客观结构化临床考试后的反馈：面对面反馈与强化书面反馈的比较

Feedback after OSCE: A comparison of face to face versus an enhanced written feedback.

作者信息

Ngim Chin Fang, Fullerton Paul Douglas, Ratnasingam Vanassa, Arasoo Valliammai Jayanthi Thirunavuk, Dominic Nisha Angela, Niap Cindy Pei Sze, Thurairajasingam Sivakumar

机构信息

Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Johor Bahru, Malaysia.

出版信息

BMC Med Educ. 2021 Mar 24;21(1):180. doi: 10.1186/s12909-021-02585-z.

DOI:10.1186/s12909-021-02585-z

PMID:33761946

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7992790/

Abstract

BACKGROUND

The Objective Structured Clinical Exam (OSCE) is a useful means of generating meaningful feedback. OSCE feedback may be in various forms (written, face to face and audio or video recordings). Studies on OSCE feedback are uncommon, especially involving Asian medical students.

METHODS

We compared two methods of OSCE feedback delivered to fourth year medical students in Malaysia: (i) Face to face (FTF) immediate feedback (semester one) (ii) Individualised enhanced written (EW) feedback containing detailed scores in each domain, examiners' free text comments and the marking rubric (semester two). Both methods were evaluated by students and staff examiners, and students' responses were compared against their OSCE performance.

RESULTS

Of the 116 students who sat for both formative OSCEs, 82.8% (n=96) and 86.2% (n=100) responded to the first and second survey respectively. Most students were comfortable to receive feedback (91.3% in FTF, 96% in EW) with EW feedback associated with higher comfort levels (p=0.022). Distress affected a small number with no differences between either method (13.5% in FTF, 10% in EW, p=0.316). Most students perceived both types of feedback improved their performance (89.6% in FTF, 95% in EW); this perception was significantly stronger for EW feedback (p=0.008). Students who preferred EW feedback had lower OSCE scores compared to those preferring FTF feedback (mean scores ± SD: 43.8 ± 5.3 in EW, 47.2 ± 6.5 in FTF, p=0.049). Students ranked the "marking rubric" to be the most valuable aspect of the EW feedback. Tutors felt both methods of feedback were equally beneficial. Few examiners felt they needed training (21.4% in FTF, 15% in EW) but students perceived this need for tutors' training differently (53.1% in FTF, 46% in EW) CONCLUSION: Whilst both methods of OSCE feedback were highly valued, students preferred to receive EW feedback and felt it was more beneficial. Learning cultures of Malaysian students may have influenced this view. Information provided in EW feedback should be tailored accordingly to provide meaningful feedback in OSCE exams.

摘要

背景

客观结构化临床考试（OSCE）是产生有意义反馈的一种有用手段。OSCE反馈可以有多种形式（书面、面对面以及音频或视频记录）。关于OSCE反馈的研究并不常见，尤其是涉及亚洲医学生的研究。

方法

我们比较了马来西亚向四年级医学生提供OSCE反馈的两种方法：（i）面对面（FTF）即时反馈（第一学期）（ii）个性化增强书面（EW）反馈，其中包含每个领域的详细分数、考官的自由文本评论和评分标准（第二学期）。两种方法都由学生和考官进行评估，并将学生的反应与其OSCE表现进行比较。

结果

在参加两次形成性OSCE考试的116名学生中，分别有82.8%（n = 96）和86.2%（n = 100）对第一次和第二次调查做出了回应。大多数学生乐于接受反馈（FTF组为91.3%，EW组为96%），EW反馈的舒适度更高（p = 0.022）。少数人受到困扰，两种方法之间没有差异（FTF组为13.5%，EW组为10%，p = 0.316）。大多数学生认为两种反馈都提高了他们的表现（FTF组为89.6%，EW组为95%）；这种看法在EW反馈中明显更强（p = 0.008）。与喜欢FTF反馈的学生相比，喜欢EW反馈的学生OSCE分数更低（平均分数±标准差：EW组为43.8±5.3，FTF组为47.2±6.5，p = 0.049）。学生将“评分标准”列为EW反馈中最有价值的方面。导师认为两种反馈方法同样有益。很少有考官觉得他们需要培训（FTF组为21.4%，EW组为15%），但学生对导师培训需求的看法不同（FTF组为53.1%，EW组为46%）。结论：虽然两种OSCE反馈方法都受到高度重视，但学生更喜欢接受EW反馈，并认为它更有益。马来西亚学生的学习文化可能影响了这一观点。EW反馈中提供的信息应相应调整，以便在OSCE考试中提供有意义的反馈。