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Experience of Conducting Objective Structured Clinical Evaluation (OSCE) in Malawi  [PDF]
Tiwonge Ethel Mbeya Munkhondya, Gladys Msiska, Evelyn Chilemba, Maureen Daisy Majamanda
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.410075
Abstract: In Malawi various nursing educational institutions have increased the enrollment of nursing students in order to respond to the rampant nursing shortage prevalent in the Malawian clinical settings. With this increase in intake, nurse educators are met with so many questions as to whether the nurses being trained are competent and fit for practice. To ensure that these nurses have appropriate competences, Objective Structured Clinical Evaluation (OSCE) has been embraced as a key strategy to evaluate student’s competence. The paper describes the lessons learnt from conducting OSCE to undergraduate student nurses at Kamuzu College of Nursing in Malawi. The paper considers the background and context of the school, the preparation of students, the formulation of OSCE tasks, recruitment of examiner and simulated patients and the evaluation of the OSCE. The paper concludes that OSCE can be a worthwhile valid strategy of teaching and assessing nursing students as long as it is properly designed. Nonetheless, profound commitment of all stakeholders involved is very vital.
Medical Students Progress in the Practice Assessment of Knowledge, Skills, and Attitudes  [PDF]
Smrr Passeri, L. M. Li, W. Nadruz Jr., A. M. Bicudo
Creative Education (CE) , 2015, DOI: 10.4236/ce.2015.68084
Abstract: We have developed an alternate instrument of evaluation named ACHA-Avalia??o de Conhecimento, Habilidades e Atitude (Assessment of Knowledge, Skills and Attitude) in our institution. We feel that the construct of this tool is more comprehensive than OSCE (Objective Structured Clinical Examination), as it includes two other domains; knowledge and attitude. This study aims to present results of ACHA in medical students during internship as a tool of monitoring their progress. We selected students enrolled in Medicine course from 2007 to 2011. We included in the analysis only 5th and 6th year students, and only those who participated in four consecutive assessments in this period of time. There was a linear progression during the four assessments. The lowest averages were found in the first tests, during the fifth and sixth year (I5Y and I6Y). The scores were separated by stations (Surgery, Internal Medicine, Obstetrics/Gynecology, and Pediatrics) to evaluate student progress. There was a significant difference between assessments in all specialties (the highest value in the II5Y assessment for Surgery (Mean = 7.43 SD = 1.59), and the lowest in the I5Y for Pediatrics (Mean = 4.49, SD = 2.33). The best correlation of improvement progression (score over time) was observed in the Internal Medicine (R2 = 0,678), while the poorest was seen in Gynecology/Obstetrics (R2 = 0.144). We felt that ACHA went beyond being only an assessment tool for evaluating student performance, but also it involved other domains of education and learning process. Perhaps the key element would be the acceptance by everyone involved (teachers and students) in the process which forced a reflection and developed actions to improve the quality of the course and the evaluation itself. We understand that it is essential for the evaluation process to be dynamic and for such the motivation of those involved is vital.
Comparison of Assessment Scores of Candidates for Communication Skills in an OSCE, by Examiners, Candidates and Simulated Patients  [PDF]
Abdul Sattar Khan, Riaz Quresh?, Hamit Acemo?lu, Syed Shabi-ul-Hassan
Creative Education (CE) , 2012, DOI: 10.4236/ce.2012.326141
Abstract: Though OSCE method has been verified by several researchers for the appropriate assessment of competence in clinical skills, yet medical educationists have some concerns regarding the value of assessment of communication skills and empathy by this method. Hence, we sought to assess the extent of differences, if any, among the examiners, the candidates and the simulated patients (SPs) for communication skills. A total of 23 general practitioners, who were preparing for their postgraduate clinical examination, participated in a practice OSCE on seven stations in this study. The examiners observed and evaluated the candidates during the whole consultation, using the pre-tested checklist including 15 items with a global rating scale. The simulated patients also evaluated the candidates at the end of consultation, using the same checklist. There were significant differences in the assessment scores of candidates by the examiners, the candidates themselves and the simulated patients regarding all aspects of communication skills. However, introduction to the patient’s scenario of some non-verbal communication did not show any significant difference (p-value => 0.05). The correlation between examiners and SPs (r = 0.07, p = 0.7) and SPs and candidates (r = 0.01, p = 0.95) was very low and not significant. Cronbach’s alpha was 0.968 across items, whereas among seven stations it was 0.931. This study has shown a significance difference in assessment scores of candidates by examiners, SPs and candidates themselves. In conclusion, there is a need for further research regarding the active role of SPs in summative assessments.
