Iris Schleicher1, Karsten Leitner2, Jana Juenger3, Andreas Moeltner4, Miriam Ruesseler5, Bernd Bender6, Jasmina Sterz7, Tina Stibane8, Sarah Koenig9, Susanne Frankenhauser10, Joachim Gerhard Kreuder11. 1. Department of Student Affairs, Faculty of Medicine, University of Giessen, Klinikstr. 32, 35037 Giessen, Germany. Electronic address: iris.schleicher@ortho.med.uni-giessen.de. 2. Department of Student Affairs, Faculty of Medicine, University of Giessen, Klinikstr. 32, 35037 Giessen, Germany. Electronic address: karstenleitner@googlemail.com. 3. Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg 69120, Germany. Electronic address: jjuenger@impp.de. 4. Center of Excellence in Medical Assessment, Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 346, 69120 Heidelberg, Germany. Electronic address: Andreas.Moeltner@med.uni-heidelberg.de. 5. Department of Trauma, Hand and Reconstructive Surgery, University of Frankfurt, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany. Electronic address: miriamruesseler@yahoo.com. 6. Department of Trauma, Hand and Reconstructive Surgery, University of Frankfurt, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany. Electronic address: bernd.bender@kgu.de. 7. Department of General Surgery, University of Frankfurt, Theodor Stern Kai, 60590 Frankfurt am Main, Germany. Electronic address: jasmina.sterz@kgu.de. 8. Centre of Medical Education, Faculty of Medicine, University of Marburg, Conradistraße 9, 35043 Marburg, Germany. Electronic address: stibane@staff.uni-marburg.de. 9. Department of General Surgery, University of Goettingen, Robert-Koch-Straße 40 37075 Göttingen, Germany. Electronic address: koenig_sarah@ukw.de. 10. Department of Anaesthesiology, University of Heidelberg, INF 110, 69120 Heidelberg, Germany. Electronic address: Susanne.Frankenhauser@med.uni-heidelberg.de. 11. Department of Student Affairs, Faculty of Medicine, University of Giessen, Klinikstr. 32, 35037 Giessen, Germany. Electronic address: Joachim.G.Kreuder@paediat.med.uni-giessen.de.
Abstract
BACKGROUND: Practical skills are often assessed using Objective Structured Clinical Skill Exams (OSCE). Nevertheless, in Germany, interchange and agreement between different medical faculties or a general agreement on the minimum standard for passing is lacking. METHODS: We developed standardized OSCE-stations for assessing structured clinical examination of knee and shoulder joint with identical checklists and evaluation standards. These were implemented into the OSCE-course at five different medical faculties. Learning objectives for passing the stations were agreed beforehand. At each faculty, one reference examiner scored independently of the local examiner. Outcome of the students at the standardized station was compared between faculties and correlated to their total outcome at the OSCE, to their results at the Part One of the National Medical Licensing Examination as a reference test during medical studies and to their previous amount of lessons in examining joints. RESULTS: Comparing the results of the reference examiner, outcome at the station differed significantly between some of the participating medical faculties. Depending on the faculty, mean total results at the knee-examination-station differed from 64.4% to 77.9% and at the shoulder-examination-station from 62.6% to 79.2%. Differences were seen in knowledge-based items and also in competencies like communication and professional manner. There was a weak correlation between outcome at the joint-examination-OSCE-station and Part One of the National Medical Licensing Examination, and a modest correlation between outcome at the joint-examination-station and total OSCE-result. Correlation to the previous amount of lessons in examining joint was also weak. CONCLUSION: Although addressing approved learning objectives, different outcomes were achieved when testing a clinical skill at different medical faculties with a standardized OSCE-station. Results can be used as a tool for evaluating lessons, training and curricula at the different sites. Nevertheless, this study shows the importance of information exchange and agreement upon certain benchmarks and evaluation standards when assessing practical skills.
BACKGROUND: Practical skills are often assessed using Objective Structured Clinical Skill Exams (OSCE). Nevertheless, in Germany, interchange and agreement between different medical faculties or a general agreement on the minimum standard for passing is lacking. METHODS: We developed standardized OSCE-stations for assessing structured clinical examination of knee and shoulder joint with identical checklists and evaluation standards. These were implemented into the OSCE-course at five different medical faculties. Learning objectives for passing the stations were agreed beforehand. At each faculty, one reference examiner scored independently of the local examiner. Outcome of the students at the standardized station was compared between faculties and correlated to their total outcome at the OSCE, to their results at the Part One of the National Medical Licensing Examination as a reference test during medical studies and to their previous amount of lessons in examining joints. RESULTS: Comparing the results of the reference examiner, outcome at the station differed significantly between some of the participating medical faculties. Depending on the faculty, mean total results at the knee-examination-station differed from 64.4% to 77.9% and at the shoulder-examination-station from 62.6% to 79.2%. Differences were seen in knowledge-based items and also in competencies like communication and professional manner. There was a weak correlation between outcome at the joint-examination-OSCE-station and Part One of the National Medical Licensing Examination, and a modest correlation between outcome at the joint-examination-station and total OSCE-result. Correlation to the previous amount of lessons in examining joint was also weak. CONCLUSION: Although addressing approved learning objectives, different outcomes were achieved when testing a clinical skill at different medical faculties with a standardized OSCE-station. Results can be used as a tool for evaluating lessons, training and curricula at the different sites. Nevertheless, this study shows the importance of information exchange and agreement upon certain benchmarks and evaluation standards when assessing practical skills.
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