Gormley Gerry, Menary Allison, Layard Brooke, Hart Nigel, McCourt Collette
Department of General Practice, Queen's University Belfast, UK.
Clin Teach. 2013 Aug;10(4):251-7. doi: 10.1111/tct.12048.
There are many issues regarding the use of real patients in objective structured clinical examinations (OSCEs). In dermatology OSCE stations, standardised patients (SPs) with clinical photographs are often used. Temporary transfer tattoos can potentially simulate skin lesions when applied to an SP. This study aims to appraise the use of temporary malignant melanoma tattoos within an OSCE framework.
Within an 11-station OSCE, a temporary malignant melanoma tattoo was developed and applied to SPs in a 'skin lesion' OSCE station. A questionnaire captured the opinions of the candidate, SP and examiners, and the degree of perceived realism of each station was determined. Standard post hoc OSCE analysis determined the psychometric reliability of the stations.
The response rates were 95.9 per cent of candidates and 100 per cent of the examiners and SPs. The 'skin lesion' station achieved the highest realism score compared with other stations: 89.0 per cent of candidates felt that the skin lesion appeared realistic; only 28 per cent of candidates had ever seen a melanoma before in training. The psychometric performance of the melanoma station was comparable with, and in many instances better than, other OSCE stations.
Transfer tattoo technology facilitates a realistic dermatology OSCE station encounter. Temporary tattoos, alongside trained SPs, provide an authentic, standardised and reliable experience, allowing the assessment of integrated dermatology clinical skills.
在客观结构化临床考试(OSCE)中使用真实患者存在诸多问题。在皮肤科OSCE站点,常使用配有临床照片的标准化患者(SP)。临时转移纹身应用于标准化患者时可模拟皮肤病变。本研究旨在评估在OSCE框架内使用临时恶性黑色素瘤纹身的情况。
在一个有11个站点的OSCE中,开发了一种临时恶性黑色素瘤纹身并应用于“皮肤病变”OSCE站点的标准化患者身上。通过问卷调查收集考生、标准化患者和考官的意见,并确定每个站点的逼真程度。采用标准的事后OSCE分析来确定各站点的心理测量可靠性。
考生的回应率为95.9%,考官和标准化患者的回应率为100%。与其他站点相比,“皮肤病变”站点的逼真度得分最高:89.0%的考生认为皮肤病变看起来逼真;在培训中,只有28%的考生曾见过黑色素瘤。黑色素瘤站点的心理测量表现与其他OSCE站点相当,在许多情况下甚至更好。
转移纹身技术有助于实现逼真的皮肤科OSCE站点体验。临时纹身与训练有素的标准化患者相结合,提供了真实、标准化且可靠的体验,可用于评估综合皮肤科临床技能。