Gillis Megan E, Scott Stephanie A, Richardson C Glen, Oxner William M, Gauthier Luc, Wilson David A, Glennie Raymond A
Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada.
Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada.
J Surg Educ. 2020 Jul-Aug;77(4):939-946. doi: 10.1016/j.jsurg.2020.02.018. Epub 2020 Mar 13.
To1 describe the development and evaluate the feasibility of a surgical objective structured clinical examination (OSCE) for the purpose of competency assessment based on the Royal College of Canada's CanMEDS framework.
A unique surgical OSCE was developed to evaluate the clinical and surgical management of common orthopaedic problems using simulated patients and cadaveric specimens. Cases were graded by degree of difficulty (less complex, complex, more complex) Developing an assessment tool with significant resource utilization and good correlation with traditional methods is challenging. The feasibility of an OSCE that evaluates independent clinical and surgical decision making was evaluated. In addition, as part of establishing construct validity, correlation of OSCE scores with previously validated O-scores was performed.
A tertiary level academic teaching hospital.
Thirty-four Postgraduate year 3-5 trainees of a 5-year Canadian orthopedic residency program creating 96 operative case performances available for final review.
The development of the OSCE cases involved a multistep process with attending surgeons, residents and a surgical education consultant. There were 4 different OSCE days, over a 3 year period (2016-2018) encompassing a variety of less complex and more complex procedures. Performance on the OSCE correlated strongly with the (O-SCORE, 0.89) and a linear regression analysis correlated moderately with year of training (r = 0.5737). The feasibility analysis demonstrated good financial practicality with solid programmatic integration.
The unique surgical OSCE scores correlate strongly with an established entrustability scale. Administering this OSCE to evaluate preoperative and intraoperative decision making to complement other forms of assessment is feasible. The financial burden to training programs is modest in comparison to the insight gained by both residents and faculty.
根据加拿大皇家内科医师和外科医师学会的CanMEDS框架，描述一种用于能力评估的外科客观结构化临床考试（OSCE）的开发情况并评估其可行性。
开发了一种独特的外科OSCE，以使用模拟患者和尸体标本评估常见骨科问题的临床和手术管理。病例按难度程度（较简单、复杂、更复杂）分级。开发一种具有大量资源利用且与传统方法具有良好相关性的评估工具具有挑战性。评估了一种评估独立临床和手术决策的OSCE的可行性。此外，作为建立结构效度的一部分，对OSCE分数与先前验证的O分数进行了相关性分析。
一家三级学术教学医院。
参加为期5年的加拿大骨科住院医师培训项目的34名三年级至五年级研究生，共产生96例可供最终评审的手术病例表现。
OSCE病例的开发涉及一个多步骤过程，参与人员包括主治外科医生、住院医师和一名外科教育顾问。在3年期间（2016 - 2018年）有4个不同的OSCE日，涵盖各种较简单和更复杂的手术。OSCE表现与（O评分，0.89）高度相关，线性回归分析与培训年份中度相关（r = 0.5737）。可行性分析表明该考试在财务方面具有良好的实用性且能很好地融入项目。
独特的外科OSCE分数与既定的可托付性量表高度相关。实施这种OSCE以评估术前和术中决策以补充其他评估形式是可行的。与住院医师和教员所获得的见解相比，培训项目的财务负担较小。
