Purpose: To develop two new types of clinical feedback
for final year medical students using OSCE mark sheets and to evaluate their
effectiveness, cost-effectiveness and student satisfaction in a randomized
trial. Methods:A randomized trial was conducted with two groups
(Cohort A and B) of students (n=350) at the
University of Birmingham (UK) participating in a two stage Objective Structured
Clinical Examination (OSCE) (November 2011 and April 2012). Students were
randomly assigned to receive one of three feedback interventions (skills-based,
station-based, or both) after the November OSCE. Multivariate regression
analysis was used to test if feedback intervention was a significant predictor
of April OSCE score, while controlling for November OSCE score. Secondary
outcomes were cost-effectiveness and student satisfaction.Results: Feedback group was
not a significant predictor of April scores for Cohort B.In Cohort A, the station-based group did better than the group who
received both types of feedback (2.8%, 95% CI 0.4% to 5.2%, p= 0.022).
There was no difference between the skills-based and station-based groups. The
cost of providing the station-based feedback was double of that for the skills-based.
Questionnaires were received from 245 students (70%). Students who received
both types of feedback were the most satisfied, followed by those in the
station-based group. Conclusion: There
was no consistent difference in effectiveness across the three trial groups.
Students tended to prefer station-based feedback over skills-based feedback,
but students found elements of the standard feedback more helpful than the
feedback evaluated in this trial.
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