Gaps in the Clinical Competency of Medical School Graduates: A Cross-Sectional Study Based on the Objective Structured Clinical Examination

Document Type : Original Article

Authors

1 Department of Medical Education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Medical education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Student Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran

4 Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Clinical education is the heart of medical education. It is one of the most important manifestations of teaching and learning in professions relating to medical sciences, leading to learners' clinical competency. This study was done to investigate general physician graduates' knowledge, performance, and clinical competency before entering the field of clinical activities.
Methods: In this descriptive cross-sectional study, the scores of different stations of the Objective Structured Clinical Examination (OSCE), held at the end of the general medicine course in Iran, were collected at Mashhad University of Medical Sciences. Totally, 266 students who participated in six periodicities of clinical competency examinations were included in the study by the census method. The clinical competency of general physician graduates assessed in the scopes were determined by the General Medical Education Council, including problem-solving, communication skills, practical action, taking the history, and performing physical examinations by the OSCE. The data were analyzed by SPSS software using descriptive and inferential statistics.
Results: The effect of different scopes of the OSCE (F(3,5652) = 7.022 and P = 0.001) and participants' performance based on their critical and non-critical indicators (T = 1.976 and P = 0.04) are significant with 95% confidence interval. This suggests that participants' performance varies in different scopes of the clinical examination, including problem-solving, communication skills, practical action, taking the history, and performing physical examinations.
Conclusions: The differences in the clinical competencies of general physician graduates in mentioned scopes were significant. This emphasizes the need to examine their essential skills to achieve the minimum competencies expected of a future physician before entering the field of clinical activity.

