total of 19 medical schools in Australia. The objective of this collaboration is to provide benchmarking andquality assurance of Objective Structured Clinical Examinations (OSCEs) on a national basis. Summary of Work: We designed and administered a semi-structured questionnaire with the objectives of 1) providing a snapshot of currentOSCE practices across Australian Medical Schools and 2) Compare these practices with current gold standard according to guidelines. Questions explored OSCE process, anal ysis, and administration.Summary of Results: 18 of 19 medical schools in Australia answered the questionnaire. Total number of stations varied from 9 to 16 and total OSCE testing time from 70 to 160 minutes. There was a variation in the type of marking sheet used, with an even divide between analytic and holistic checklist scales.Discussion: There are similarities and variations in OSCE process and content in Australian Medical Schools.Conclusion: We hope that the results of our survey will allow participating schools to compare and reflect on their current OSCE practices in relation to other medical schools in Australia, and recommended gold standard practices.Take Home Message: Variations in the interpretation and implementation of accepted guidelines for OSCEs is inevitable, given the need to respond to local needs and limitations. Sharing of such diversity is important in order to maintain the strength of OSCE assessment and to meet the changing needs of medical education.<br/

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Bond UniversityResearch RepositoryA snapshot of OSCE practices at Australian Medical SchoolsSmith, Jane W; Heal, Clare; D’Souza, Karen; Malau-Aduli, Bunmi S.; Turner, RichardPublished in:Journal of Islamic International Medical CollegePublished: 01/03/2018Document Version:Peer reviewed versionLink to publication in Bond University research repository.Recommended citation(APA):Smith, J. W., Heal, C., D’Souza, K., Malau-Aduli, B. S., & Turner, R. (2018). A snapshot of OSCE practices atAustralian Medical Schools. Journal of Islamic International Medical College, 13(Supplement), 123-124.General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright ownersand it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.For more information, or if you believe that this document breaches copyright, please contact the Bond University research repositorycoordinator.Download date: 10 May 2019• A/Prof Jane Smith• Prof Clare Heal• Dr. Karen d’Souza• Dr. Bunmi Malau-Aduli• Prof Richard Turner• Dr Jenny BanksA Snapshot of OSCE practices in Australian Medical schoolsBackgroundACCLAIM started in 2011• Firstly: James Cook University (JCU) and University of Tasmania(UTAS)• Was 15 of 19, now 15 of 21 Australian Medical Schools ACCLAiM AIMS:• Collaboratively develop shared OSCE stations • Online examiner training with discussion and feedback• Analysis of student performance data• A framework to facilitate national benchmarking“SNAP SHOT” Methods• Ideas from ACCLAIM meeting August 2016• Questionnaire designed Nov 2016• Ethics, in order to send to ALL medical schools• Email survey monkey link sent early 2017Aims: Measure and compare OSCE practices with “Gold Standard”Results• 18/19 Australian Medical Schools participated (2 new ones since survey)• All 15 ACCLAIM members, and 3 non-members• 71 questions were askedHow many OSCE stations are in your exam?0123456789 10 12 13 16Number of Medical SchoolsNumber of OSCE stationsHow long is each station?01234567896 7 8 9 10 >10Number of Medical SchoolsLength in MinutesHow long is perusal time?0246810121 2 3 4 5Number of Medical SchoolsLength of Perusal time in minutesMay notes be written in perusal time?9• 50% allow notes• 50% DON’T allow notes• Australian Medical Council DO NOT allow notesDevices NOT permitted in OSCE0 2 4 6 8 10 12 14 16 18WatchesPensFit -Bit bandsSmart watchesRecording deviceMobile phoneNumber of Medical Schools applying restrictions 11Blueprinting• ALL use their own curriculum+/- Graduate outcomes from• Australian Medical Council(AMC)• Medical Deans of Australia & New Zealand (MDANZ )Procedural skills tested in OSCEs14 do, and 4 don’t0 1 2 3 4 5 6SuturingPAP smearCPR/life supportInjection/ABGUrinary catheterSTI screenNumber of Medical schools using specified procedural skillTypes of rating scales used to score marks0 1 2 3 4 5 6 7Competency- basedChecklistChecklist & CompetencyMarks added from Global ratingNumber of Medical Schools usingStandard setting used for OSCE0 2 4 6 8 10 12Borderline RegressionBorderline GroupsAngoffOtherHofsteeEbelNumber of Medical Schools using eachHow much time until re-assessment OSCE?0 1 2 3 4 5 60 to 23 to 45 to 6up to 16Number of Medical SchoolsWeeks until  Re-assessment OSCEThe multiple sources of simulated Patients0 2 4 6 8 10 12 14 16ActorsGeneral PublicStaffOtherMedicalStudentsNumber of Medical schools using each type of simulated PatientOther: real patients, elective international students, community volunteers, general public who have been trainedUse of REAL PATIENTS in OSCEsEXAMPLES:• Abnormal heart sounds• Abnormal respiratory sounds eg pulmonary fibrosis• Musculoskeletal deformities• Diabetic limb• Neurological signs eg Parkinsons, eg peripheral neuropathy • SplenomegalyJust under half use real patients in OSCE physical examination stationsSimulated Patients marking the studentSCORING of• rapport and communication with patient • whether they were respectful • showed empathy • how they felt treated as a patientIn 20% of the responding Medical schools Simulated patient give 10% of the station marksRates of pay to simulated patients0 1 2 3 4 5 6TransportGift card $ 30-50 total$20/hr$30/hr$40/hr$50/hr$800/dayNumber of Medical schoolsWHO are the EXAMINERS?(ALL had multiple answers)0 2 4 6 8 10 12 14 16 18General PractitionersSpecialistsRegistrarsJunior DoctorsRetired and AlumniMedical StudentsExaminer Training ?• Orientation to OSCE & calibration • Training workshops• Briefing before the OSCE• Documents to read prior to the OSCE• Orientation to examiner’s OSCE station • Online training prior to the OSCEDo medical schools pay examiners?1/3 DO,  2/3 DONT“Gold Standard” AMEE guide 81• Examiner training reduces examiner variation in scoring• Poorly standardized simulated patients = poor reliability• Checklist v competency based v global rating scale• Standard setting varies from recommended• Quarantine recommended & practiced• Devices = many more than phonesConclusions• ACCLAiM is a great example of collaboration• Variation between medical schools• Shared information is of use to all• Many future research possibilities• ACCLAiM contact jcu.acclaim@gmail.com• My email jsmith@bond.edu.au

A snapshot of OSCE practices at Australian Medical Schools

https://pure.bond.edu.au/ws/files/29712737/AcclaimOSCE.JaneSmithOTTAWA2018.pdf

A snapshot of OSCE practices at Australian Medical Schools

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