Advances in Pharmaceutical Education: An Experience with the Development and Implementation of an Objective Structured Clinical Examination (OSCE) in an Undergraduate Pharmacy Program
Keywords:Advances, clinical competence, OSCE, pharmaceutical education
AbstractThe objective of this paper is to describe how a hybrid- OSCE was developed and applied to an undergraduate clinical pharmacy course as a pilot for assessing clinical competence in a Malaysian university; to present some of the instruments utilized for the conduct and assessment of the examination; and to evaluate the performance of the students in the OSCE. A seven-station OSCE (five live and two rest stations) was designed and implemented to accomplish the learning objectives of the clinical pharmacy course(s) as enshrined in our bachelor of pharmacy curriculum. The key processes involved in designing and implementing the OSCE include: development of a blueprint which served as a guideline; development and face-validation of the seven stations in accordance with the blueprint; design of dichotomous performance checklist/assessment instruments for individual stations; feasibility/pilot testing and rehearsals at OSCE stations; and conduct of the final examination. The broad competencies tested in the OSCE included patient counselling and communication, identification and resolution of drug-related problems (DRPs) using evidence-based approach, and literature evaluation/drug information provision. The students scored the highest marks in insulin delivery devices counselling station (mean ± SD=17.6±3.1), followed by DRPs identification/resolution and warfarin counselling stations with mean ± SD of 17.36±2.7 and 16.9±2.2, respectively. Examinees also scored the least in the drug information station (mean ± SD=15.55±3.8). There were statistically significant differences between students’ performances at the individual OSCE stations (F=3.698; p=0.012). The study revealed that undergraduate pharmacy students were better in performing patient counselling and identification/resolution of DRPs than in the drug information task. The design and implementation of theOSCE among fourth-year BPharm students was technically feasible and a great success.
Alinier G (2003) “Nursing students’ and lecturers’ perspectives of objective structured clinical examination incorporating simulation” Nurse Education Today 23: 419–426.
Austin Z, O’Byrne CC, Pugsley J, Munoz LQ (2003) “Development and validation processes for an objective structured clinical examination (OSCE) for entry-to-practice certification in pharmacy: the Canadian experience” Am J Pharm Educ. 67(3): article 76.
Awaisu A, Nik Mohamed MH, Al-Efan QAM (2007) “Perception of pharmacy students in Malaysia on the use of objective structured clinical examinations to evaluate competence” Am J Pharm Educ.71(6):Article 118.
Brandt BF (2000) “Effective teaching and learning strategies” Pharmacotherapy. 20(10 Pt 2), 307S–316S0
.Bruce SP, Bower A, Hak E, Schwartz AH (2006) “Utilization of the Center for the Advancement of Pharmaceutical Education Educational Outcomes, Revised Version 2004: Report of the 2005 American College of Clinical Pharmacy Educational Affairs Committee” Pharmacotherapy 26(8), 1193–1200).
Carpenter JL (1995) “Cost analysis of OSCEs (Review)” Acad Med. 70, 828-833.
Carraccio C, Englander R (2000) “The objective structured clinical examination, a step in the direction of competency-based evaluation” Arch Pediatr Adolesc Med.154, 736-741.
Cerveny JD, Knapp R, DelSignore M, Carson DS (1999) “Experience with objective structured clinical examinations as a participant evaluation instrument in disease management certificate programs” Am J Pharm Educ 63, 377-381.
Commission to implement change in pharmaceutical education (1993) “Background paper II: Entry-level curricular outcomes, curricular content and educational process”. Am J Pharm Educ. 57, 377-385.
Corbo M, Patel JP, Abdel Tawab R, Davies JG (2006) “Evaluating clinical skills of undergraduate pharmacy students using objective structured clinical examinations (OSCEs)” Pharmacy Education 6 (1), 53 –58.
Fielding DW, Page GG, Rogers WT, O’Byrne CC, Schulzer M, Moody KG, Dyer S (1997) “Application of objective structured clinical examinations in an assessment of pharmacists’ continuing competency” Am J Pharm Educ. 61, 117-25.
Harden R, Stevenson M, Wilson Downie W and Wilson G (1975) “Assessment of clinical competence using objective structured examination” British Medical Journal(February) 447–451.
Monaghan MS, Turner PD, Vanderbush RE, Grady AR (2000) “Traditional student, nontraditional student, and pharmacy practitioner attitudes toward the use of standardized patients in the assessment of clinical skills” Am J Pharm Educ. 64, 27-32.
Monaghan MS, Vanderbush RE, McKay AB (1995) “Evaluation of clinical skills in pharmaceutical education: past, present and future” Am J Pharm Educ. 59: 354-358.
Newble D, Dawson B (eds) et al. (1994). “Guidelines for assessing clinical competence” Teaching and Learning in Medicine 6, 213-220.
Newble D, Reed M (1997) “Developing and running an objective structured clinical examination (OSCE)” (Unpublished).
Pierre RB, Wierenga A, Barton M, Branday JM, Christie CD (2004) “Student evaluation of an OSCE in paediatrics at the University of the West Indies, Jamaica” BMC Medical Education 4:22 doi:10.1186/1472-6920-4-22.
Available from http://www.biomedcentral.com/1472-6920/4/22.
Ross M, Carroll G, Knight J, Chamberlain M, Fothergill-Bourbonnais F and Linton J (1988) “Using the OSCE to measure clinical skills performance in nursing” Journal of Advanced Nursing13: 45–56.
Rushforth HE (2007) “Objective structured clinical examination (OSCE): Review of literature and implications for nursing education” Nurse Educ Today27 (5): 481-90.
Rutter, PM (2002) “The introduction of observed structured clinical examinations (OSCEs) to the M.Pharm degree pathway” Pharmacy Education 1 (3), 173 –180.
Stowe CD, Gardner SF (2005) “Real-time standardized participant grading of an objective structured clinical examination” Am J Pharm Educ 69(3), 272-276.
Swanson DB, Norcini JJ, Grosso LJ (1987) “Assessment of clinical competence: written and computer-based simulations” Assess. Eval. Higher Educ.12, 220-246.
Tan CP, Rokiah P (2005) “The Use of OSCE (Objective Structured Clinical Examination) as an assessment tool –initial experiences at the University of Malaya” Med J Malaysia 60 (Suppl D), 48-53.
Woodburn J, Sutcliffe N(1996) “The reliability, validity and evaluation of the objective structured clinical examination in podiatry” Assessment Evaluation Higher Educ 21, 131-147.