Kamat Sheryll N, Patel Rishil A, Patel Ria
Internal Medicine, University College Hospital, London, GBR.
Internal Medicine, Chesterfield Royal Hospital, London, GBR.
Cureus. 2024 Nov 26;16(11):e74540. doi: 10.7759/cureus.74540. eCollection 2024 Nov.
Introduction The COVID-19 pandemic resulted in the suspension of formative Objective Structured Clinical Examinations (OSCEs) at numerous institutions. This resulted in a significant gap in OSCE exposure for junior medical students, including those at our university. Drawing upon our prior experiences with OSCEs, we created a program to evaluate the effectiveness of near-peer teaching (NPT) in preparing third-year medical students to experience and succeed in OSCEs. This program was conducted at the University of Buckingham Medical School (Milton Keynes, GBR) from July to October 2022. Methodology Two final-year medical students, under a medical consultant's supervision, led the program development and implementation. This consisted of 2.5 hours of weekly face-to-face OSCE simulation over 12 weeks. The program was designed to mirror the university's OSCE format but provided the intended benefit of designated feedback and teaching at the end of each station. Each week, five dedicated final-year medical students constructed OSCE stations focused on common clinical presentations and skills. Sixty third-year medical students who had completely missed formative OSCEs due to the COVID-19 pandemic enrolled in the program. Pre- and post-session surveys were administered to assess the effectiveness of the NPT program among students. Results In our study, the paired t-test analysis of data showed a statistically significant improvement after attending our OSCE NPT program in all three domains assessed. Participants reported enhanced preparedness in OSCE (p<0.001), a better awareness of the OSCE structure (p<0.001), and an improved understanding of how General Medical Council (GMC) 'Outcomes for Graduates' themes may be assessed (p<0.001). These findings collectively suggest that the NPT intervention effectively enhanced the participants' clinical competencies and preparedness for OSCEs. Conclusion The peer-led OSCE preparation session, facilitated by senior medical students, effectively augmented third-year medical students' clinical skills and knowledge, enhancing their readiness for the OSCE. These sessions provided a unique opportunity for skill development and practice in a simulated clinical environment, fostering greater confidence and proficiency among participating students. Our findings highlight the crucial role of NPT in preparing students for OSCEs. We recommend using NPT to supplement learning, both during periods when traditional OSCEs are unavailable and as a regular adjunct to medical education.
新冠疫情导致众多机构暂停了形成性客观结构化临床考试（OSCE）。这使得包括我校在内的低年级医学生在OSCE方面的接触出现了显著差距。借鉴我们之前在OSCE方面的经验，我们创建了一个项目，以评估近伴教学（NPT）在帮助三年级医学生体验并成功通过OSCE方面的有效性。该项目于2022年7月至10月在白金汉大学医学院（英国米尔顿凯恩斯）开展。
两名即将毕业的医学生在一名医学顾问的监督下，负责项目的开发和实施。该项目包括在12周内每周进行2.5小时的面对面OSCE模拟。该项目旨在模仿学校的OSCE形式，但在每个考站结束时提供了指定反馈和教学的预期益处。每周，五名即将毕业的医学生专门设计以常见临床症状和技能为重点的OSCE考站。60名因新冠疫情完全错过形成性OSCE的三年级医学生参加了该项目。在课程前后进行了调查，以评估NPT项目在学生中的有效性。
在我们的研究中，对数据的配对t检验分析显示，在参加我们的OSCE NPT项目后，在所有三个评估领域都有统计学上的显著改善。参与者报告称在OSCE方面的准备有所增强（p<0.001），对OSCE结构有了更好的认识（p<0.001），并且对如何评估英国医学总会（GMC）的“毕业生能力要求”主题有了更好的理解（p<0.001）。这些发现共同表明，NPT干预有效地提高了参与者的临床能力和对OSCE的准备程度。
由高年级医学生推动的同伴主导的OSCE准备课程有效地增强了三年级医学生的临床技能和知识，提高了他们对OSCE的准备程度。这些课程为在模拟临床环境中的技能发展和实践提供了独特的机会，增强了参与学生的信心和熟练程度。我们的研究结果突出了NPT在帮助学生准备OSCE方面的关键作用。我们建议在传统OSCE无法进行期间以及作为医学教育的常规辅助手段时，使用NPT来补充学习。
