Perceptions of postgraduate trainees on the impact of objective structured clinical examinations on their study behavior and clinical practice

Abstract

Background

The objective structured clinical examination (OSCE) is a commonly used method of assessing clinical competence at various levels, including at the postgraduate level. How the OSCE impacts on learning in higher education is poorly described. In this study, we evaluated the perceptions of postgraduate trainees regarding the impact of the OSCE on their study and clinical behavior.

Methods

We employed an explorative qualitative research design by conducting focus group discussions with 41 pediatric postgraduate trainees at the College of Health Science, Makerere University. A semi-structured tool was used to obtain the views and experiences of the trainees. Transcripts from the discussion were analyzed in an iterative manner using thematic content analysis.

Results

The trainees reported the OSCEs as a fair and appropriate tool for assessing clinical competency at the postgraduate level. However, they noted that whereas OSCEs assess a broad range of skills and competencies relevant to their training, there were areas that they did not adequately assess. In particular, OSCEs did not adequately assess in-depth clinical knowledge or detailed history-taking skills. Overall, the majority of the trainees reported that the OSCEs inspired them to study widely and improve their procedural and communication skills.

Conclusion

OSCEs are a useful tool for assessing clinical competencies in postgraduate education. However, the perceived limitations in their ability to assess complex skills raises concerns about their use as a standalone mode of assessment at the postgraduate level. Future studies should evaluate how use of OSCEs in combination with other assessment tools impacts on learning.

Keywords:

• objective structured clinical examination
• assessment
• higher education
• perceptions
• clinical practice
• study
• learning behavior

Supplementary materials

Focus group discussion guide

Introduction

Assessment drives learning – both desirable and undesirable learning strategies. The OSCE is the commonly acceptable method used for assessing clinical competencies. The aim of this study is to explore what impact the OSCE as a method of assessment has on your day-to-day study and clinical behavior.

Table

Acknowledgments

We thank all the senior house officers from the Department of Paediatrics and Child Health, Makerere University, who participated and freely shared their views and experiences with us. We acknowledge the contributions of Mabel Mayende and Carol Akullu in assisting with the focus group work as well as those of Jolly Nankunda and Joseph Rujumba for useful suggestions to improve this research. A summary of this work was presented at a medical education conference in Kampala in June 2014. The study was supported in part by a MEPI grant (5R24TW008886) awarded to a consortium of Ugandan Medical Schools (MESAU).

Author contributions

ROO, SK, MG, and ED were involved in the design of this study. ROO wrote the first draft of the paper. ASS conducted the focus group discussions. All authors contributed toward data analysis, revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.