REVIEW: It matters how we do it: A review of best practices of Observed Structured Clinical Examination in pharmacy education
DOI:
https://doi.org/10.46542/pe.2021.211.283291Keywords:
Pharmacy, Skills assessment, Performance-based assessment, OSCEAbstract
Objective: Since the introduction of the Observed Structured Clinical Examination (OSCE) in medical education more than four decades ago, OSCEs have been adopted by a majority of healthcare professional education programmes, including pharmacy. This article aims to review the best practices as well as explore novel approaches to the use of OSCE in pharmacy education.
Method: As with any assessment method, the development of OSCE stations starts with blueprinting. Personnel involved in the OSCE are briefed and adequately trained, based on their expertise and prior experience to ensure the efficient running of the OSCE as well as help maintain the reliability and validity of the assessment process.
Conclusion: The OSCE assesses a range of clinical and communication skills, yet it is resource-intensive and requires extensive planning. However, it must be considered an important and essential means to develop and assess the skills required by the pharmacy graduates for safe future practice.
References
Abdelaziz, A., Hany, M., Atwa, H., Talaat, W., & Hosny, S. (2015). Development, implementation, and evaluation of an integrated multidisciplinary Objective Structured Clinical Examination (OSCE) in primary health care settings within limited resources. Medical Teacher, 38(3), 272–279. https://doi.org/10.3109/0142159x.2015.1009018
Adamo, G. (2003). Simulated and standardized patients in OSCEs: Achievements and challenges 1992–2003. Medical Teacher, 25, 262–270. https://doi.org/10.1080/0142159031000100300
Aeder L., Altshuler L., Kachur E., Barrett S., Hilfer A., Koepfer S., Schaeffer H., Shelov S.P. (2007). The "Culture OSCE" - Introducing a Formative Assessment into a Postgraduate Program. Education for Health, 20(1), 11
Ali, M. (2020). What now and what next? The new era of OSCE. Pharmacy Education, 20, 56-58. https://doi.org/10.46542/pe.2020.202.5658
American Educational Research Association. (1999). Standards for educational and psychological testing. Washington, DC: American Educational Research Association.
Angelo, T.A., & Cross, K.P. (2018). Classroom assessment techniques: A handbook for college teachers. Vancouver, B.C.
Angoff, W.H. (1971). Scales, norms and equivalent score. In Educational measurement, edited by Thorndike RL. 2nd ed. Washington DC: American Council on Education.
Awaisu, A., Abd Rahman, N.S., Nik Mohamed, M.H., Bux Rahman, Bux., S.H., & Mohamed Nazar, N.I. (2010). Malaysian pharmacy students' assessment of an objective structured clinical examination (OSCE). American Journal of Pharmaceutical Education, 74(2), 34. https://doi.org/10.5688/aj740234
Awaisu, A., Mohamed, M.H., & Al-Efan, Q.A. (2007). Perception of pharmacy students in Malaysia on the use of objective structured clinical examinations to evaluate compe-tence. American Journal of Pharmaceutical Education, 71(6), 118. https://doi.org/10.5688/aj7106118
Azim, A., Kumar, A., Krishnamurthy, K., Ojeh, N., Adams, O., & Sa, B. (2019). An evaluative study of objective structured clinical examination (OSCE): students and examiners perspectives. Advances in Medical Education and Practice, 10, 387–397. https://doi.org/10.2147/amep.s197275
Barrows, S.H. (1993). An overview of the uses of standardized patients for teaching and evaluating clinical skills. Academic Medicine, 68, 443–451. https://doi.org/10.1097/00001888-199306000-00002
Boursicot, K.A.M. (2010). Structured assessments of clinical competence. British Journal of Hospital Medicine, 71, 342–344. https://doi.org/10.12968/hmed.2010.71.6.48450
Chisnall, B., Vince, T., Hall, S., & Tribe, R. (2015). Evaluation of outcomes of a formative objective structured clinical examination for second-year UK medical students. International Journal of Medical Education, 6, 76–83. https://doi.org/10.5116/ijme.5572.a534
Cizek, G.J. (Ed.). (2011). Setting Performance Standards: Foundations, Methods, and Innovations (2nd ed.). Routledge. https://doi.org/10.4324/9780203848203
Cleland, J.A., Abe, K., & Rethans, J.J. (2009). The use of simulated patients in medical education: AMEE Guide No 42. Medical Teacher, 31, 477–486. https://doi.org/10.1080/01421590903002821
Cunnington, J.P.W., Neville, A.J., & Norman, G.R. (1997). The risks of thoroughness: reliability and validity of global ratings and checklists in an OSCE. Advances in Health Sciences Education: Theory and Practice, 1(3), 227–33. https://doi.org/10.1007/BF00162920
Downing, S.M. (2010). Validity: Establishing meaning for assessment data through scientific evidence. St George’s Advanced Assessment Course: London.
Ebel, R. (1972). Essentials of educational measurement. New Jersey, NJ: Prentice-Hall.