Keywords

References

  1. Saif A. Measurement, assessment and educational evaluation. Tehran. Doran Press; 2007. Persian.
  2. Bazargan A. Introduction to assessing quality in higher medical education in Iran: Challenges and perspectives. Quality in higher education. 1999;5(1):61-7.
  3. Haghani F, Alavi M. An Introduction to some new approaches in clinical education. Iranian Journal of Medical Education. 2011;10(5): 801-6. Persian.
  4. Soler-González J, Buti M, Boada J, Ayala V, Peñascal E, Rodriguez T. Do primary health centres and hospitals contribute equally towards achievement of the transversal clinical competencies of medical students? Performance on the Objective Structured Clinical Examination (OSCE) in competency acquisition. Aten Primaria. 2016;48(1):42-8.
  5. Szasz P, Louridas M, Harris KA, Grantcharov TP. Strategies for increasing the feasibility of performance assessments during competency-based education: subjective and objective evaluations correlate in the operating room. Am. J. Surg. 2017;214(2):365-72.
  6. Ataro G. Methods, methodological challenges and lesson learned from phenomenological study about OSCE experience: Overview of paradigm-driven qualitative approach in medical education. Ann Med Surg . 2020;49:19-23.
  7. Miller GE. The assessment of clinical skills/competence/performance. Acad med. 1990;65(9):S63-7.
  8. Rethans J, Norcini J. Baron/Maldonado M, Blackmore D, Jolly BC, Laduca T, et al. The relationship between competence and performance: implications for assessing practice performance. Med Educ. 2002;36:901-9.
  9. Southwick F, Katona P, Kauffman C, Monroe S, Pirofski L-a, Del Rio C, et al. Commentary: IDSA guidelines for improving the teaching of preclinical medical microbiology and infectious diseases. Acad Med. 2010;85(1):19-22.
  10. Sulaiman ND, Shorbagi SI, Abdalla NY, Daghistani MT, Mahmoud IE, Al-Moslih AM. Group OSCE (GOSCE) as a formative clinical assessment tool for pre-clerkship medical students at the University of Sharjah. J TaibahUniv Med Sci. 2018;13(5):409-14.
  11. Lee Y-s. OSCE for the medical licensing examination in Korea. Kaohsiung J Med Sci. 2008;24(12):646-50.
  12. Huang YS, Liu M, Huang CH, Liu KM. Implementation of an OSCE at Kaohsiung Medical University. Kaohsiung J Med Sci. 2007;23(4):161-9.
  13. Vickers NJ. Animal communication: when i'm calling you, will you answer too? Curr biol. 2017;27(14):R713-R5.
  14. Davis MH. OSCE: the Dundee experience. Med teach. 2003;25(3):255-61.
  15. Townsend A, Mcllvenny S, Miller C, Dunn E. The use of an objective structured clinical examination (OSCE) for formative and summative assessment in a general practice clinical attachment and its relationship to final medical school examination performance. Med educ. 2001;35(9):841-6.
  16. Smee S. Skill based assessment. Bmj. 2003;326(7391):703-6.
  17. Boursicot K, Roberts T. How to set up an OSCE. Clin Teach. 2005;2(1):16-20.
  18. Newble D. Techniques for measuring clinical competence: objective structured clinical examinations. Med educ. 2004;38(2):199-203.
  19. Adamo G. Simulated and standardized patients in OSCEs: achievements and challenges 1992-2003. Med teach. 2003;25(3):262-70.
  20. Yang Y-Y, Lee F-Y, Hsu H-C, Huang C-C, Chen J-W, Cheng H-M, et al. Assessment of first-year post-graduate residents: usefulness of multiple tools. J Chin Med Assoc. 2011;74(12):531-8.
  21. A Group of Authors. Capabilities of General Medicine Graduates of Tehran University of Medical Sciences. Tehran University of Medical Sciences Press; 2011. Persian.
  22. Khan KZ, Ramachandran S, Gaunt K, Pushkar P. The objective structured clinical examination (OSCE): AMEE guide no. 81. Part I: an historical and theoretical perspective. Med teach. 2013;35(9):e1437-e46.
  23. Taylor D, Quick S. Students' perceptions of a near-peer Objective Structured Clinical Examination (OSCE) in medical imaging. Radiography. 2020;26(1):42-8.
  24. Marshall G, Harris P. A study of the role of an objective structured clinical examination (OSCE) in assessing clinical competence in third year student radiographers. Radiography. 2000;6(2):117-22.
  25. Al Nazzawi AA. Dental students' perception of the objective structured clinical examination (OSCE): The Taibah University experience, Almadinah Almunawwarah, KSA. J TaibahUniv Med Sci. 2018;13(1):64-9.
  26. Saunders A, Say R, Visentin D, McCann D. Evaluation of a collaborative testing approach to objective structured clinical examination (OSCE) in undergraduate nurse education: A survey study. Nurse Educ Pract. 2019;35:111-6.
  27. Hsieh M-C, Cheng W-C, Chen T-Y. Objective Structured Clinical Examination (OSCE) including critical simulation: Evaluation of medical student competence. Tzu Chi Med J. 2014;26(1):40-3.
  28. Baharin S. Objective structured clinical examination (OSCE) in operative dentistry course-its implementation and improvement. ProcediaSoc Behav Sci. 2012;60:259-65.
  29. Mitchell M, Henderson A. Groves M, Dalton M, Nulty D. The objective structured clinical examination (OSCE): Optimising its value in the undergraduate nursing curriculum. Nurse Educ Today. 2009;29(4):398-404.
  30. Kamarudin MA, Mohamad N, Halizah MNABH, Yaman MN. The relationship between modified long case and objective structured clinical examination (OSCE) in final professional examination 2011 Held in UKM Medical Centre. ProcediaSoc Behav Sci. 2012;60:241-8.
  31. Deane RP, Joyce P, Murphy DJ. Team Objective Structured Bedside Assessment (TOSBA) as formative assessment in undergraduate Obstetrics and Gynaecology: a cohort study. BMC med educ. 2015;15(1):1-12.
  32. Zhou Y, Hartemink AE, Shi Z, Liang Z, Lu Y. Land use and climate change effects on soil organic carbon in North and Northeast China. Sci Total Environ. 2019;647:1230-8.
  33. Wimmers PF, Schauer GF. Validating OSCE Performance: The Impact of General Intelligence. Health Prof Educ. 2017;3(2):79-84.
  34. van der Want AC, Bloemendaal PM, van der Hage JA. Examiners' Perceptions in Surgical Education: The Blind Spot in the Assessment of OSCEs. J Surg Educ. 2021;78(2):590-96.
Future of Medical Education Journal
Volume 12, Issue 1
March 2022
Pages 29-34

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