Department of Medical Education, Dongguk University School of Medicine, Goyang, Korea.
Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
Korean J Med Educ. 2020 Mar;32(1):59-65. doi: 10.3946/kjme.2020.153. Epub 2020 Mar 1.
We sought to determine the impact of medical students' prior experience of assessing peers in the objective structured clinical examination (OSCE) on their clinical performance.
Forty-two year 4 medical students participated in an OSCE comprised of three 10-minute stations (syncope, hemoptysis, and back pain). Each student took part in two iterations of the three-station OSCE as either the examiner or examinee, and student performance was assessed using a checklist by a medical faculty member and a student simultaneously. Students were randomly assigned to two groups and their OSCE scores were compared. Students in the control group were tested at a station first and then participated at the same station as a peer examiner, and those in the intervention group participated as a peer examiner first and then as an examinee. Moreover, student OSCE scores rated by peer examiners were compared with those awarded by faculty to evaluate the accuracy of peer assessment. Following the test, students completed surveys on their perceptions of the usefulness of this formative OSCE.
Student overall OSCE scores did not differ between groups. Students in the study group performed better at the hemoptysis station (p<0.001), but poorer at the syncope station (p<0.01). Student performances at the back-pain station were similar in these two groups (p=0.48). OSCE scores rated by faculty and peer examiners were moderately negatively associated at the hemoptysis station (p<0.05), but no such association was observed at the other two stations. This trend was similar in peer examiners who were high-achievers and low-achievers in OSCEs. Students showed positive perceptions of their experience with this OSCE.
Student experience as peer assessor offers a feasible means of providing them greater access to OSCEs without consuming more resources, although its impact on enhancing performance in the OSCE is likely to differ across stations.
我们旨在确定医学生在客观结构化临床考试（OSCE）中评估同伴的先前经验对其临床表现的影响。
42 名四年级医学生参加了一项 OSCE，该考试由三个 10 分钟的站点组成（晕厥、咯血和背痛）。每位学生都作为考官或考生参加了三个站点的两个迭代，由一名医学教师和一名学生同时使用检查表对学生的表现进行评估。学生被随机分配到两个组，比较他们的 OSCE 成绩。对照组的学生先在一个站点接受测试，然后作为同伴考官在同一个站点参加考试，而干预组的学生先作为同伴考官参加考试，然后作为考生参加考试。此外，还比较了同伴考官对学生 OSCE 成绩的评分与教师的评分，以评估同伴评估的准确性。测试结束后，学生完成了有关他们对这种形成性 OSCE 有用性的看法的调查。
两组学生的整体 OSCE 成绩没有差异。研究组学生在咯血站的表现更好（p<0.001），但在晕厥站的表现更差（p<0.01）。在这两个站点，学生在背痛站的表现相似（p=0.48）。在咯血站，教师和同伴考官的 OSCE 评分中度负相关（p<0.05），但在其他两个站点则没有这种相关性。在 OSCE 中表现优异和表现较差的同伴考官中，这种趋势相似。学生对他们在这种 OSCE 中的经验表现出积极的看法。
作为同伴评估者的学生经验为他们提供了更多参与 OSCE 的可行途径，而不会消耗更多资源，尽管其对提高 OSCE 表现的影响可能因站点而异。