Epstein, R.M. (2007). Assessment in Medical Education. The New England Journal of Medicine, 356, 387–396. https://doi.org/10.1056/NEJMra054784
Fouad, S., Gouda, E., Abdel Nasser, A., & Kamal, D. (2019). Perception of students, staff and simulated patients towards objective structured clinical examination (OSCE). Education in Medicine Journal, 11, 27–42. https://doi.org/10.21315/eimj2019.11.2.4
Geisinger, K.F. (2012). Norm- and criterion-referenced testing. In Cooper, H., Camic, P.M., Long, D.L., Panter, A.T., Rindskopf, D., & Sher K.J. (Eds.), APA handbooks in psychology: APA handbook of research methods in psychology. American Psychological Association. https://doi.org/10.1037/13619-020
Gibbs, G., & Simpson, C. (2004). Conditions under which assessment supports students learning. Learning and Teaching in Higher Education, (1), 3-31.
Hadi, M.A., Ali, M., Haseeb, A., Mohamed, M., Elrggal, M.E, & Cheema, E. (2018). Impact of test anxiety on pharmacy students' performance in Objective Structured Clinical Examination: a cross-sectional survey. International Journal of Pharmacy Practice, 26(2), 191–194. https://doi.org/10.1111/ijpp.12389
Harden, R.M., Stevenson, M., Downie, W.W., & Wilson, G.M. (1975). Assessment of Clinical Competence using Objective Structured Examination. British Medical Journal, 1, 447–451. https://doi.org/10.1136/bmj.1.5955.447
Harden, R., & Gleeson, F. (1979). Assessment of clinical competence using an objective structured clinical examination (OSCE). Medical Education, 13, 41-54.
Heidi, S. (2008). What does an OSCE checklist measure?. Essays and Commentaries, 40(8), 589–591.
Hodges, B., Hanson, M., McNaughton, N., Regehr, G., & University of Toronto Psychiatric Skills Assessment Project (2002). Creating, monitoring, and improving a psychiatry OSCE: a guide for faculty. Academic Psychiatry, 26(3), 134–161. https://doi.org/10.1176/appi.ap.26.3.134
Hodges, B., & Mcilroy, J.H. (2003). Analytic global OSCE ratings are sensitive to level of training. Medical Education, 37, 1012–1016. https://doi.org/10.1046/j.1365-2923.2003.01674.x
Hsieh, M., Cheng, W., & Chen, T. (2014). Objective structured clinical examination (OSCE) including critical simulation: Evaluation of medical student competence. Tzu Chi Medical Journal, 26(1), 40–43. https://doi.org/10.1016/j.tcmj.2013.08.001
Humphris, G.M., & Kaney, S. (2001). Examiner fatigue in communication skills objective structured clinical examination. Medical Education, 35, 444–449. https://doi.org/10.1046/j.1365-2923.2001.00893.x
Khan, K., & Ramachandran, S. (2012). Conceptual Framework for Performance Assessment: Competency, Competence and Performance in the Context of Assessments in Healthcare – Deciphering the Terminology. Medical Teacher, 34(11), 920–928. https://doi.org/10.3109/0142159X.2012.722707
Khan, K.G., Sankaranarayanan, R., & Piyush, P. (2013). The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part II: Organisation & Administration. Medical Teacher, 35(9), https://doi.org/10.3109/0142159X.2013.818634
Kirton, S.B., & Kravitz, L. (2011). Objective Structured Clinical Examinations (OSCEs) compared with traditional assessment methods. American Journal of Pharmaceutical Education, 75(6), 111. https://doi.org/10.5688/ajpe756111
Kristina, S., & Wijoyo, Y. (2018). Assessment of pharmacy students’ clinical skills using objective structured clinical examination (OSCE): A Literature Review. Systematic Reviews in Pharmacy, 10(1), 55–60.
Mccoy, J.A., & H.W, Merrick, H.W, eds. (2001). The Objective Structured Clinical Examination. Association for Surgical Education. Springfield, IL.
McLaughlin, K., Gregor, L., Jones, A., & Coderre, S. (2006). Can standardized patients replace physicians as OSCE examiners?. British Medical Coucil Medical Education, 6(12), 1–5. https://doi.org/10.1186/1472-6920-6-12
Mookherjee, S., Chang, A., Boscardin, C.K., Hauer, K.E. (2013). How to develop a competency-based examination blueprint for longitudinal standardized patient clinical skills assessments. Medical Teacher, 35, 883-990. https://doi.org/10.3109/0142159X.2013.809408
Morgan, P.J., Cleave-Hogg, D., & Guest, C.B. (2001). A comparison of global ratings and checklist scores from an undergraduate assessment using an anesthesia simulator. Academic Medicine, 76, 1053–1055. https://doi.org/10.1097/00001888-200110000-00016
Newble, D.I., Hoare, J., & Sheldrake, P.F. (1980). The selection and training of examiners for clinical examinations. Medical Education, 14, 345–349. https://doi.org/10.1111/j.1365-2923.1980.tb02379.x
Newble, D. (2004). Techniques for measuring clinical competence: Objective structured clinical examinations. Medical Education, 38, 199–203. https://doi.org/10.1111/j.1365-2923.2004.01755.x
Pierre, R., Wierenga, A., Barton, M., Branday, J., & Christie, C. (2004). Student evaluation of an OSCE in paediatrics at the University of the West Indies, Jamaica. British Medical Council Medical Education, 4(22), 1–7. https://doi.org/10.1186/1472-6920-4-22
Prince, R. (2016). Predicting success in higher education: the value of criterion and norm-referenced assessments. Practitioner Research in Higher Education, 10(1), 22–38.
