Formative objective structured clinical examination with immediate feedback improves surgical clerks’ self-confidence and clinical competence

Abstract

Objective

Clerkship is crucial for fourth-year medical students before entering the clinical environment. However, lack of confidence impairs clerks’ performance during the clinical rotation. We assess the impact of formative Objective Structured Clinical Examination (OSCE) with immediate feedback on surgical clerks’ self-confidence and clinical competence.

Methods

This is a prospective randomized controlled study. Thirty-eight fourth-year medical students starting their surgical clerkship were randomly divided into the control group (n = 19) and the OSCE group (n = 19), where an extra 6-station formative OSCE was given prior to the surgical rotation with immediate feedback on the participant’s performance. Self-confidence assessment (SCA) was collected from each participant before, right after the formative OSCE and one month later. Clinical competence was assessed using a mini-clinical evaluation exercise (mini-CEX) with a case of acute abdominal pain and direct observation of procedural skills (DOPS) with incision and suture one month later.

Results

The SCAs were significantly improved in the OSCE group right after the training, and a month later, compared to the control group. The mini-CEX score was significantly higher in the OSCE group compared to the control group, but not the DOPS score of incision and suture.

Conclusion

The formative OSCE with immediate feedback could significantly enhance surgical clerks’ self-confidence and their clinical competence when taking the history, performing the physical examination, and in clinical reasoning; however, the formative OSCE did not improve their dexterity in performing the procedural skills.

Keywords:

• Clerkship
• formative OSCE
• immediate feedback
• self-confidence
• clinical competence

Disclosure statement

The authors declare that they have no conflict of interest.

Glossary

Formative OSCE: Are primarily learning tools that use the format of OSCE as an assessment while provide feedback to learners and guide future learning.

Additional information

Funding

This work was supported by the Zhejiang Provincial Natural Science Foundation of China (LQ20H160038) and Collaborative Education Project of Industry University Cooperation of the Ministry of Education (202102177006).

Notes on contributors

Peng Luo

Peng Luo, MD, is a senior fellow surgeon in the Department of General Surgery, at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang province, China. He obtained his MD from Zhejiang University.

Jiliang Shen

Jiliang Shen, MD, is senior fellow surgeon in the Department of General Surgery, at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang province, China. He obtained his MD from Zhejiang University.

Tunan Yu

Tunan Yu, MD, is an attending surgeon in the Department of General Surgery, at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang province, China. He obtained his MD from Zhejiang University.

Xiaochen Zhang

Xiaochen Zhang, MD, is a faculty in the Education Office, at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang province, China. She obtained her MD from Heilongjiang University of Chinese Medicine.

Bin Zheng

Bin Zheng, MD, PhD, is an associate professor in the Department of Surgery, Director of Surgical Simulation Research Lab, University of Alberta, Edmonton, Alberta, Canada. He obtained his MD from China Medical University, and PhD from Simon Fraser University, Canada.

Jin Yang

Jin Yang, MD, PhD, is an attending surgeon in the Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang province, China. She obtained her MD and PhD from Zhejiang University.