Faculty of Medicine, University of Southampton, Building 85, University Road, Southampton, SO17 1BJ, UK.
BMC Med Educ. 2019 May 2;19(1):126. doi: 10.1186/s12909-019-1571-5.
Objectively structured clinical examinations (OSCEs) are a stressful experience for many health care students and professionals in training. Mock OSCEs have been shown to be beneficial for student OSCE preparation. However, due to their expense and administrative burden students may only get a few opportunities to partake in these. To address this gap in student preparation a series of regularly run totally peer led multi-role practice OSCEs (PrOSCEs) was developed.
Fifteen PrOSCEs were run over five-months. A total of 32 second year medical students took part, all of whom were enrolled on the graduate-entry programme at the University of Southampton. In each PrOSCE, 18 participants rotated through the roles of 'student', 'examiner' and 'patient' in six simulated stations designed by their peers. Peer feedback was provided after each station. At the end of the series of PrOSCEs students were asked to fill in an anonymous online feedback survey to assess the usefulness of the PrOSCEs in exam preparation.
Twenty-two students responded to the survey. 100% of respondents deemed routine participation either 'very useful' or 'useful' in preparing for their exam. PrOSCEs were found to improve confidence (mean = 7.9/10, 95% CI 7.4-8.3), expected performance (mean = 7.5/10, 95% CI 6.8-8.2) and help guide revision (mean = 8.3/10, 95% CI 7.6-9.0). Self-perceived teaching performance and confidence in providing feedback was also positively associated with participation. The most beneficial roles were 'student' and 'station creator'. Free-text feedback suggests that the informal setting and regular practice were particularly beneficial.
The peer-led nature of the PrOSCEs allows for a low cost, low administrative burden and easy to replicate adjunct or alternative to large scale mock OSCEs. In addition the multi-role aspect of this approach could enhance exam preparation and may also improve aptitude as a clinical teacher. Further studies are required to understand if repeated practice has beneficial implications on OSCE performance.
客观结构化临床考试（OSCE）对许多医学生和培训中的医疗保健专业人员来说是一种压力体验。模拟 OSCE 已被证明对学生 OSCE 准备有好处。然而，由于其费用和行政负担，学生可能只有几次机会参加这些考试。为了解决学生准备方面的这一差距，开发了一系列定期运行的完全由同行领导的多角色实践 OSCE（PrOSCE）。
在五个月内进行了十五次 PrOSCE。共有 32 名二年级医学生参加了这项活动，他们都参加了南安普顿大学的研究生入学课程。在每次 PrOSCE 中，18 名参与者都会在由他们的同龄人设计的六个模拟站中轮流担任“学生”、“考官”和“患者”的角色。每个站后都会提供同行反馈。在一系列 PrOSCE 结束后，学生被要求填写一份匿名在线反馈调查，以评估 PrOSCE 在考试准备中的有用性。
22 名学生对调查做出了回应。100%的受访者认为常规参与对准备考试非常有用或有用。PrOSCE 被发现可以提高信心（平均值=7.9/10，95%CI 7.4-8.3）、预期表现（平均值=7.5/10，95%CI 6.8-8.2）和帮助指导复习（平均值=8.3/10，95%CI 7.6-9.0）。自我感知的教学表现和提供反馈的信心也与参与度呈正相关。最有益的角色是“学生”和“站点创建者”。自由文本反馈表明，非正式的设置和定期的实践特别有益。
PrOSCE 的同行领导性质允许以低成本、低行政负担和易于复制的方式作为大型模拟 OSCE 的附加或替代方法。此外，这种方法的多角色方面可以增强考试准备，并且还可以提高作为临床教师的能力。需要进一步的研究来了解重复实践对 OSCE 表现是否有有益的影响。
