Choi Alex, Murtha Tanya D, Morrison Laura J, Talwalkar Jaideep S
Department of Medicine, Yale School of Medicine, New Haven, CT, USA.
Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA.
J Med Educ Curric Dev. 2024 Mar 25;11:23821205241241375. doi: 10.1177/23821205241241375. eCollection 2024 Jan-Dec.
This study investigates the effectiveness of a virtual format of an advanced communication skills observed structured clinical examination (OSCE) for senior medical students in comparison to an in-person format. The study also examines the emotional support students experience in the virtual setting. Our analysis was based on quantitative data collected through objective checklists and post-OSCE survey results.
The virtual OSCE was a revision of an earlier in-person formative advanced communication skills OSCE for fourth-year medical students. Student performances were assessed by self and peers using objective checklists-the modified Master Interview Rating Scale (mMIRS) and Communication Behavior Checklist (CBC). The mMIRS measured interview process such as avoiding jargon and demonstrating empathy. The CBC examined interview content which included tasks specific to the content of the case. The OSCE was followed by a faculty-led debrief and quantitative survey. The virtual OSCE was conducted in 2021, and the results of the checklists and survey were compared with those collected from two earlier in-person OSCEs.
Eighty-three students participated in the virtual OSCE. There was no difference in mMIRS scores between the virtual and in-person OSCE. Overall CBC scores were lower in the virtual OSCE compared to in-person (< 0.05). Sixty-seven out of 83 (80.7%) students completed the post-OSCE survey. There were no differences between the virtual and in-person OSCE in terms of educational value, whether the OSCE would change the way participants talk to patients, and preparedness to have serious conversations with patients. All respondents somewhat or strongly agreed with feeling emotionally supported during the virtual OSCE.
The virtual format was a suitable alternative to an in-person, formative, advanced communication skills OSCE for medical students. The virtual OSCE was educationally effective and was met with student satisfaction and a sense of emotional support. Future virtual iterations must ensure adequate instruction on interview content.
本研究调查了与现场形式相比,高级沟通技能虚拟结构化临床考试(OSCE)对高年级医学生的有效性。该研究还考察了学生在虚拟环境中所体验到的情感支持。我们的分析基于通过客观检查表和OSCE后调查结果收集的定量数据。
虚拟OSCE是对早期面向四年级医学生的现场形成性高级沟通技能OSCE的修订。学生表现由自我和同伴使用客观检查表——修改后的主面试评分量表(mMIRS)和沟通行为检查表(CBC)进行评估。mMIRS衡量面试过程,如避免使用行话和表现出同理心。CBC检查面试内容,包括与病例内容特定的任务。OSCE之后是由教师主导的汇报和定量调查。虚拟OSCE于2021年进行,检查表和调查结果与之前两次现场OSCE收集的结果进行了比较。
83名学生参加了虚拟OSCE。虚拟OSCE和现场OSCE的mMIRS分数没有差异。与现场OSCE相比,虚拟OSCE的总体CBC分数较低(<0.05)。83名学生中有67名(80.7%)完成了OSCE后调查。在教育价值、OSCE是否会改变参与者与患者交谈的方式以及与患者进行严肃对话的准备程度方面,虚拟OSCE和现场OSCE没有差异。所有受访者在一定程度上或强烈同意在虚拟OSCE期间感受到情感支持。
虚拟形式是医学生现场形成性高级沟通技能OSCE的合适替代方案。虚拟OSCE在教育上是有效的,并且得到了学生的满意度和情感支持感。未来的虚拟迭代必须确保对面试内容进行充分指导。