Impact of integrating objective structured clinical examination into academic student assessment: Large-scale experience in a French medical school

被引：16

作者：

Matet, Alexandre ^{[1
,2
,3
]}

Fournel, Ludovic ^{[1
,4
,5
]}

Gaillard, Francois ^{[6
]}

Amar, Laurence ^{[1
,7
,8
]}

Arlet, Jean-Benoit ^{[1
,9
]}

Baron, Stephanie ^{[1
,6
]}

Bats, Anne-Sophie ^{[1
,10
,11
]}

Buffel du Vaure, Celine ^{[12
]}

Charlier, Caroline ^{[1
,13
,14
]}

De Lastours, Victoire ^{[1
,15
,16
]}

Faye, Albert ^{[1
,17
]}

Jablon, Eve ^{[18
]}

Kadlub, Natacha ^{[1
,19
]}

Leguen, Julien ^{[1
,20
]}

Lebeaux, David ^{[1
,21
]}

Malmartel, Alexandre ^{[12
]}

Mirault, Tristan ^{[1
,7
,8
]}

Planquette, Benjamin ^{[1
,22
,23
]}

Regent, Alexis ^{[1
,24
,25
]}

Thebault, Jean-Laurent ^{[12
]}

Dinh, Alexy Tran ^{[1
,26
,27
]}

Nuzzo, Alexandre ^{[1
,28
]}

Turc, Guillaume ^{[1
,29
,30
]}

Friedlander, Gerard ^{[1
,6
,31
]}

Ruszniewski, Philippe ^{[1
,29
,32
]}

Badoual, Cecile ^{[1
,7
,33
]}

Ranque, Brigitte ^{[1
,7
,9
]}

Oualha, Mehdi ^{[1
,34
,35
]}

Courbebaisse, Marie ^{[1
,6
,31
]}

机构：

[1] Univ Paris, Fac Med, Paris, France

[2] INSERM, Ctr Rech Cordeliers, UMR1138, Paris, France

[3] Inst Curie, Serv Ophtalmol, Paris, France

[4] INSERM, UMR1124, Paris, France

[5] Hop Cochin, AP HP, Serv Chirurg Thorac, Paris, France

[6] Hop Europe Georges Pompidou, AP HP, Dept Physiol, Paris, France

[7] INSERM, PARCC, U970, Paris, France

[8] Hop Europe Georges Pompidou, AP HP, Dept Hypertens Arterielle, Paris, France

[9] Hop Europe Georges Pompidou, AP HP, Serv Med Interne, Paris, France

[10] INSERM, UMR S 1147, Paris, France

[11] Hop Europe Georges Pompidou, AP HP, Serv Gynecol Oncol & Chirurg Sein, Paris, France

[12] Univ Paris, Fac Med, Dept Med Gen, Paris, France

[13] INSERM, Inst Pasteur, U1117, Paris, France

[14] Hop Univ Necker, AP HP, Dept Malad Infect & Trop, Paris, France

[15] INSERM, IAME, UMR1137, Paris, France

[16] Hop Beaujon, AP HP, Serv Med Interne, Clichy, France

[17] Hop Robert Debre, Serv Pediat Gen, INSERM, ECEVE 1123, Paris, France

[18] Univ Paris, Fac Med, Serv AGIR, Paris, France

[19] Hop Univ Necker, AP HP, Dept Chirurg Maxillofaciale & Chirurg Plast, Paris, France

[20] Hop Europe Georges Pompidou, AP HP, Serv Geriatr, Paris, France

[21] Hop Europe Georges Pompidou, AP HP, Dept Microbiol, Paris, France

[22] INSERM, UMR S1140, Paris, France

[23] Hop Europe Georges Pompidou, AH HP, Serv Pneumol & Soins Intensifs, Paris, France

[24] CNRS, Inst Cochin, INSERM, LabEx INFLAMEX,U1016,UMR 8104, Paris, France

[25] Hop Cochin, AP HP, Ctr Reference Malad Syst Auto Immunes Rares Ile D, Serv Med Interne, Paris, France

[26] INSERM, LVTS, U1148, Villetanneuse, France

[27] Hop Bichat Claude Bernard, AP HP, Dept Anesthesie Reanimat, Paris, France

[28] Hop Beaujon, AP HP, Serv Gastroenterol & Pancreatol, Paris, France

[29] INSERM, U1266, Paris, France

[30] Hop St Anne, AH HP, Serv Neurol, Paris, France

[31] CNRS, INSERM, Inst Necker Enfants Malades, U1151,UMR8253, Paris, France

[32] INSERM, UMR1149, Paris, France

[33] Hop Europe Georges Pompidou, AP HP, Serv Anatomopathol, Paris, France

[34] Univ Paris, Fac Med, Unite EA7323, Paris, France

[35] Hop Univ Necker, AP HP, Serv Reanimat & Surveillance Continue Medicochiru, Paris, France

来源：

PLOS ONE | 2021年 / 16卷 / 01期

关键词：

EXAMINATION OSCE; EDUCATION; SKILLS; RELIABILITY; PERFORMANCE; EXAMINERS; FEEDBACK; SCORES;

D O I：

10.1371/journal.pone.0245439

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Purpose 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.

引用

页数：17

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