Singapore General Hospital, Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Perspect Med Educ. 2021 Oct;10(5):293-298. doi: 10.1007/s40037-020-00643-8. Epub 2020 Dec 22.
Peer assessments are increasingly prevalent in medical education, including student-led mock Objective Structured Clinical Examinations (OSCE). While there is some evidence to suggest that examiner training may improve OSCE assessments, few students undergo training before becoming examiners. We sought to evaluate an examiner training programme in the setting of a student-led mock OSCE.
A year‑2 mock OSCE comprised of history taking (Hx) and physical examination (PE) stations was conducted involving 35 year‑3 (Y3) student examiners and 21 year‑5 (Y5) student examiners who acted as reference examiners. Twelve Y3 student-examiners attended an OSCE examiner training programme conducted by senior faculty. During the OSCE, Y3 and Y5 student examiners were randomly paired to grade the same candidates and scores were compared. Scores for checklist rating (CR) and global rating (GR) domains were assigned for both Hx and PE stations.
There was moderate to excellent correlation between Y3 and Y5 student examiners for both Hx (ICC 0.71-0.96) and PE stations (ICC 0.71-0.88) across all domains. For both Hx and PE stations, GR domain had poorer correlation than CR domains. Examiner training resulted in better correlations for PE but not Hx stations. Effect sizes were lower than the minimum detectible effect (MDE) sizes for all comparisons made.
Y3 student examiners are effective substitutes for Y5 student examiners in a Y2 mock OSCE. Our findings suggest that examiner training may further improve marking behaviour especially for PE stations. Further studies with larger sample sizes are required to further evaluate the effects of dedicated examiner training.
同伴评估在医学教育中越来越普遍,包括学生主导的模拟客观结构化临床考试(OSCE)。虽然有一些证据表明,考官培训可以提高 OSCE 评估的质量,但很少有学生在成为考官之前接受培训。我们旨在评估学生主导的模拟 OSCE 中的考官培训计划。
在一个 2 年级的模拟 OSCE 中,涉及 35 名 3 年级(Y3)学生考官和 21 名 5 年级(Y5)学生考官,他们担任参考考官。12 名 Y3 学生考官参加了由资深教师进行的 OSCE 考官培训计划。在 OSCE 中,Y3 和 Y5 学生考官被随机配对,对同一考生进行评分,并比较评分。为病史采集(Hx)和体格检查(PE)站的检查表评分(CR)和总体评分(GR)域分配了分数。
在所有域中,Y3 和 Y5 学生考官之间的 Hx(ICC 0.71-0.96)和 PE 站(ICC 0.71-0.88)之间存在中度至极好的相关性。对于 Hx 和 PE 站,GR 域的相关性均不如 CR 域。考官培训仅使 PE 站的评分相关性更好,而不是 Hx 站。与所有比较的最小可检测效应(MDE)相比,所有比较的效应大小都较低。
Y3 学生考官在 Y2 模拟 OSCE 中可以有效替代 Y5 学生考官。我们的研究结果表明,考官培训可能会进一步改善评分行为,特别是对于 PE 站。需要进行具有更大样本量的进一步研究,以进一步评估专门的考官培训的效果。