11. OSCE 創新學習與雲端大數據高峰論壇
PISA 國際學生能力評量計劃
PISA (the Programme for International Student Assessment)
PISA 2012 共有 65 個國家或地區參與,超過 51 萬名15 歲學生進行兩小時的紙
筆式評量。
閱讀、數學和科學三大素養
PISA 2012 results in focus: What 15-year-olds know and what they can do with what
they know. (2014). Retrieved from www.oecd.org/pisa
20. OSCE 創新學習與雲端大數據高峰論壇
Awaisu, A., Abd Rahman, N. S., Mohamed, M. H. N., Bux, S., & Nazar, N. I. M. (2010). Malaysian pharmacy students' assessment
of an objective structured clinical examination (OSCE). American Journal of Pharmaceutical Education, 74(2), 9.
the majority of the
respondents remained neutral
on many questions, thereby
limiting the generalizabilty of
the results
大多數藥學生 沒意見
21. OSCE 創新學習與雲端大數據高峰論壇
Problems with the OSCE rating system
OSCE的評分問題
OSCE depends on the raters’ impression of the performance of the students.
Even if the raters are well trained using a standardized method of assessment, there is
no format for presenting the raters’ assessments.
Kubota, Y., Yano, Y., Seki, S., Takada, K., Sakuma, M., Morimoto, T., . . . Hiraide, A. (2011). Assessment of pharmacy students' communication competence using the
roter interaction analysis system during objective structured clinical examinations. American Journal of Pharmaceutical Education, 75(3), 6.
22. OSCE 創新學習與雲端大數據高峰論壇
Malaysian pharmacy students‘ assessment of OSCE
馬來西亞藥學生對OSCE意見
A 13-station OSCE included: patient counseling and communication, clinical
pharmacokinetics (CPK), identification and resolution of drug-related problems (DRPs),
and literature evaluation/drug information provision.
A majority felt the tasks required in some stations required a higher degree of
learning than they had achieved.
Future efforts should include providing clearer instructions at OSCE stations and
balancing the complexity of the competencies assessed.
Awaisu, A., Abd Rahman, N. S., Mohamed, M. H. N., Bux, S., & Nazar, N. I. M. (2010). Malaysian pharmacy students' assessment
of an objective structured clinical examination (OSCE). American Journal of Pharmaceutical Education, 74(2), 9.
23. OSCE 創新學習與雲端大數據高峰論壇
OSCEs are costly, requiring significant
time, teaching staff, and space
OSCE很花錢 花時間 花人力 花空間
(Hussainy, Styles, & Duncan, 2012)
Hussainy, S. Y., Styles, K., & Duncan, G. (2012). A virtual practice environment to develop communication skills in
pharmacy students. American Journal of Pharmaceutical Education, 76(10), 8. doi:10.5688/ajpe7610202
24. OSCE 創新學習與雲端大數據高峰論壇
OSCE implementation: High-end and Low-end costs estimation.
OSCE的花費
The high-end costs were €145.23 per student (= NT $5000)
the low-end costs were €31.51 per student (= NT $1100)
Palese, A., Bulfone, G., Venturato, E., Urli, N., Bulfone, T., Zanini, A., . . . Dante, A. (2012). The
cost of the objective structured clinical examination on an Italian nursing bachelor's degree
course. Nurse Education Today, 32(4), 422-426. doi:10.1016/j.nedt.2011.03.003
25. OSCE 創新學習與雲端大數據高峰論壇
Strategies for reducing costs
如何減少花費
Creating a network of nursing bachelor's degree courses for swapping scenarios,
cases and clinical situations
Cooperating with Patient Associations to involve them as volunteers in the clinical
scenarios
Establishing links with hospitals to obtain space for conducting the OSCE
Palese, A., Bulfone, G., Venturato, E., Urli, N., Bulfone, T., Zanini, A., . . . Dante, A. (2012). The
cost of the objective structured clinical examination on an Italian nursing bachelor's degree
course. Nurse Education Today, 32(4), 422-426. doi:10.1016/j.nedt.2011.03.003
33. OSCE 創新學習與雲端大數據高峰論壇
Physical attractiveness on academic performance
外表對成績影響
Photographs of the student ID
Approval from the institution
Multiple raters (1-5)
The same 50 images for normalization
Google 大仁科大正妹
French, M. T., Robins, P. K., Homer, J. F., & Tapsell, L. M. (2009). Effects of physical
attractiveness, personality, and grooming on academic performance in high school. Labour
Economics, 16(4), 373-382.
34. OSCE 創新學習與雲端大數據高峰論壇
Grooming hasthe largest effect on GPAformale students,having a
very attractive personality is most importantfor female students.
