In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 1 ( 2021-1-14), p. e0245439-
Abstract:
Objective structured clinical examinations (OSCE) evaluate clinical reasoning, communication skills, and interpersonal behavior during medical education. In France, clinical training has long relied on bedside clinical practice in academic hospitals. The need for a simulated teaching environment has recently emerged, due to the increasing number of students admitted to medical schools, and the necessity of objectively evaluating practical skills. This study aimed at investigating the relationships between OSCE grades and current evaluation modalities. Methods Three-hundred seventy-nine 4 th -year students of University-of-Paris Medical School participated to the first large-scale OSCE at this institution, consisting in three OSCE stations (OSCE#1–3). OSCE#1 and #2 focused on cardiovascular clinical skills and competence, whereas OSCE#3 focused on relational skills while providing explanations before planned cholecystectomy. We investigated correlations of OSCE grades with multiple choice (MCQ)-based written examinations and evaluations of clinical skills and behavior (during hospital traineeships); OSCE grade distribution; and the impact of integrating OSCE grades into the current evaluation in terms of student ranking. Results The competence-oriented OSCE#1 and OSCE#2 grades correlated only with MCQ grades ( r = 0.19, P 〈 0.001) or traineeship skill grades ( r = 0.17, P = 0.001), respectively, and not with traineeship behavior grades ( P 〉 0.75). Conversely, the behavior-oriented OSCE#3 grades correlated with traineeship skill and behavior grades ( r = 0.19, P 〈 0.001, and r = 0.12, P = 0.032), but not with MCQ grades ( P = 0.09). The dispersion of OSCE grades was wider than for MCQ examinations ( P 〈 0.001). When OSCE grades were integrated to the final fourth-year grade with an incremental 10%, 20% or 40% coefficient, an increasing proportion of the 379 students had a ranking variation by ±50 ranks ( P 〈 0.001). This ranking change mainly affected students among the mid-50% of ranking. Conclusion This large-scale French experience showed that OSCE designed to assess a combination of clinical competence and behavioral skills, increases the discriminatory capacity of current evaluations modalities in French medical schools.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0245439
DOI:
10.1371/journal.pone.0245439.g001
DOI:
10.1371/journal.pone.0245439.g002
DOI:
10.1371/journal.pone.0245439.g003
DOI:
10.1371/journal.pone.0245439.g004
DOI:
10.1371/journal.pone.0245439.g005
DOI:
10.1371/journal.pone.0245439.g006
DOI:
10.1371/journal.pone.0245439.t001
DOI:
10.1371/journal.pone.0245439.t002
DOI:
10.1371/journal.pone.0245439.t003
DOI:
10.1371/journal.pone.0245439.t004
DOI:
10.1371/journal.pone.0245439.s001
DOI:
10.1371/journal.pone.0245439.s002
DOI:
10.1371/journal.pone.0245439.s003
DOI:
10.1371/journal.pone.0245439.s004
DOI:
10.1371/journal.pone.0245439.s005
DOI:
10.1371/journal.pone.0245439.r001
DOI:
10.1371/journal.pone.0245439.r002
DOI:
10.1371/journal.pone.0245439.r003
DOI:
10.1371/journal.pone.0245439.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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