Department of Dermatology, King Faisal University, Al-Hassa, Saudi Arabia.
Department of Dermatology, University College of Medical Sciences, Delhi, India.
Indian J Dermatol Venereol Leprol. 2020 Sep-Oct;86(5):606. doi: 10.4103/ijdvl.IJDVL_596_19.
Objective structured clinical examination (OSCE) is being increasingly used as an assessment tool for undergraduate dermatology courses. One of the practical difficulties in conducting OSCEs in dermatology is getting patients with typical skin lesions which can be used for the whole group to ensure uniformity of assessment. We present a study on the use of simple moulage techniques to create uniform and standardized skin lesions for OSCEs in dermatology.
As a first step, the dermatology faculty in our department chose the clinical conditions which could be covered by using moulages. The main criteria considered were the importance of the condition to the exam blueprint, ease of making and resistance to handling (should not require frequent retouching). Moulages were created on volunteers after taking consent and the same were used in OSCEs s for a group of 5-year students (N = 102). Difficulty and discrimination indices were compared between the stations using the moulage and the other stations. Qualitative feedback was obtained regarding the same from both the faculty and the students.
There was consensus among the faculty and the majority of the students that the lesions were clearly recognizable. As far as other psychometrics were concerned, average difficulty and discrimination of the stations using the moulage were good (average difficulty index-0.78 and average discrimination index-0.68) and compared favorably with the other stations (average difficulty index-0.77 and average discrimination index-0.57).
Limited number of stations included, lack of detailed item analysis and lack of feedback from the simulated patients were the main limitations in this study.
For most common skin conditions creating moulages to simulate the corresponding lesions is an easy procedure and can be an effective tool to standardize dermatology OSCEs for undergraduates, especially in resource-poor settings.
客观结构化临床考试（OSCE）越来越多地被用作本科皮肤科课程的评估工具。在皮肤科进行 OSCE 考试的实际困难之一是获得具有典型皮损的患者，以便为整个小组使用，以确保评估的一致性。我们提出了一项关于使用简单的塑形技术为皮肤科 OSCE 创建统一和标准化皮损的研究。
作为第一步，我们系的皮肤科教师选择了可以通过塑形来涵盖的临床情况。考虑的主要标准是该情况对考试大纲的重要性、制作的难易程度和耐处理性（不应需要频繁修饰）。在获得同意后，在志愿者身上制作塑形，并在一组 5 年制学生（N=102）的 OSCE 中使用。使用塑形和其他站之间比较了难度和区分度指数。从教师和学生那里获得了关于相同的定性反馈。
教师和大多数学生一致认为，皮损清晰可辨。就其他心理测量学而言，使用塑形的站的平均难度和区分度良好（平均难度指数为 0.78，平均区分度指数为 0.68），并且与其他站相比表现良好（平均难度指数为 0.77，平均区分度指数为 0.57）。
本研究的主要局限性包括纳入的站数有限、缺乏详细的项目分析以及缺乏来自模拟患者的反馈。
对于大多数常见的皮肤情况，制作模拟相应皮损的塑形是一个简单的过程，对于标准化本科生的皮肤科 OSCE，尤其是在资源匮乏的环境中，这是一种有效的工具。
