Tuesday, March 8, 2011

OSCEs and distance students

I am currently considering the issues involved with working with distance midwifery students, especially in terms of assessment. I have the job of devising an Objective Structured Clinical Assessment (OSCA) exam (some people call them OSCEs). What I want to test is students' knowledge and how they integrate it into clinical practice; safety ie students understand the concepts of safe clinical practice, and communication skills.

Distance students
In the past I have managed these exams on campus. But at Griffith University we have quite a few distance midwifery students, so I am thinking about how we can manage the OSCAs so they are reliable and equitable, yet meet the needs of the distance students and possibly not require them to come onto campus.

I did think of video but that will be too time consuming for me to watch 40 odd videos. It isn't interactive so lecturers will be unable to give students just-in-time feedback that supports them to pass the OSCA.

Remote locations
The other option would be to run individual OSCAs in the students' home location, asking midwives in the local hospitals to do the assessment. It goes without saying that the midwives would receive training and support to carry out the assessment. However, I am concerned about reliability, equity and moderation...the more assessors involved with this form of exam, the greater the chance of inaccuracies. I am also concerned that midwives would find it very difficult to "fail" students.

I'd love to hear from any other health educators who face similar challenges - what would you advise me according to your personal experience? I'd also be interested in hearing from midwifery students - what do you think about OSCAs?

Or, should I be thinking of using other forms of assessment?

Image: 'untitled'


Anne Marie said...

It's interesting tobthink about distance students having clinical assessments. Who does their teaching?

Personally I think best to bring students to the centre. But it depends on how high stakes the exams are. You could use video for formative feedback but it might have some limitations.

Sarah Stewart said...

I agree with you, Anne-Marie...I'm thinking we'll have to bring them back to campus. But it does beg the question of how we manage OSCEs next year with students who live hours away from campus.

Jean Jacoby said...

This sounds like an amazing opportunity for a virtual assessment. With some clever planning and a good designer, you could assess clinical judgement and clinical skills, and, with any luck, even mark it automatically! I guess it would all depend on your budget.

Sarah Stewart said...

Jean...what were you thinking...any suggestions for me?

Sarah Stewart said...

Reply by email:

Sarah we do most of our OSCEs in the university at all levels. However we are moving back towards grading in practice to capture the clinical experience and put this towards degrees these are marked by the mentors and users. Moderated by us or the practice teachers.

Anonymous said...

I am doing OSCEs in a On-line Peds course with FNP students. These are all done with a paid trained actress posing as a caregiver of a infant or child. I currently have 3 scenerios designed as an episodic visit. The students call into a secure phone line and are instructed to consider this a clinic visit. Once they begn the interview it all seems very very real, even though they cannot "see" the actress. After the history is obtained they end and state they are going to examine the child which tells the actress the history is completed and she can debrief them. I listen to the interview and grade a SOAP note they generate from the experience. Thus far after doing well over 100 of these, it is a rich experience, well accepted, and I am transitioning to other courses. Further I am trying to use Skype with webcamera but that is not without its problems. For the distance learner this bumps up the learning process. I highly recommend it. I tell students 80% of the diagnosis comes from the history...learn to do one, and before you get to clinical. Preceptors have little time these days for students to be fumbling around with that. Judi Daniels

Sarah Stewart said...

Hi Judi

thanks so much for this...certainly given me food for thought. But about hands-on skills...how do you test them?

David LaPierre said...

This is a great discussion. What about using peer evaluation, using structured forms? Certainly this could be helpful for formative sessions, but if an evaluation is on the line, it gets trickier. Perhaps having a panel of peers, and averaging the results?

The key, I feel, is a well-designed evaluation tool. And honesty!

Sarah Stewart said...

I have to throw in some pragmatics as well, David. Setting up peer panels is going to be time-consuming. And there's still the problem of where/how students carry out the skills. It's not the who but the how that I am thinking about.

cheers Sarah