Objective Structured Clinical Examination in Undergraduate Pharmacy Students: Time to Switching to an Alternative Exam for Clerkship Courses

Background: Significant changes in the clinical context of health professional education and impressive body of research on the measurement of clinical competence support the use of the Objective Structured Clinical Exam (OSCE) as the preferred means of performance-based assessment to current teaching and evaluation method. The objective of this paper is to describe how the OSCE method was developed and applied to an undergraduate community pharmacy clerkship course, as a pilot for assessing clinical competence and skills of these students. Methods: A seven-station OSCE was designed and implemented to assess the learning objectives of community pharmacy clerkship course(s) in the Pharmacy Doctorate program of pharmacy curriculum of the Isfahan University of Medical Sciences. The key process in designing and implementing the OSCE includes: development and face-validation of seven stations in accordance with our learning objectives of the course; designing of dichotomous performance checklists or suitable assessment instruments for individual stations; and conducting of the final examination. The broad competencies tested in the OSCE included: drug labeling, patient education and counseling, drug usage instruction, reading and evaluating prescriptions and use of drug information resources (electronic or hard copy texts) for determining probable drug interactions. Results: The students scored the highest marks in use of drug information resources for determining probable drug interactions (mean +/- SD: 5.6 +/- 0.68) and the lowest marks in drug usage instruction (mean +/- SD: 4.8 +/- 0.56). Most of the students (84%) found OSCE as an appealing and useful method of assessment. Conclusion: The assessment methods and educational objectives should be aligned with each other. Although OSCE is not commonly used in Iranian pharmacy schools, however, due to the practical nature of clerkship courses of the pharmacy doctorate program, OSCE seems to be a more suitable and relevant method to evaluate the community pharmacy clerkship course compared to conventional written exams.