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OSCE para Competências de Comunicação Clínica e Profissionalismo: Relato de Experiência e Meta-Avaliação Translated title: OSCE for Communication Skills and Professionalism: Case Report and Meta-Analysis

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      Abstract

      RESUMO A comunicação clínica e o profissionalismo estão entre as principais competências médicas e, portanto, devem ter sua avaliação garantida. Nesse contexto, o exame clínico objetivo estruturado (OSCE) tem papel fundamental. Objetivos Descrever as etapas de elaboração de um OSCE, bem como a avaliação da qualidade das estações e a percepção do estudante de Medicina sobre a sua realização. Método O estudo é composto pela realização de um OSCE com quatro estações por 16 estudantes de Medicina e pela análise da qualidade psicométrica e aplicação de um questionário de satisfação. Resultados Para os estudantes, o OSCE é o método que melhor avalia e ensina essas competências, ao passo que os testes de múltipla escolha estão no polo oposto quanto à avaliação. Em relação à qualidade múltipla das estações: duas se apresentaram com boa confiabilidade, uma se tornou satisfatória após adequação e uma se revelou inconsistente. Conclusão Mesmo bem avaliadas pelos estudantes, algumas estações apresentaram falhas. A análise do OSCE é fundamental para sua validade e mensurabilidade, em especial para o OSCE de alta aposta.

      Translated abstract

      ABSTRACT Clinical communication and professionalism are among the primary medical competencies and therefore must have guaranteed assessment. In this context, the objective structured clinical examination (OSCE) plays an important role. Objectives To describe the steps of developing an OSCE, as well as evaluating the quality of the stations and the medical student’s view of the OSCE. Method The study involved an OSCE with four stations performed by 16 medical students, psychometric quality analysis and the application of a user satisfaction questionnaire. Results For the students, the OSCE is the best assessment and teaching method for these skills, whereas multiple choice tests are at the worst form of assessment. Regarding the multiple quality of the stations, two showed good reliability, one became satisfactory following adjustment and one was inconsistent. Conclusion Although highly rated by the students some of the stations were flawed. Analysis of the OSCE is essential for its validity and measurability, especially for high stakes OSCEs.

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      Most cited references 31

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      Essential elements of communication in medical encounters: the Kalamazoo consensus statement.

       G Makoul (2001)
      In May 1999, 21 leaders and representatives from major medical education and professional organizations attended an invitational conference jointly sponsored by the Bayer Institute for Health Care Communication and the Fetzer INSTITUTE: The participants focused on delineating a coherent set of essential elements in physician-patient communication to: (1) facilitate the development, implementation, and evaluation of communication-oriented curricula in medical education and (2) inform the development of specific standards in this domain. Since the group included architects and representatives of five currently used models of doctor-patient communication, participants agreed that the goals might best be achieved through review and synthesis of the models. Presentations about the five models encompassed their research base, overarching views of the medical encounter, and current applications. All attendees participated in discussion of the models and common elements. Written proceedings generated during the conference were posted on an electronic listserv for review and comment by the entire group. A three-person writing committee synthesized suggestions, resolved questions, and posted a succession of drafts on a listserv. The current document was circulated to the entire group for final approval before it was submitted for publication. The group identified seven essential sets of communication tasks: (1) build the doctor-patient relationship; (2) open the discussion; (3) gather information; (4) understand the patient's perspective; (5) share information; (6) reach agreement on problems and plans; and (7) provide closure. These broadly supported elements provide a useful framework for communication-oriented curricula and standards.
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        Assessing communication competence: a review of current tools.

        The assessment of communication competence has become a major priority of medical educational, policy, and licensing organizations in the United States and Canada. Multiple tools are available to assess communication competence, but there are few studies that compare the tools. A consensus panel of six family medicine educators evaluated 15 instruments measuring the physician-patient interview. The primary evaluation criteria came from the Kalamazoo Consensus Statement (KCS), which derived from a multidisciplinary panel of experts that defined seven essential elements of physician-patient communication. We evaluated psychometric properties of the instruments and other assessment criteria felt to be important to family physicians (exploring family issues, interview efficiency, and usability/practicality). Instruments that received the highest ratings on KCS elements were designed for faculty raters and varied in their practicality/usability ratings and psychometric properties. Few instruments were rated high on psychometric properties or exploring family issues. The process successfully reviewed and provided a framework for assessing communication skills instruments. There is a need to expand the study, including use of a larger cohort of reviewers to provide more validity to the results and minimize potential biases.
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          Diretrizes curriculares nacionais do curso de graduação em medicina

           AM Roquete (2001)
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            Author and article information

            Affiliations
            [1 ] Pontifícia Universidade Católica do Paraná Brazil
            [2 ] Universidade do Porto Portugal
            Contributors
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Role: ND
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            Role: ND
            Journal
            rbem
            Revista Brasileira de Educação Médica
            Rev. bras. educ. med.
            Associação Brasileira de Educação Médica (Rio de Janeiro )
            1981-5271
            September 2015
            : 39
            : 3
            : 433-441
            S0100-55022015000300433
            10.1590/1981-52712015v39n3e02832014

            http://creativecommons.org/licenses/by/4.0/

            Product
            Product Information: SciELO Brazil
            Categories
            HEALTH CARE SCIENCES & SERVICES

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