gms | German Medical Science

Question: Do students who attended a new course (standardized curriculum, teacher training) perform better in an OSCE than students attending the traditional course? Is an additional OSCE workshop before taking the first OSCE necessary?

Our students completed a course in physical examination and history taking in their third year of medical studies. In order to improve a new curriculum, a teacher-training course and an OSCE workshop for the students were set up.

Methods: A new curriculum for an eight day course (2, 5 hrs each day) was developed. The course consists of three parts:

1.

History taking and practice with standardized patients (2, 5 hrs)

2.

Teaching clearly defined parts of physical examination and practice with one another (3x2, 5 hrs)

3.

Practice with real patients (4x2, 5 hrs).

Prior to the course all teachers (n=14) attended a 6-hour interactive “Train-the-teacher workshop”. The new curriculum, the teaching methods and information on standardized patients were presented. The teaching method for clinical skills according to Rodney Peyton was introduced. Trying to get used to the Peyton-like method working in small groups with examples of physical examination were carried out.

60 students were randomised into group A (new course with trained teachers; n=24) and group B (traditional course; n=36). Group A was further subdivided into group A1 without OSCE workshop (n=10) and group A2 with an additional OSCE workshop prior to the examination (n=14).

Results: Group A performed better in the OSCE and reached a median of 65% and group B a median of 54.05% of possible maximum points (p<0.001; 95% confidence interval of the difference 6.1-15.6). In the subgroup analysis there was no significant difference between group A1 (median of 63.5%) and group A2 (median of 65.85%; p=0.47; 95% confidence interval of the difference -10.4-5.3) in the OSCE performance.

All of the workshop participants were very satisfied with the workshop and rated it with 1.32 ± 0.46 (mean ± SD on a 6-point Likert scale, 1 = excellent, 6 = terrible) overall. Teachers rated their preparedness for teaching after our workshop with a mean value of 1.93 ± 0.47 (mean ± SD) and after carrying out the course they rated their preparedness for the course as a consequence of the workshop even better with 1.57 ± 0.57.

Conclusions: This study confirmed that a well structured course with specifically trained teachers increased the performance of the course participants in an OSCE. The study failed to show that an additional OSCE workshop can improve the results further.

Our study showed that teachers appreciate specific preparation for teaching duties and that their estimate of preparedness still increases during teaching. This study convinced our faculty to introduce this system for the whole course [1], [2].