Bernard Aaron W, Ceccolini Gabbriel, Feinn Richard, Rockfeld Jennifer, Rosenberg Ilene, Thomas Listy, Cassese Todd
a Frank H. Netter MD School of Medicine at Quinnipiac , Hamden , CT , USA.
Med Educ Online. 2017;22(1):1324718. doi: 10.1080/10872981.2017.1324718.
Performance feedback is considered essential to clinical skills development. Formative objective structured clinical exams (F-OSCEs) often include immediate feedback by standardized patients. Students can also be provided access to performance metrics including scores, checklists, and video recordings after the F-OSCE to supplement this feedback. How often students choose to review this data and how review impacts future performance has not been documented.
We suspect student review of F-OSCE performance data is variable. We hypothesize that students who review this data have better performance on subsequent F-OSCEs compared to those who do not. We also suspect that frequency of data review can be improved with faculty involvement in the form of student-faculty debriefing meetings.
Simulation recording software tracks and time stamps student review of performance data. We investigated a cohort of first- and second-year medical students from the 2015-16 academic year. Basic descriptive statistics were used to characterize frequency of data review and a linear mixed-model analysis was used to determine relationships between data review and future F-OSCE performance.
Students reviewed scores (64%), checklists (42%), and videos (28%) in decreasing frequency. Frequency of review of all metric and modalities improved when student-faculty debriefing meetings were conducted (p<.001). Among 92 first-year students, checklist review was associated with an improved performance on subsequent F-OSCEs (p = 0.038) by 1.07 percentage points on a scale of 0-100. Among 86 second year students, no review modality was associated with improved performance on subsequent F-OSCEs.
Medical students review F-OSCE checklists and video recordings less than 50% of the time when not prompted. Student-faculty debriefing meetings increased student data reviews. First-year student's review of checklists on F-OSCEs was associated with increases in performance on subsequent F-OSCEs, however this outcome was not observed among second-year students.
绩效反馈被认为是临床技能发展的关键。形成性客观结构化临床考试(F-OSCE)通常包括标准化病人提供的即时反馈。在F-OSCE结束后,也可以向学生提供包括分数、检查表和视频记录在内的绩效指标,以补充这种反馈。学生选择查看这些数据的频率以及查看对未来表现的影响尚未有文献记载。
我们怀疑学生对F-OSCE绩效数据的查看情况各不相同。我们假设,与未查看数据的学生相比,查看这些数据的学生在后续F-OSCE中的表现更好。我们还怀疑,通过师生汇报会的形式让教师参与进来,可以提高数据查看的频率。
模拟记录软件跟踪并标记学生对绩效数据的查看情况。我们调查了2015 - 16学年的一批大一和大二医学生。使用基本描述性统计来描述数据查看频率,并使用线性混合模型分析来确定数据查看与未来F-OSCE表现之间的关系。
学生查看分数(64%)、检查表(42%)和视频(28%)的频率依次降低。当举行师生汇报会时,所有指标和形式的查看频率都有所提高(p<0.001)。在92名大一学生中,查看检查表与后续F-OSCE表现的提高相关(p = 0.038),在0 - 100分的评分标准上提高了1.07个百分点。在86名大二学生中,没有任何一种查看形式与后续F-OSCE表现的提高相关。
在没有提示的情况下,医学生查看F-OSCE检查表和视频记录的时间不到50%。师生汇报会增加了学生对数据的查看。大一学生对F-OSCE检查表的查看与后续F-OSCE表现的提高相关,然而在大二学生中未观察到这一结果。