乾淨對男生成績比較重要,魅力對女生成績比較重要
Personal appearance measures
Models
Males (N = 2487) Females (N = 2878)
A B C D E F G H
Very physically attractive 0.055 − 0.122* 0.080** − 0.047
Below average physical attractiveness − 0.146** − 0.005 − 0.114 − 0.044
Very attractive personality 0.145*** 0.081 0.173*** 0.145***
Below average personality attractiveness − 0.182** − 0.114 − 0.128* − 0.091
Very well groomed 0.263*** 0.274*** 0.163*** 0.114**
Below average grooming − 0.492*** − 0.468*** − 0.197* − 0.155
R squared 0.219 0.222 0.235 0.237 0.29 0.294 0.293 0.297
linear regression results for the effects of personal appearance on overall GPA
French, M. T., Robins, P. K., Homer, J. F., & Tapsell, L. M. (2009). Effects of physical attractiveness, personality, and grooming on
academic performance in high school. Labour Economics, 16(4), 373-382. doi:10.1016/j.labeco.2009.01.001
35. OSCE 創新學習與雲端大數據高峰論壇
More
Attractive female students earn higher grades than unattractive ones (Hernández-
Julián & Peters, 2015)
Rating of charisma and the display of an attractive photograph were both positively
associated with Teaching effectiveness ratings (Rannelli et al., 2014)
Scholars‘ physical appearance is significantly correlated with their research
performance (Dilger, Lutkenhoner, & Muller, 2015)
Lombarts, Kmjmh. (2014). A (good) look at the rating of teaching effectiveness: Towards holistic and programmatic assessment. Medical Education, 48(8), 744-747. doi:10.1111/medu.12491
Rannelli, L., Coderre, S., Paget, M., Woloschuk, W., Wright, B., & McLaughlin, K. (2014). How do medical students form impressions of the effectiveness of classroom teachers? Medical
Education, 48(8), 831-837. doi:10.1111/medu.12420
Hernández-Julián, Rey, & Peters, Christina. (2015). Student appearance and academic performance. Metropolitan State University of Denver.
36. OSCE 創新學習與雲端大數據高峰論壇
But
Attractiveness can be a disadvantage in some situations (Lombarts, 2014)
Disadvantaged when applying for military
Less may be expected of them
Appearance is significantly smaller for both male and female students in online course
environments (Hernández-Julián & Peters, 2015)
Scholars' research performance is especially correlated with perceived
trustworthiness (Dilger, Lutkenhoner, & Muller, 2015)
37. OSCE 創新學習與雲端大數據高峰論壇
Reliability and validity of OSCE
OSCE的信效度議題
Interrater reliability
Internal consistency
Test–retest reliability
Marking tools
Pass mark
Concurrent and predictive validity
Validity as ‘Real World’ assessment
Rushforth, H. E. (2007). Objective structured clinical examination (OSCE): Review of literature and implications for nursing
education. Nurse Education Today, 27(5), 481-490. doi:10.1016/j.nedt.2006.08.009
38. OSCE 創新學習與雲端大數據高峰論壇
Limitations of OSCEs
OSCE的限制
Since 2 parallel OSCEs were conducted, the training emphasized consistency in
grading between each pair of examiners to ensure the same scores were achieved by
a student.
However, no data were generated to support the sufficiency of this in ensuring the
validity and reliability of the examination.
Overall scores on the OSCE are often not very reliable
Awaisu, A., Abd Rahman, N. S., Mohamed, M. H. N., Bux, S., & Nazar, N. I. M. (2010). Malaysian pharmacy students' assessment
of an objective structured clinical examination (OSCE). American Journal of Pharmaceutical Education, 74(2), 9.
39. OSCE 創新學習與雲端大數據高峰論壇
It is more difficult to reliably assess
communication skills than clinical skills.
溝通能力比診斷能力難評量
Brannick, M. T., Erol-Korkmaz, H. T., & Prewett, M. (2011). A systematic review of the reliability of objective structured clinical
examination scores. Medical Education, 45(12), 1181-1189. doi:10.1111/j.1365-2923.2011.04075.x
40. OSCE 創新學習與雲端大數據高峰論壇
Assessment of pharmacy students’
communication competence
評量藥學生的溝通能力
The patient case used for the OSCE was that of a diabetic patient.
Interview to gather information regarding the patient’s medical history.
Each interview was limited to 5 minutes.
The 3 raters who evaluated the students, who were certified as official raters by the
Common Achievement Test Organization in Japan.
The raters used a 6-point global rating scale (6=the student’s performance did not
differ from that of a real pharmacist.)
