A peer-led mock OSCE improves subsequent performance: What about objectivity?

Dear Sir

The peer-led teaching of clinical skills is a popular research subject, with nine presentations specifically reporting on the topic at the recent AMEE Conference in Milan, 2014 (AMEE 2014). An increasingly common peer-led construct for improving students’ clinical skills is the mock-OSCE; a formative OSCE facilitated by near-peers that simulates the institution’s summative OSCE. There is some subjective evidence that a peer-led mock-OSCE prepares candidates for summative OSCEs, but little objective evidence that it improves subsequent OSCE performance (Young et al. 2014). Our group, an undergraduate medical education society, designed a study that attempts to address this previously unanswered question.

In 2013 we designed, wrote and co-ordinated the medical school’s first year 4 mock-OSCE, the subject of this study. We offered places on a first come, first serve basis 11 weeks before the summative OSCE in 2013. We provided each candidate with personalised written feedback as well as the marking schemes to use as reflection tools.

Multiple regression analysis demonstrated that there was a significant relationship between change in percentile rank between year 3 and year 4 (n = 145) and mock-OSCE (yes n = 63, no n = 82, p < 0.009) but no significant relationship with gender (male n = 61, female n = 84, p = 0.27) or intercalated degree status (yes n = 75, no n = 70, p = 0.80). Not randomising the candidates is indeed a possible entry point for selection bias, however, analysis of previous OSCE performance demonstrated an insignificant difference (Wilcox rank sum test, p = 0.11).

This work is, to the authors’ knowledge, the first attempt to objectively demonstrate improvement in OSCE-assessed clinical skill after a peer-led mock-OSCE. If demonstrated more robustly, it would advocate a peer-led mock OSCE as a viable educational avenue for teaching clinical skills that does not strain faculty resources. I would be very interested to read further articles objectively analysing the educational value of a peer-led mock-OSCE.

Declaration of interest: The authors report no conflicts of interest.