Clinical Performance Clinical Trial
Official title:
Impact of Formative Objective Structured Clinical Examination (OSCE) on Students' Summative Clinical Performance: A Randomized Controlled Trial
Assessment is now seen as a learning experience. there is little literature on objective
structured clinical examination role for formative assessment especially in developing world
Many studies showed that formative-OSCE contributes positively to final summative examination
performance though most studies address this point through the students' perception toward
the formative-OSCE.
Having research that evaluates the effect of formative-OSCE introduction on a subsequent
summative-OSCE in randomised controlled design may be of benefit for institutions considering
the establishment of their own formative-OSCEs particularly in low resource countries.
Formative assessments are systematically designed instructional interventions to assess and
provide feedback on students' strengths and weaknesses in the course of teaching and learning
and educational experts recommend its use in addition to summative assessment. Moreover, it
is a requirement in undergraduate medical education and must be at the heart of student
training not just included to satisfy accreditation requirement, yet unlike other
professional training culture such as music in which feedback is expected, respected and
given regularly to all learners, the investigators haven't cultivated a true feedback culture
in medical education.
In a performance-based assessment, the Objective Structured Clinical Examination (OSCE) has
gained importance because of its reliability and could be in a summative or formative manner
to measure clinical competence. Clinical skills development requires time and practice at a
rate that can accelerated by feedback to optimize experiential learning and improve future
performance for which a learner should enter a reflection period during which available
feedback is examined.
There are some medical schools where formative assessments are institutionalized and carried
out systematically, unfortunately, this kind of assessment is not very frequent in
Mediterranean countries.
Undergraduate medical education in Iraq is currently going through a transitional period. The
Medical college of Hawler medical university (HMU) which provides a 6-year MBChB program, has
started the process of changing its curriculum to competency-based medical education (CBME)
and formative assessment is a requirement in this process. In the traditional curriculum
training in pediatric is introduced in 5th year with summative assessment composed of 50%
written test, 30% OSCE, 10% logbook, 10% history taking skills. Students should be competent
to record case history, examine children, make a provisional diagnosis, interpret
investigations and communicate with children and their families given that at the allotted
time end, students present the case findings and evaluated by the faculty. However, a faculty
member doesn't actively observe the students' actual performance of these skills or
competencies so the purpose of formative assessment is not fully met. Use of OSCE as
formative assessment can overcome this problem.
Attempts have been made in OSCE implementation for summative assessment, however,
formative-OSCEs introduction and evaluation in Iraqi medical colleges is lacking. Iraqi
medical schools are facing challenges in staff recruitment and adequate resource provision.
The latter is one of the numerous concerns and challenges to the CBME implementation.
Many studies showed that formative-OSCE contributes positively to final summative examination
performance though most studies address this point through the students' perception toward
the formative-OSCE.
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