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Evaluation of the effectiveness of postgraduate general medicine training by objective structured clinical examination---pilot study and reflection on the experiences of Kaohsiung Medical University Hospital.
Kaohsiung J Med Sci. 2008 Dec; 24(12):627-33.KJ

Abstract

Objective structured clinical examination (OSCE) is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1) residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman) with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five-point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self-evaluation on performance by examinees revealed significantly lower global ratings on post-course OSCE (4.14 +/- 0.80 vs. 3.68 +/- 0.66; p < 0.02). Surveys from tutors and standardized patients (SPs) completed at pre- and post-course OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 +/- 0.17 vs. 4.0 +/- 0.12, nonsignificant). However, a survey of the examinees completed at pre- and post-course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 +/- 0.09 vs. 3.7 +/- 0.18; p < 0.05). Qualitative information revealed that tutors and SPs remarked that PGY1 residents' medical knowledge performance was satisfactory but their clinical reasoning performance, communication skills (giving bad news) and self-confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a rational and feasible assessment method for evaluating the effectiveness of our PGY general medicine training program. The quantitative data and qualitative information provide a foundation to improve the quality of the program design and evaluation in implementing postgraduate general medicine training.

Authors+Show Affiliations

College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19251557

Citation

Tsai, Jer-Chia, et al. "Evaluation of the Effectiveness of Postgraduate General Medicine Training By Objective Structured Clinical Examination---pilot Study and Reflection On the Experiences of Kaohsiung Medical University Hospital." The Kaohsiung Journal of Medical Sciences, vol. 24, no. 12, 2008, pp. 627-33.
Tsai JC, Liu KM, Lee KT, et al. Evaluation of the effectiveness of postgraduate general medicine training by objective structured clinical examination---pilot study and reflection on the experiences of Kaohsiung Medical University Hospital. Kaohsiung J Med Sci. 2008;24(12):627-33.
Tsai, J. C., Liu, K. M., Lee, K. T., Yen, J. C., Yen, J. H., Liu, C. K., & Lai, C. S. (2008). Evaluation of the effectiveness of postgraduate general medicine training by objective structured clinical examination---pilot study and reflection on the experiences of Kaohsiung Medical University Hospital. The Kaohsiung Journal of Medical Sciences, 24(12), 627-33. https://doi.org/10.1016/S1607-551X(09)70027-0
Tsai JC, et al. Evaluation of the Effectiveness of Postgraduate General Medicine Training By Objective Structured Clinical Examination---pilot Study and Reflection On the Experiences of Kaohsiung Medical University Hospital. Kaohsiung J Med Sci. 2008;24(12):627-33. PubMed PMID: 19251557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the effectiveness of postgraduate general medicine training by objective structured clinical examination---pilot study and reflection on the experiences of Kaohsiung Medical University Hospital. AU - Tsai,Jer-Chia, AU - Liu,Keh-Min, AU - Lee,Kun-Tai, AU - Yen,Jo-Chu, AU - Yen,Jeng-Hsien, AU - Liu,Ching-Kuan, AU - Lai,Chung-Sheng, PY - 2009/3/3/entrez PY - 2009/3/3/pubmed PY - 2009/6/6/medline SP - 627 EP - 33 JF - The Kaohsiung journal of medical sciences JO - Kaohsiung J Med Sci VL - 24 IS - 12 N2 - Objective structured clinical examination (OSCE) is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1) residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman) with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five-point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self-evaluation on performance by examinees revealed significantly lower global ratings on post-course OSCE (4.14 +/- 0.80 vs. 3.68 +/- 0.66; p < 0.02). Surveys from tutors and standardized patients (SPs) completed at pre- and post-course OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 +/- 0.17 vs. 4.0 +/- 0.12, nonsignificant). However, a survey of the examinees completed at pre- and post-course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 +/- 0.09 vs. 3.7 +/- 0.18; p < 0.05). Qualitative information revealed that tutors and SPs remarked that PGY1 residents' medical knowledge performance was satisfactory but their clinical reasoning performance, communication skills (giving bad news) and self-confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a rational and feasible assessment method for evaluating the effectiveness of our PGY general medicine training program. The quantitative data and qualitative information provide a foundation to improve the quality of the program design and evaluation in implementing postgraduate general medicine training. SN - 1607-551X UR - https://www.unboundmedicine.com/medline/citation/19251557/Evaluation_of_the_effectiveness_of_postgraduate_general_medicine_training_by_objective_structured_clinical_examination___pilot_study_and_reflection_on_the_experiences_of_Kaohsiung_Medical_University_Hospital_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1607-551X(09)70027-0 DB - PRIME DP - Unbound Medicine ER -