Alexandre Matet1,2,3, Ludovic Fournel1,4,5, François Gaillard6, Laurence Amar1,7,8, Jean-Benoit Arlet1,9, Stéphanie Baron1,6, Anne-Sophie Bats1,10,11, Celine Buffel du Vaure12, Caroline Charlier1,13,14, Victoire De Lastours1,15,16, Albert Faye1,17, Eve Jablon18, Natacha Kadlub1,19, Julien Leguen1,20, David Lebeaux1,21, Alexandre Malmartel12, Tristan Mirault1,7,8, Benjamin Planquette1,22,23, Alexis Régent1,24,25, Jean-Laurent Thebault12, Alexy Tran Dinh1,26,27, Alexandre Nuzzo1,28, Guillaume Turc1,29,30, Gérard Friedlander1,6,31, Philippe Ruszniewski1,29,32, Cécile Badoual1,7,33, Brigitte Ranque1,7,9, Mehdi Oualha1,34,35, Marie Courbebaisse1,6,31. 1. Université de Paris, Faculté de Médecine, Paris, France. 2. Centre de Recherche des Cordeliers, INSERM UMR1138, Paris, France. 3. Service d'ophtalmologie, Institut Curie, Paris, France. 4. INSERM UMR1124, Paris, France. 5. Service de chirurgie thoracique, AP-HP, Hôpital Cochin, Paris, France. 6. Département de physiologie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France. 7. PARCC INSERM U970, Paris, France. 8. Département d'hypertension artérielle, AP-HP, Hôpital Européen Georges Pompidou, Paris, France. 9. Service de Médecine interne, AP-HP, Hôpital Européen Georges Pompidou, Paris, France. 10. INSERM UMR-S 1147, Paris, France. 11. Service de gynécologie oncologique et de chirurgie du sein, AP-HP, Hôpital Européen Georges Pompidou, Paris, France. 12. Département de médecine générale, Université de Paris, Faculté de Médecine, Paris, France. 13. Institut Pasteur, INSERM U1117, Paris, France. 14. Département de maladies infectieuses et tropicales, AP-HP, Hôpital Universitaire Necker, Paris, France. 15. IAME, UMR1137, INSERM, Paris, France. 16. Service de Médecine Interne, AP-HP, Hôpital Beaujon, Clichy, France. 17. Service de Pédiatrie Générale, Hôpital Robert Debré, Paris, INSERM ECEVE 1123, Paris, France. 18. Service AGIR, Université de Paris, Faculté de Médecine, Paris, France. 19. Département de chirurgie maxillo-faciale et de chirurgie plastique, AP-HP, Hôpital Universitaire Necker, Paris, France. 20. Service de Gériatrie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France. 21. Département de Microbiologie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France. 22. INSERM UMR S1140, Paris, France. 23. Service de Pneumologie et de soins intensifs, AH-HP, Hôpital Européen Georges Pompidou, Paris, France. 24. Institut Cochin, INSERM U1016, CNRS UMR 8104, LabEx INFLAMEX, Paris, France. 25. Service de Médecine Interne, Centre de Référence pour les Maladies Systémiques Auto immunes Rares d'Ile-de-France, AP-HP, Hôpital Cochin, Paris, France. 26. INSERM U1148 LVTS, Villetanneuse, France. 27. Département d'Anesthésie-Réanimation, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France. 28. Service de gastro-entérologie et pancréatologie, AP-HP, Hôpital Beaujon, Paris, France. 29. INSERM U1266, Paris, France. 30. Service de neurologie, Hôpital Sainte Anne, AH-HP, Paris, France. 31. Institut Necker-Enfants Malades, INSERM U1151-CNRS UMR8253, Paris, France. 32. INSERM UMR1149, Paris, France. 33. Service d'anatomopathologie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France. 34. Unité EA7323, Université de Paris, Faculté de Médecine, Paris, France. 35. Service de réanimation et de surveillance continue médico-chirurgicale pédiatrique, AP-HP, Hôpital Universitaire Necker, Paris, France.
