Department of Psychiatry, University of Western Ontario, London, Ont.
Can J Ophthalmol. 2012 Dec;47(6):484-8. doi: 10.1016/j.jcjo.2012.09.003.
To validate the Queen's University Ophthalmoscopy Objective Structured Clinical Examination (OSCE) Checklist (QUOOC) by correlating the score derived from this instrument to the ability of a candidate to correctly identify retinal pathology.
Educational Instrument Validation Study.
Thirteen second-year medical students and 4 ophthalmology residents participated in an OSCE station examining the posterior segment of a series of patients' left eyes with the direct ophthalmoscope.
Participants were asked to evaluate the cup-disc ratio, disc margins, and the macula for the presence of pathology. They were also evaluated for proper direct ophthalmoscopy skills. Each participant was assigned a composite clinical proficiency score. Participants' skills were scored using the QUOOC. Based on this evaluation, we correlated clinical proficiency (QUOOC) score to diagnostic accuracy.
QUOOC was completed successfully within a 3-minute time frame that was deemed to be practical given the physical and time constraints of OSCE stations. Significant (P<0.01) differences were noted between medical students and residents with regard to both technique and clinical proficiency. A strong correlation was found between QUOOC score and a participant's ability to correctly detect retinal pathology (r = 0.71; P = 0.001).
QUOOC was successful in discriminating between more and less experienced and competent participants. Using the QUOOC to evaluate proficiency at direct ophthalmoscopy is a good predictor of correctly detecting retinal pathology when present. We believe that using the QUOOC with standardized patients without physical findings is an accurate and feasible way of measuring students' proficiency in using direct ophthalmoscope in OSCE stations.
通过将该工具得出的分数与候选人正确识别视网膜病理的能力相关联，验证皇后大学检眼镜客观结构化临床考试（OSCE）检查表（QUOOC）的有效性。
教育仪器验证研究。
13 名二年级医学生和 4 名眼科住院医师参加了一项 OSCE 站检查，使用直接检眼镜检查一系列患者左眼的后段。
要求参与者评估杯盘比、盘缘和黄斑是否存在病变。他们还评估了正确的直接检眼镜技能。为每位参与者分配了综合临床熟练程度评分。参与者的技能使用 QUOOC 进行评分。根据该评估，我们将临床熟练程度（QUOOC）评分与诊断准确性相关联。
QUOOC 在 3 分钟的时间内成功完成，考虑到 OSCE 站的身体和时间限制，这被认为是可行的。医学生和住院医师在技术和临床熟练程度方面均存在显著差异（P<0.01）。QUOOC 评分与参与者正确检测视网膜病理的能力之间存在很强的相关性（r = 0.71；P = 0.001）。
QUOOC 成功地区分了经验丰富和能力更强的参与者和经验不足的参与者。使用 QUOOC 评估直接检眼镜的熟练程度是正确检测存在的视网膜病理的良好预测指标。我们认为，在没有身体发现的标准化患者中使用 QUOOC 来衡量学生在 OSCE 站使用直接检眼镜的熟练程度是一种准确且可行的方法。
