Aranda Josephine P, Davies Marie L, Jackevicius Cynthia A
Western University of Health Sciences, College of Pharmacy, 309 E. Second St., Pomona, CA, United States.
Western University of Health Sciences, College of Pharmacy, 309 E. Second St., Pomona, CA, United States; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
Curr Pharm Teach Learn. 2019 Mar;11(3):302-308. doi: 10.1016/j.cptl.2018.12.012. Epub 2019 Jan 4.
Studies have examined evidence-based medicine (EBM) focused objective structured clinical examinations (OSCEs) in medical training, but data are lacking in pharmacy trainees. This study sought to assess student pharmacists' performance on and perceptions of a novel EBM OSCE.
This EBM OSCE included answering a drug-information inquiry, researching background questions, calling a simulated provider to acquire specific patient information, developing a foreground clinical question, reviewing pre-appraised trial synopses, and applying evidence to write a recommendation. Pharmacy faculty served as simulated providers and assessed students on knowledge/analytical (AC) and global communication (GC) skills. Students completed a worksheet (WS) that included developing a patient, intervention, comparison, outcome (PICO) statement, trial selection, and clinical recommendation. After OSCE completion, students were surveyed regarding perceptions of their performance and OSCE applicability. Outcomes assessed were performance scores (AC, GC, WS) and student perceptions.
One-hundred twenty-nine students completed the survey and were included in analysis. AC, WS, and GC performance [median (IQR)] were 75.0 (37.8), 86.4 (36.9), and 88.9 (22.2), respectively, on a 100-point scale. On the WS, 89% of students developed a suitable searchable clinical question and 61% selected the correct trial synopsis to apply to the case. Students felt literature application and WS development were most challenging. A majority of students felt this OSCE increased comfort in engaging with providers (74%) and that these skills correlate with real clinical scenarios (77%).
OSCEs can be a valuable tool for simulating clinical scenarios and assessing student pharmacists' EBM skills.
已有研究探讨了医学培训中以循证医学(EBM)为重点的客观结构化临床考试(OSCE),但药学实习生方面的数据尚缺。本研究旨在评估学生药剂师在新型循证医学客观结构化临床考试中的表现及看法。
本次循证医学客观结构化临床考试包括回答药物信息询问、研究背景问题、致电模拟医疗服务提供者以获取特定患者信息、提出前景临床问题、查阅预先评估的试验概要,以及应用证据撰写建议。药学教员担任模拟医疗服务提供者,并对学生的知识/分析(AC)和整体沟通(GC)技能进行评估。学生完成一份工作表(WS),其中包括制定患者、干预措施、对照、结局(PICO)陈述、试验选择和临床建议。客观结构化临床考试结束后,就学生对自身表现及客观结构化临床考试适用性的看法进行了调查。评估的结果为表现分数(AC、GC、WS)和学生看法。
129名学生完成了调查并纳入分析。在100分制中,AC、WS和GC表现[中位数(四分位间距)]分别为75.0(37.8)、86.4(36.9)和88.9(22.2)。在工作表方面,89%的学生提出了合适的可检索临床问题,61%的学生选择了适用于该病例的正确试验概要。学生们认为文献应用和工作表制定最具挑战性。大多数学生认为这种客观结构化临床考试提高了与医疗服务提供者沟通的舒适度(74%),并且这些技能与实际临床场景相关(77%)。
客观结构化临床考试可以成为模拟临床场景和评估学生药剂师循证医学技能的宝贵工具。