Abstract
PURPOSE: Objective structured clinical examinations (OSCE) evaluate clinical reasoning, communication skills, and interpersonal behavior during medical education. In France, clinical training has long relied on bedside clinical practice in academic hospitals. The need for a simulated teaching environment has recently emerged, due to the increasing number of students admitted to medical schools, and the necessity of objectively evaluating practical skills. This study aimed at investigating the relationships between OSCE grades and current evaluation modalities. METHODS: Three-hundred seventy-nine 4th-year students of University-of-Paris Medical School participated to the first large-scale OSCE at this institution, consisting in three OSCE stations (OSCE#1-3). OSCE#1 and #2 focused on cardiovascular clinical skills and competence, whereas OSCE#3 focused on relational skills while providing explanations before planned cholecystectomy. We investigated correlations of OSCE grades with multiple choice (MCQ)-based written examinations and evaluations of clinical skills and behavior (during hospital traineeships); OSCE grade distribution; and the impact of integrating OSCE grades into the current evaluation in terms of student ranking. RESULTS: The competence-oriented OSCE#1 and OSCE#2 grades correlated only with MCQ grades (r = 0.19, P<0.001) or traineeship skill grades (r = 0.17, P = 0.001), respectively, and not with traineeship behavior grades (P>0.75). Conversely, the behavior-oriented OSCE#3 grades correlated with traineeship skill and behavior grades (r = 0.19, P<0.001, and r = 0.12, P = 0.032), but not with MCQ grades (P = 0.09). The dispersion of OSCE grades was wider than for MCQ examinations (P<0.001). When OSCE grades were integrated to the final fourth-year grade with an incremental 10%, 20% or 40% coefficient, an increasing proportion of the 379 students had a ranking variation by ±50 ranks (P<0.001). This ranking change mainly affected students among the mid-50% of ranking. CONCLUSION: This large-scale French experience showed that OSCE designed to assess a combination of clinical competence and behavioral skills, increases the discriminatory capacity of current evaluations modalities in French medical schools.
PURPOSE: Objective structured clinical examinations (OSCE) evaluate clinical reasoning, communication skills, and interpersonal behavior during medical education. In France, clinical training has long relied on bedside clinical practice in academic hospitals. The need for a simulated teaching environment has recently emerged, due to the increasing number of students admitted to medical schools, and the necessity of objectively evaluating practical skills. This study aimed at investigating the relationships between OSCE grades and current evaluation modalities. METHODS: Three-hundred seventy-nine 4th-year students of University-of-Paris Medical School participated to the first large-scale OSCE at this institution, consisting in three OSCE stations (OSCE#1-3). OSCE#1 and #2 focused on cardiovascular clinical skills and competence, whereas OSCE#3 focused on relational skills while providing explanations before planned cholecystectomy. We investigated correlations of OSCE grades with multiple choice (MCQ)-based written examinations and evaluations of clinical skills and behavior (during hospital traineeships); OSCE grade distribution; and the impact of integrating OSCE grades into the current evaluation in terms of student ranking. RESULTS: The competence-oriented OSCE#1 and OSCE#2 grades correlated only with MCQ grades (r = 0.19, P<0.001) or traineeship skill grades (r = 0.17, P = 0.001), respectively, and not with traineeship behavior grades (P>0.75). Conversely, the behavior-oriented OSCE#3 grades correlated with traineeship skill and behavior grades (r = 0.19, P<0.001, and r = 0.12, P = 0.032), but not with MCQ grades (P = 0.09). The dispersion of OSCE grades was wider than for MCQ examinations (P<0.001). When OSCE grades were integrated to the final fourth-year grade with an incremental 10%, 20% or 40% coefficient, an increasing proportion of the 379 students had a ranking variation by ±50 ranks (P<0.001). This ranking change mainly affected students among the mid-50% of ranking. CONCLUSION: This large-scale French experience showed that OSCE designed to assess a combination of clinical competence and behavioral skills, increases the discriminatory capacity of current evaluations modalities in French medical schools.
Authors: W. Dale Dauphinee; David E. Blackmore; Sydney Smee; Arthur I. Rothman; Richard Reznick Journal: Adv Health Sci Educ Theory Pract Date: 1997 Impact factor: 3.853
Authors: Abdulrasheed A Nasir; Ayodeji S Yusuf; Lukman O Abdur-Rahman; Olasunkanmi M Babalola; Ademola A Adeyeye; Ademola A Popoola; James O Adeniran Journal: J Surg Educ Date: 2014-07-08 Impact factor: 2.891
Authors: Karen L Lewis; Carrie A Bohnert; Wendy L Gammon; Henrike Hölzer; Lorraine Lyman; Cathy Smith; Tonya M Thompson; Amelia Wallace; Gayle Gliva-McConvey Journal: Adv Simul (Lond) Date: 2017-06-27