Objective structured clinical examination in radiology
Agarwal Anurag,Batra Bipin,Sood A,Ramakantan Ravi
Indian Journal of Radiology and Imaging , 2010,
Abstract: There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed "key-list" that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as "manned" or "unmanned" stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations.
Preparing and Conducting Objective Structured Clinical Examination for Oman Medical Specialty Board R1-R4 Residents
Hamed Al Sinawi,Marwan Al Sharbati,Yousif Obaid,Nonna Viernes
Oman Medical Journal , 2012,
Abstract: The Objective Structured Clinical Examination (OSCE) has been a common tool of assessment in both undergraduate and postgraduate medicine, and has been reported to have both higher reliability and validity over the oral exam. In addition, another advantage is that it reduces luck by standardizing both examiners and patients. This article describes our experience in organizing and conducting an OSCE for Oman Medical Specialty Board residents in Psychiatry.
A Rule of Law Agenda for Central Asia
Gerald Staberock
Essex Human Rights Review , 2005,
Abstract: The article analyses the state of the rule of law in the five former Soviet Republics of Central Asia.The author sets out the rule of law as a rule of rights contrasted by the lack of checks and balances in theconstitutional, legal and judicial framework. The need for reform includes criminal proceedings andan overhaul of the Soviet-style Prokuratura. Penitentiary reform and attempts to establish humanrights institutions confirm that progress is possible only so long as it is not perceived as a threat topresidential or executive power.The analysis concludes that Central Asia still carries most insignia of the Soviet legal legacy.This is both an expression of the missing democratic transition in the region and an impediment tofuture transition. Political will is required to set an agenda for reform of the rule of law for CentralAsia. Otherwise it risks losing contact with law reforms in other parts of the Commonwealth ofIndependent States as well. A reform agenda should be based on clear benchmarks and politicallyembedded in a strong international process under the leadership of the Organization for Security andCo-operation in Europe (OSCE). While the challenges are similar, the author warns against treatingall Central Asian states identically. The pervasive, systematic and gross human rights violations inTurkmenistan and Uzbekistan require urgent attention by the international community. Finally, theauthor warns against tendencies to compromise human rights in the fight against terrorism and toaccept the security rhetoric of the leaders of the region.
First-year medical student objective structured clinical exam performance and specialty choice
Nicole J. Borges,Katherine A. Backes,Bruce Binder,Brenda Roman
International Journal of Medical Education , 2013, DOI: 10.5116/ijme.5103.b037
Abstract: Objective: The aim of this study was to determine if first-year physical exam and interview Objective Structured Clinical Examination scores differ for medical students entering person or technique-oriented specialties. Methods: Objective Structured Clinical Examination physical exam and interview scores from 2004 to 2007 for first-year medical students (n=280) at one United States medical school were compared using t-tests based on specialty choice from this cohort of students. Results: T-test results (p<0.05) showed a significant difference in the mean physical exam (mean=92.85, sd=3.94) versus interview (mean=90.77, sd=6.76) scores for students entering person-oriented specialties (n=157, p<0.001). There was also a significant difference (p<0.05) in the mean physical exam (mean=93.46, sd=3.92) versus interview (mean=91.40, sd=5.75) scores for students entering technique-oriented specialties (n=123, p<0.001). Results indicate that physical exam scores are significantly higher than interview scores for students regardless of whether they enter person or technique-oriented specialties, except for psychiatry where interview scores were significantly higher than physical exam scores. Conclusion: Subsequent studies are needed to better understand the relationship of Objective Structured Clinical Examination performance and specialty choice by medical students.
