Fields Henry W, Rowland Michael L, Vig Katherine W L, Huja Sarandeep S
Section of Orthodontics, Ohio State University College of Dentistry, Columbus, Ohio 43218-2357, USA.
Am J Orthod Dentofacial Orthop. 2007 May;131(5):656-63. doi: 10.1016/j.ajodo.2007.01.013.
Continuous evaluation of residents and the advanced education curriculum is required to maintain the quality of a program and ensure appropriate accreditation status. The purpose of this project was to describe the process of introducing the objective structured clinical examination (OSCE) into an advanced orthodontic education program and to evaluate its impact on the curriculum.
To determine the content of the examination, 60 orthodontic practitioners were consulted to identify the most important clinical skills that an entry-level practitioner must be able to perform proficiently. From 18 critical clinical skills, 13 were evaluated by the OSCE in the areas of diagnosis, clinical evaluation and synthesis, and orthodontic technique. The OSCE was given to 3 classes of residents each year for 3 years (n = 46).
The classes were tracked longitudinally, and the students' levels were evaluated cross-sectionally. Curriculum changes were evaluated for impact in areas of deficiency. There were no significant correlations between student confidence and performance or faculty prediction of proficiency and performance beyond the first year. Great gains in performance were observed between the first and second years of the 3-year program. All skills did not reach proficiency levels, and peak performance did not always occur during the third year. Some curriculum changes were fruitful, and others were not sustained by improved performance.
An OSCE can provide important information regarding students and the curriculum in a clinically meaningful way that might be otherwise unattainable.
需要持续评估住院医师和进阶教育课程,以维持项目质量并确保获得适当的认证状态。本项目的目的是描述将客观结构化临床考试(OSCE)引入正畸进阶教育项目的过程,并评估其对课程的影响。
为确定考试内容,咨询了60位正畸从业者,以确定入门级从业者必须能够熟练掌握的最重要临床技能。从18项关键临床技能中,选择了13项通过OSCE在诊断、临床评估与综合以及正畸技术领域进行评估。在3年时间里,每年对3组住院医师进行OSCE(n = 46)。
对这些组进行纵向跟踪,并对学生水平进行横断面评估。评估课程变化在不足之处的影响。除第一年外,学生信心与表现之间以及教师对熟练程度的预测与表现之间均无显著相关性。在三年制项目的第一年和第二年之间观察到表现有很大提升。并非所有技能都达到了熟练水平,且最佳表现并非总是出现在第三年。一些课程变化富有成效,而另一些则未因表现改善而持续下去。
OSCE能够以一种临床上有意义的方式提供有关学生和课程的重要信息,而这可能是通过其他方式无法获得的。