gms | German Medical Science

Introduction: Many important professional activities in medicine are done, after or prior to direct encounter, remote from patients. Resident's daily routine contains multiple tasks of documenting or transmitting information. To ensure effective and safe patient care as well as economically reasonable decisions, profound competencies in patient management are essential. However, the respective competencies are rarely explicitly assessed during undergraduate medical training in Basel.

Objectives: The aim of the project was to develop, implement and analyze an assessment, based on OSCE addressing clinical skills remote from direct patient encounters.

Materials & methods: An expert workshop was conducted to develop post encounter OSCE stations with tasks in fields like documentation, managing pre-elective procedures or discharge from hospital. To guarantee equal initial conditions for the designated assessment the corresponding patient encounter was scripted, videotaped and integrated in the station. Two developed OSCE stations were implemented and tested during the formative OSCE by 127 respectively 97 students. The followed evaluation concerned feasibility, characteristics and acceptability.

Results: Two 13 minutes stations were developed in the field of admission and hand-over. The realization was analogue to OSCE station with integrated videos, which took 3 and 6 minutes. On the contrary to OSCEs about 30 students were tested at once. The Students performance was documented in requisition slips, standard forms and standardized medical reports. The rating was checklist based and followed time independent. The exam analysis showed diverse characteristics (reliability of .444 and .103; mean difficulty index of .76 and .2). The evaluation results reveal that the students perceive the new OSCE format as useful and relevant for their jobs and wish to have more exams in this format during medical training.

Conclusion: The developed OSCE based assessment format is a feasible in development, implementation and reporting. Using video taped patient encounters as standardized introduction to test clinical skills like documentation and hand-over is useful. The format seems to test a distinct entity separate from the OSCEs and is broadly accepted by students. Further research is needed concerning possibilities to teach those skills and ways to optimize the exam format.