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将客观结构化临床考试作为妇产科研究生住院医师学习工具的新冠疫情前及疫情期间经历——一项质量改进研究

Pre-COVID and COVID experience of objective structured clinical examination as a learning tool for post-graduate residents in Obstetrics & Gynecology-a quality improvement study.

作者信息

Sharma Charu, Singh Pratibha, Shekhar Shashank, Bhardwaj Abhishek, Jhirwal Manisha, Ghuman Navdeep Kaur, Gothwal Meenakshi, Yadav Garima, Kathuria Priyanka, Mishra Vibha

机构信息

Department of Obstetrics & Gynecology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

出版信息

Obstet Gynecol Sci. 2023 Jul;66(4):316-326. doi: 10.5468/ogs.22266. Epub 2023 Apr 19.

Abstract

OBJECTIVE

Due to its comprehensive, reliable, and valid format, the objective structured clinical examination (OSCE) is the gold standard for assessing the clinical competency of medical students. In the present study, we evaluated the importance of the OSCE as a learning tool for postgraduate (PG) residents assessing their junior undergraduate students. We further aimed to analyze quality improvement during the pre-coronavirus disease (COVID) and COVID periods.

METHODS

This quality-improvement interventional study was conducted at the Department of Obstetrics and Gynecology. The PG residents were trained to conduct the OSCE. A formal feedback form was distributed to 22 participants, and their responses were analyzed using a five-point Likert scale. Fishbone analysis was performed, and the 'plan-do-study-act' (PDSA) cycle was implemented to improve the OSCE.

RESULTS

Most of the residents (95%) believed that this examination system was extremely fair and covered a wide range of clinical skills and knowledge. Further, 4.5% believed it was more labor- and resource intensive and time-consuming. Eighteen (81.8%) residents stated that they had learned all three domains: communication skills, time management skills, and a stepwise approach to clinical scenarios. The PDSA cycle was run eight times, resulting in a dramatic improvement (from 30% to 70%) in the knowledge and clinical skills of PGs and the standard of OSCE.

CONCLUSION

The OSCE can be used as a learning tool for young assessors who are receptive to novel tools. The involvement of PGs in the OSCE improved their communication skills and helped overcome human resource limitations while manning various OSCE stations.

摘要

目的

客观结构化临床考试(OSCE)因其全面、可靠且有效的形式,是评估医学生临床能力的金标准。在本研究中,我们评估了OSCE作为研究生(PG)住院医师评估低年级本科生的学习工具的重要性。我们还旨在分析冠状病毒病(COVID)之前和COVID期间的质量改进情况。

方法

本质量改进干预研究在妇产科进行。对PG住院医师进行了OSCE实施培训。向22名参与者发放了正式的反馈表,并使用五点李克特量表分析他们的回答。进行了鱼骨分析,并实施了“计划-执行-研究-行动”(PDSA)循环以改进OSCE。

结果

大多数住院医师(95%)认为该考试系统极其公平,涵盖了广泛的临床技能和知识。此外,4.5%的人认为它更加耗费人力和资源且耗时。18名(81.8%)住院医师表示他们学到了所有三个领域的知识:沟通技巧、时间管理技巧以及临床场景的逐步处理方法。PDSA循环运行了八次,PG的知识和临床技能以及OSCE的标准有了显著提高(从30%提高到70%)。

结论

OSCE可作为乐于接受新工具的年轻评估者的学习工具。PG参与OSCE提高了他们的沟通技巧,并有助于在为各个OSCE站点配备人员时克服人力资源限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43cc/10375219/0307acfcaccb/ogs-22266f1.jpg

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