Rebel, A., Hester, D., DiLorenzo, A., McEvoy, M., & Schell, R. (2018). Beyond the “E” in OSCE. Anesthesia Analgesia, 127(4), 1092–1096. https://doi.org/10.1213/ane.0000000000003317
Reznick, R.K., Regehr, G., Yee, G., Rothman, A., Blackmore, D., & Dauphinee, D. (1998). Process-rating forms versus task-specific checklists in an OSCE for medical licensure. Medical Council of Canada. Academic Medicine, 73. https://doi.org/10.1097/00001888-199810000-00058
Roberts, C., Newble, D., Jolly, B., Reed, M., & Hampton, K. (2006). Assuring the quality of high-stakes undergraduate assessments of clinical competence. Medical Teacher, 28(6), 535–543. https://doi.org/10.1080/01421590600711187
Rothman, A.I., Blackmore, D., Dauphinee, W.D. et al. (1996). The use of global ratings in OSCE station scores. Advanced Health and Science Education, 1, 215–219.
Rushforth, H. (2007). “Objective structured clinical examination (OSCE): Review of literature and implications for nursing education”. Nurse Education Today, 27(5), 481–490. https://doi.org/10.1016/j.nedt.2006.08.009
Searle, N.S., Teal, C.R., Richards, B.F., Friedland, J.A., Weigel, N.L., Hernandez, R.A., Lomax, J.W., Coburn, M., & Nelson, E.A. (2012). A standards-based, peer-reviewed teaching award to enhance a medical school's teaching environment and inform the promotions process. Academic Medicine, 87(7), 870–876. https://doi.org/10.1097/ACM.0b013e3182584130
Shumway, J.M., & Harden, R.M. (2003). The assessment of learning outcomes for the competent and reflective physician: AMEE Guide No. 25. Medical Teacher, 25, 569–584. https://doi.org/10.1080/0142159032000151907
Smee, S. (2003). ABC of learning and teaching in medicine Skill based assessment. British Medical Journal, 326, 703–706. https://doi.org/10.1136/bmj.326.7391.703
Swanson, D.B, Norman, G.R, & Linn, R.L. (1995). Performance-Based Assessment: Lessons From the Health Professions. Educational Researcher, 24, 5–11. https://doi.org/10.3102/0013189X024005005
Toklu, H., & Hussain, A. (2013). “The changing face of pharmacy practice and the need for a new model of pharmacy education”. Journal of Young Pharmacists, 5(2), 38–40. https://doi.org/10.1016/j.jyp.2012.09.001
Turnbull, J.M. (1989). What is … normative versus criterion-referenced assessment. Medical Teacher, 11(2), 145–50.
Turner, J.L, & Dankoski, M.E. (2008). Objective Structured Clinical Exams: A Critical Review. Family Medicine, 40(8), 574–578.
Van der Vleuten, C.P., Norman, G.R., & E, De Graaff. (1991). Pitfalls in the pursuit of objectivity: issues of reliability. Medical Education, 25(2), 110–8. https://doi.org/10.1111/j.1365-2923.1991.tb00036.x
Van der Vleuten, C.P.M. (1996). The Assessment of Professional Competence: Developments, Research and Practical Implications. Advances in Health Sciences Education, 1, 41-67. https://doi.org/10.1007/BF00596229
Wakeford, R. (2001). Principles of Assessment. In: Fry H, Ketteridge S and Marshall S A Handbook for Teaching and Learning in Higher Education. Kogan Page Ltd, London.
Wallace, J., Rao, R., & Haslam, R. (2002). Simulated patients and objective structured clinical examinations: review of their use in medical education. Advances in Psychiatric Treatment, 8(5), 342–348. https://doi.org/10.1192/apt.8.5.342
Whelan, G.P. (1999). Educational commission for Foreign Medical Graduates – clinical skills assessment prototype. Medical Teacher, 21(2), 156–160. https://doi.org/10.1080/01421599979789
Wilkinson, T.J., Frampton, C.M., Thompson-Fawcett, M., & Egan, T. (2003). Objectivity in Objective Structured Clinical Examinations: Checklists Are No Substitute for Examiner Commitment. Academic Medicine, 78(2), 219–223. https://doi.org/ 10.1097/00001888-200302000-00021
Williams, R.G. (2004). Have Standardized Patient Examinations Stood the Test of Time and Experience? Teaching and Learning in Medicine, 16, 215–222. https://doi.org/10.1207/s15328015tlm1602_16
Yazbeck Karam, V., Park, Y., Tekian, A., & Youssef, N. (2018). Evaluating the validity evidence of an OSCE: results from a new medical school. British Medical Council Medical Education, 18, 313. https://doi.org/10.1186/s12909-018-1421-x
