Biolik A, Heide S, Lessig R, Hachmann V, Stoevesandt D, Kellner J, Jäschke C, Watzke S
Dorothea Erxleben Learning Centre, Medical Faculty of the Martin Luther University of Halle-Wittenberg, Halle, Germany.
Institute for Forensic Medicine, Martin Luther University of Halle-Wittenberg, Franzosenweg 1, 06112, Halle (Saale), Germany.
J Forensic Leg Med. 2018 Apr;55:33-38. doi: 10.1016/j.jflm.2018.02.010. Epub 2018 Feb 10.
One option for improving the quality of medical post mortem examinations is through intensified training of medical students, especially in countries where such a requirement exists regardless of the area of specialisation. For this reason, new teaching and learning methods on this topic have recently been introduced. These new approaches include e-learning modules or SkillsLab stations; one way to objectify the resultant learning outcomes is by means of the OSCE process. However, despite offering several advantages, this examination format also requires considerable resources, in particular in regards to medical examiners. For this reason, many clinical disciplines have already implemented computer-based OSCE examination formats. This study investigates whether the conventional exam format for the OSCE forensic "Death Certificate" station could be replaced with a computer-based approach in future. For this study, 123 students completed the OSCE "Death Certificate" station, using both a computer-based and conventional format, half starting with the Computer the other starting with the conventional approach in their OSCE rotation. Assignment of examination cases was random. The examination results for the two stations were compared and both overall results and the individual items of the exam checklist were analysed by means of inferential statistics. Following statistical analysis of examination cases of varying difficulty levels and correction of the repeated measures effect, the results of both examination formats appear to be comparable. Thus, in the descriptive item analysis, while there were some significant differences between the computer-based and conventional OSCE stations, these differences were not reflected in the overall results after a correction factor was applied (e.g. point deductions for assistance from the medical examiner was possible only at the conventional station). Thus, we demonstrate that the computer-based OSCE "Death Certificate" station is a cost-efficient and standardised format for examination that yields results comparable to those from a conventional format exam. Moreover, the examination results also indicate the need to optimize both the test itself (adjusting the degree of difficulty of the case vignettes) and the corresponding instructional and learning methods (including, for example, the use of computer programmes to complete the death certificate in small group formats in the SkillsLab).
提高医学尸检质量的一种选择是加强对医学生的培训，特别是在那些无论专业领域如何都有此类要求的国家。因此，最近引入了关于这个主题的新教学方法。这些新方法包括电子学习模块或技能实验室工作站；客观评估学习成果的一种方法是通过客观结构化临床考试（OSCE）流程。然而，尽管这种考试形式有几个优点，但它也需要大量资源，特别是在涉及医学检查人员方面。因此，许多临床学科已经采用了基于计算机的OSCE考试形式。本研究调查了未来OSCE法医“死亡证明”站的传统考试形式是否可以被基于计算机的方法所取代。在本研究中，123名学生完成了OSCE“死亡证明”站的考试，采用了基于计算机的和传统的两种形式，一半学生在OSCE轮转中先从计算机形式开始，另一半先从传统形式开始。考试病例的分配是随机的。比较了两个站的考试结果，并通过推断统计分析了总体结果和考试清单的各个项目。在对不同难度水平的考试病例进行统计分析并校正重复测量效应后，两种考试形式的结果似乎具有可比性。因此，在描述性项目分析中，虽然基于计算机的和传统的OSCE站之间存在一些显著差异，但在应用校正因子后，这些差异并没有反映在总体结果中（例如，只有在传统站才可能因医学检查人员的协助而扣分）。因此，我们证明基于计算机的OSCE“死亡证明”站是一种经济高效且标准化的考试形式，其产生的结果与传统形式考试的结果相当。此外，考试结果还表明需要优化测试本身（调整病例 vignette 的难度程度）以及相应的教学和学习方法（包括例如在技能实验室中以小组形式使用计算机程序来填写死亡证明）。
