Undergraduate Medical School, The University of Glasgow, Glasgow, Scotland.
Anaesthetics Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland.
BMC Med Educ. 2024 Sep 2;24(1):954. doi: 10.1186/s12909-024-05943-9.
Near-peer teaching is a popular pedagogical teaching tool however many existing models fail to demonstrate benefits in summative OSCE performance. The 3-step deconstructed (3-D)skills near-peer model was recently piloted in undergraduate medicine showing short term improvement in formative OSCE performance utilising social constructivist educational principles. This study aims to assess if 3-D skills model teaching affects summative OSCE grades.
Seventy-nine third year medical students attended a formative OSCE event at the University of Glasgow receiving an additional 3-minutes per station of either 3-D skills teaching or time-equivalent unguided practice. Students' summative OSCE results were compared against the year cohort to establish whether there was any difference in time delayed summative OSCE performance.
3-D skills and unguided practice cohorts had comparable demographical data and baseline formative OSCE performance. Both the 3-D skill cohort and unguided practice cohort achieved significantly higher median station pass rates at summative OSCEs than the rest of the year. This correlated to one additional station pass in the 3-D skills cohort, which would increase median grade banding from B to A. The improvement in the unguided practice cohort did not achieve educational significance.
Incorporating the 3-D skills model into a formative OSCE is associated with significantly improved performance at summative OSCEs. This expands on the conflicting literature for formative OSCE sessions which have shown mixed translation to summative performance and suggests merit in institutional investment to improve clinical examination skills.
同伴教学是一种流行的教学工具，但许多现有的模式未能证明在总结性 OSCE 表现中具有优势。最近，三步骤解构（3-D）技能同伴教学模式在本科医学中进行了试点，利用社会建构主义教育原则，在形成性 OSCE 表现方面显示出短期改善。本研究旨在评估 3-D 技能模型教学是否会影响总结性 OSCE 成绩。
79 名三年级医学生在格拉斯哥大学参加了一次形成性 OSCE 活动，在每个站点接受额外的 3 分钟 3-D 技能教学或同等时间的无指导实践。将学生的总结性 OSCE 成绩与当年的队列进行比较，以确定是否存在延迟总结性 OSCE 表现的差异。
3-D 技能和无指导实践组具有可比的人口统计学数据和基线形成性 OSCE 表现。3-D 技能组和无指导实践组在总结性 OSCE 中的中位站点通过率均显著高于其他学生。这相当于 3-D 技能组增加了一个站点通过，将中位数成绩等级从 B 提高到 A。无指导实践组的提高没有达到教育意义。
将 3-D 技能模型纳入形成性 OSCE 与总结性 OSCE 中的表现显著提高相关。这扩展了对形成性 OSCE 课程的相互矛盾的文献，这些文献表明对总结性表现的翻译存在混合效果，并表明在改善临床检查技能方面，机构投资具有价值。