Kubota, Y., Yano, Y., Seki, S., Takada, K., Sakuma, M., Morimoto, T., . . . Hiraide, A. (2011). Assessment of pharmacy students' communication competence using the
roter interaction analysis system during objective structured clinical examinations. American Journal of Pharmaceutical Education, 75(3), 6.
41. OSCE 創新學習與雲端大數據高峰論壇
Roter Interaction Analysis System (RIAS): A method for coding medical dialogue
Kubota, Y., Yano, Y., Seki, S., Takada, K., Sakuma, M., Morimoto, T., . . . Hiraide, A. (2011). Assessment of pharmacy students' communication competence using the
roter interaction analysis system during objective structured clinical examinations. American Journal of Pharmaceutical Education, 75(3), 6.
42. OSCE 創新學習與雲端大數據高峰論壇
Figure 2. Relationship between the students’ global rating
score and number of utterances in the business category
(R = 0.4305; P = 0.1092)
Figure 1. Relationship between the students’ global rating sc
and number of utterances in the socio-emotional category
(R= 0.662; P < 0.01).
A good interview in the OSCE has been defined as one consisting of a numerous
variety of utterances, especially in the socio-emotional category.
跟社會情感有關的對話越多,OSCE成績越高.
Kubota, Y., Yano, Y., Seki, S., Takada, K., Sakuma, M., Morimoto, T., . . . Hiraide, A. (2011). Assessment of pharmacy students' communication competence using the
roter interaction analysis system during objective structured clinical examinations. American Journal of Pharmaceutical Education, 75(3), 6.
46. OSCE 創新學習與雲端大數據高峰論壇
Robots that can adapt like animals
機器人像動物一樣適應
Cully, Antoine, Clune, Jeff, Tarapore, Danesh, & Mouret, Jean-Baptiste. (2015). Robots that can adapt like animals. Nature, 521(7553), 503-U476. doi:10.1038/nature14422
Using the Intelligent Trial
and Error algorithm, robots,
like animals, can quickly
adapt to recover from
damage.
56. OSCE 創新學習與雲端大數據高峰論壇
模擬藥局
Students had to imagine patients’ characteristics and
could not observe important aspects, such as body language, which help a pharmacist
appropriately communicate with a patient.
Hussainy, S. Y., Styles, K., & Duncan, G. (2012). A virtual practice environment to develop communication skills in
pharmacy students. American Journal of Pharmaceutical Education, 76(10), 8. doi:10.5688/ajpe7610202
57. OSCE 創新學習與雲端大數據高峰論壇
A virtual practice environment
Figure 2. Example of how a case was presented to students in the Communication and Counseling Tutorials
Hussainy, S. Y., Styles, K., & Duncan, G. (2012). A virtual practice environment to develop communication skills in
pharmacy students. American Journal of Pharmaceutical Education, 76(10), 8. doi:10.5688/ajpe7610202
58. OSCE 創新學習與雲端大數據高峰論壇
Scenario-based simulation course training on
nurses‘ communication competence
以模擬課程訓練護生溝通技巧
Compare the effect of a traditional course versus scenario-based simulation training
on
nurses' communication competency,
communication self-efficacy, and
communication performance in discharge planning OSCE.
Hsu, L. L., Chang, W. H., & Hsieh, S. I. (2015). The effects of scenario-based simulation course training on nurses' communication competence and
self-efficacy: A randomized controlled trial. Journal of Professional Nursing, 31(1), 37-49. doi:10.1016/j.profnurs.2014.05.007
59. OSCE 創新學習與雲端大數據高峰論壇 Table 2. Study Protocol for the Two Groups
Hsu, L. L., Chang, W. H., & Hsieh, S. I. (2015). The effects of scenario-based simulation course training on nurses' communication competence and
self-efficacy: A randomized controlled trial. Journal of Professional Nursing, 31(1), 37-49. doi:10.1016/j.profnurs.2014.05.007
60. OSCE 創新學習與雲端大數據高峰論壇
Hsu, L. L., Chang, W. H., & Hsieh, S. I. (2015). The effects of scenario-based simulation course training on nurses' communication competence and
self-efficacy: A randomized controlled trial. Journal of Professional Nursing, 31(1), 37-49. doi:10.1016/j.profnurs.2014.05.007
61. OSCE 創新學習與雲端大數據高峰論壇
Hsu, L. L., Chang, W. H., & Hsieh, S. I. (2015). The effects of scenario-based simulation course training on nurses' communication competence and
self-efficacy: A randomized controlled trial. Journal of Professional Nursing, 31(1), 37-49. doi:10.1016/j.profnurs.2014.05.007
Table 5. Between-Subjects Effects of the Communication Training Course on the Communication Competence
and Self-Efficacy at the First Posttest (N = 116)
Table 6. Between-Subjects Effects of the Communication Training Course on the Learning Satisfaction and Communication
Performance at the First or Second Posttest (N = 116 at T2 and n = 78 at T3)
62. OSCE 創新學習與雲端大數據高峰論壇
Empathy is related to OSCE scores
同理心跟OSCE分數有關
Ogle, J., Bushnell, J. A., & Caputi, P. (2013). Empathy is related to clinical competence in medical care. Medical Education,
47(8), 824-831. doi:10.1111/medu.12232
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7
not at all a lot
(1) Did the physician provide the opportunity for the patient to give his/her opinion?
