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      Students benefit from developing their own emergency medicine OSCE stations: a comparative study using the matched-pair method

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          Abstract

          Background

          Students can improve the learning process by developing their own multiple choice questions. If a similar effect occurred when creating OSCE (objective structured clinical examination) stations by themselves it could be beneficial to involve them in the development of OSCE stations. This study investigates the effect of students developing emergency medicine OSCE stations on their test performance.

          Method

          In the 2011/12 winter semester, an emergency medicine OSCE was held for the first time at the Faculty of Medicine at the University of Leipzig. When preparing for the OSCE, 13 students (the intervention group) developed and tested emergency medicine examination stations as a learning experience. Their subsequent OSCE performance was compared to that of 13 other students (the control group), who were parallelized in terms of age, gender, semester and level of previous knowledge using the matched-pair method. In addition, both groups were compared to 20 students who tested the OSCE prior to regular emergency medicine training (test OSCE group).

          Results

          There were no differences between the three groups regarding age (24.3 ± 2.6; 24.2 ± 3.4 and 24 ± 2.3 years) or previous knowledge (29.3 ± 3.4; 29.3 ± 3.2 and 28.9 ± 4.7 points in the multiple choice [MC] exam in emergency medicine). Merely the gender distribution differed (8 female and 5 male students in the intervention and control group vs. 3 males and 17 females in the test OSCE group).

          In the exam OSCE, participants in the intervention group scored 233.4 ± 6.3 points (mean ± SD) compared to 223.8 ± 9.2 points ( p < 0.01) in the control group. Cohen’s effect size was d = 1.24. The students of the test OSCE group scored 223.2 ± 13.4 points.

          Conclusions

          Students who actively develop OSCE stations when preparing for an emergency medicine OSCE achieve better exam results.

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          Most cited references9

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          Assessment of clinical competence using objective structured examination.

          To avoid many of the disadvantages of the traditional clinical examination we have introduced the structured clinical examination. In this students rotate round a series of stations in the hospital ward. At one station they are asked to carry out a procedure, such as take a history, undertake one aspect of physical examination, or interpret laboratory investigations in the light of a patient's problem, and at the next station they have to answer questions on the findings at the previous station and their interpretation. As they cannot go back to check on omissions multiple-choice questions have a minimal cueing effect. The students may be observed and scored at some stations by examiners using a check list. In the structured clinical examination the variables and complexity of the examination are more easily controlled, its aims can be more clearly defined, and more of the student's knowledge can be tested. The examination is more objective and a marking strategy can be decided in advance. The examination results in improved feed-back to students and staff.
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            Assessment of clinical competence using an objective structured clinical examination (OSCE).

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              A model of the pre-assessment learning effects of assessment is operational in an undergraduate clinical context

              Background No validated model exists to explain the learning effects of assessment, a problem when designing and researching assessment for learning. We recently developed a model explaining the pre-assessment learning effects of summative assessment in a theory teaching context. The challenge now is to validate this model. The purpose of this study was to explore whether the model was operational in a clinical context as a first step in this process. Methods Given the complexity of the model, we adopted a qualitative approach. Data from in-depth interviews with eighteen medical students were subject to content analysis. We utilised a code book developed previously using grounded theory. During analysis, we remained alert to data that might not conform to the coding framework and open to the possibility of deploying inductive coding. Ethical clearance and informed consent were obtained. Results The three components of the model i.e., assessment factors, mechanism factors and learning effects were all evident in the clinical context. Associations between these components could all be explained by the model. Interaction with preceptors was identified as a new subcomponent of assessment factors. The model could explain the interrelationships of the three facets of this subcomponent i.e., regular accountability, personal consequences and emotional valence of the learning environment, with previously described components of the model. Conclusions The model could be utilized to analyse and explain observations in an assessment context different to that from which it was derived. In the clinical setting, the (negative) influence of preceptors on student learning was particularly prominent. In this setting, learning effects resulted not only from the high-stakes nature of summative assessment but also from personal stakes, e.g. for esteem and agency. The results suggest that to influence student learning, consequences should accrue from assessment that are immediate, concrete and substantial. The model could have utility as a planning or diagnostic tool in practice and research settings.
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                Author and article information

                Contributors
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central
                1472-6920
                2013
                7 October 2013
                : 13
                : 138
                Affiliations
                [1 ]Department of Anaesthesiology and Intensive Care Medicine, University of Leipzig, Liebigstrasse 20, Leipzig 04103, Germany
                [2 ]Training Clinic of the Faculty of Medicine, University of Leipzig, Liebigstrasse 27, Leipzig 04103, Germany
                [3 ]Faculty of Health, University of Witten/Herdecke, Alfred-Herrhausen-Straße 50, Witten 58448, Germany
                [4 ]Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstrasse 20, Leipzig 04103, Germany
                [5 ]Department of Medical Education, Munich University Hospital, Ludwig-Maximilians-University Munich, Ziemssenstraße 1, Munich 80336, Germany
                Article
                1472-6920-13-138
                10.1186/1472-6920-13-138
                3852440
                24098996
                c8225309-46ab-42f9-a443-91784fed2885
                Copyright © 2013 Heinke et al.; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 November 2012
                : 4 October 2013
                Categories
                Research Article

                Education
                osce,emergency medicine,undergraduate education,assessment of training
                Education
                osce, emergency medicine, undergraduate education, assessment of training

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