Integration einer OSCE in das zahnmedizinische Physikum [Integration of an Objective Structured Clinical Examination (OSCE) into the Dental Preliminary Exams]
Ratzmann, Anja,Wiesmann, Ulrich,Korda?, Bernd
GMS Zeitschrift für Medizinische Ausbildung , 2012, DOI: 10.3205/zma000779
Abstract: [english] Introduction: In the pre-clinical phase of the study of dentistry at the University of Greifswald, the course “Early Patient Contact (EPC)” is conducted within the framework of Community Medicine/Dentistry. The course is based on three pillars: the patient visiting program, special problem-oriented seminars, and communication training for doctors. The essential goal consists of providing students with real patient contact right at the beginning of their study of dentistry, thus making the study of dentistry patient-based very early on. Students are trained in taking comprehensive anamneses and recording clinical findings.Methods: Within the framework of the dental preliminary exams, the course is evaluated using an OSCE on a standardized patient. Furthermore, the added value of an additional training unit (conducting anamnesis and clinical examination) in preparation for the OSCE was evaluated. The exam results of a group without training (control group) were compared with those of a group with training (intervention group).Results: The intervention group performed significantly better than the control on the following items: the total number of points achieved on the OSCE early patient contact, and in the most important points of the anamnesis and clinical examination. In addition, the intervention group tended to score higher in terms of the item “oral health status”.Conclusion: The present study showed a positive effect of an additional training unit on students’ performance in the OSCE. Taking the limitations of the study and the results of a literature review into account, we recommend conducting such training as preparation for the OSCE. [german] Einleitung: An der Universit t Greifswald wird im vorklinischen Abschnitt des Studienganges der Zahnmedizin im Rahmen der Community Medicine/Dentistry der Kurs Der Frühe Patientenkontakt (FPK)“ durchgeführt. Der Kurs basiert auf drei Prinzipien: dem Patientenbesuchsprogramm, speziellen problemorientierten Seminaren und dem rztlichen Kommunikationstraining. Die wesentliche Zielstellung besteht darin, den Studierenden bereits zu Beginn des Zahnmedizinstudiums einen realen Patientenkontakt zu erm glichen und somit das Studium frühzeitig patientennah zu gestalten. Die Studierenden trainieren das Erheben einer umfangreichen Anamnese sowie die klinische Befundung.Methode: Der Kurs wird im Rahmen des zahnmedizinischen Physikums anhand eines OSCE an einem standardisierten Patienten überprüft. Das OSCE bestand aus den drei Stationen: Anamnesegespr ch, Zahnstatus und Mundhygienestatus.Ziel: Es wurde der
Examen Clínico Objetivo Estructurado como instrumento para evaluar la competencia clínica en Pediatría. Estudio piloto
Gamboa-Salcedo, Tamara;Martínez-Viniegra, Norma;Pe?a-Alonso, Yolanda Rocío;Pacheco-Ríos, Aarón;García-Durán, Rocío;Sánchez-Medina, Jerónimo;
Boletín médico del Hospital Infantil de México , 2011,
Abstract: background. assessment is an essential component of the teaching-learning process that stimulates and leads learners towards their goals and allows teachers to ascertain whether the students have acquired the necessary knowledge and clinical skills to be professionally competent. in medicine, the ideal assessment method does not exist; therefore, the use of several assessment instruments is advised; among them, the objective structured clinical examination (osce) has proven its advantage assessing clinical skills. the aim of this work is to describe the experience of teachers and learners developing and applying an osce in a children's hospital. methods. twenty osce stations were designed and applied in a pilot study. the assessment criteria for each station were defined. individual marks were recorded and means for each station and year of residency were calculated (two first-year residents, seven second-year residents and 11 third-year residents). results. the osce lasted 2 h and 20 min. overall, 12 stations were accredited. the overall mean was 6.53, standard deviation (sd) 0.62; the mean for first-year residents was 6.13 (sd 0.43), for second-year residents 6.26 (sd 0.60) and 6.76 for third-year residents (sd 0.59). conclusions. the osce isa valid and reliable method that permits an integral evaluation of clinical competence. the experience with this instrument has been limited to assessing postgraduate students. this study, however, shows that it is a useful tool that may be valuable for resident pediatricians and their professors.
NATO e Rússia: novos lances estratégicos
Rela??es Internacionais (R:I) , 2010,
Abstract: since the resurgence of russia under putin?s leadership the recurring contestation of nato?s legitimacy has evolved from the rhetoric level to a greater oppositional capacity. the features of the new strategic concept of the atlantic alliance, being outlined by a group of experts, and the new russian doctrines guiding its external actions that have been approved in the last two years, do not indicate political convergences. the forthcoming nato lisbon summit of november 2010 will have to manage a balance between its legitimacy issues towards the kremlin that have crystallized in europe, and the need to cooperate with the russian giant in the global strategic environment.
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