(2) Did the physician treat the patient as an equal partner?
(3) Did the physician show understanding of the patient’s point of view?
(4) Did the physician try to put him/herself in the position of the patient?
(5) Did the physician show interest in the patient’s opinion?
(6) Did the physician put the patient under pressure?
(7) Did the physician "preach"?
(8) Did the physician admonish the patient?
(9) Was the physician responsive to the patient?
66. OSCE 創新學習與雲端大數據高峰論壇
Emotion recognition with the facial
expression software
用表情辨識軟體辨識情緒
Students’ emotional states from the recorded clips were recognized by using
FaceReader facial expression software
(http://www.noldus.com/facereader/facereader-online).
The method for indicating whether the emotional status of the subject is positive or
negative is based on a valence value.
The valence indicates whether the facial expressions are positive or negative
67. OSCE 創新學習與雲端大數據高峰論壇
Emotional states of the clips
Figure 4. The valences of an example clip indicating the generally negative emotion of a student
N
Valence
Mean SD 95% CI to mean
24 -0.07 0.14 -0.13 to -0.01
Table 7. Valence mean scores, standard deviations
70. OSCE 創新學習與雲端大數據高峰論壇
Reliable differences in sensor features
characterizing low vs. high creativity students
高低創造力成績的差異The low creativity students had
– marginally fewer total fixations
– significantly shorter total saccade path length
– significantly lower average saccade speed
– marginally lower saccade speed standard deviation
– marginally more short term excitement
– marginally greater standard deviation of frustration
Classifier TPR FPR F-measure
Rule Nnge 85.7 21.4 85.4
Naive bayes – simple 76.2 33.3 75.7
True Positive Rate, higher is better.
False Positive Rate, lower is better.
77. OSCE 創新學習與雲端大數據高峰論壇
The GAP, silver, and unsolved times significantly relate to the
PMP and the physics posttest scores for low performers
遊戲測毅力對低成就比較有用
PMP GAP Unsolved Silver Gold Enjoy Self-p
GAP .51**
Unsolved .47** .96**
Silver .42** .81** .62**
Gold .00 .22 .14 .32**
Enjoy .23 .08 .02 .18 .06
Self P .10 −.01 −.01 .00 .03 −.05
Physics post test .30* .33** .31* .29* .08 .18 .15
Correlations for 70 low performers in Newton’s Playground.
GAP = unsolved and silver times; unsolved = unsolved time; silver = silver time; gold = gold time;
enjoy = I enjoyed playing NP; self P = self-report measure of persistence.
78. OSCE 創新學習與雲端大數據高峰論壇
The GAP relates much lower to the PMP for high performers
versus low performers
遊戲測毅力對高成就比較沒用
PMP GAP Unsolved Silver Gold Enjoy Self-p
GAP .22
*
Unsolved .12 .94
**
Silver .31
**
.84
**
.60
**
Gold .12 .30
**
.36
**
.11
Enjoy .10 .11 .11 .09 −.03
Self P .09 −.06 −.05 −.05 −.13 .07
Physics post
test
.16 .02 .01 .04 −.21 .15 .15
Correlations for 84 high performers in Newton’s Playground.
GAP = unsolved and silver times; unsolved = unsolved time; silver = silver time; gold = gold time;
enjoy = I enjoyed playing NP; self P = self-report measure of persistence.
81. OSCE 創新學習與雲端大數據高峰論壇
Upload knowledge to your brain
記憶吐司
穿顱直流電刺激tDCS
Working memory is linked primarily
with brain activity in the
dorsolateral prefrontal cortex
(DLPFC)
Skill acquisition and procedural
learning is linked primarily with
brain activity in primary motor
cortex (M1)
Choe, Jaehoon, Coffman, Brian A, Bergstedt, Dylan T, Ziegler, Matthias, & Phillips, Matthew E. (2016).
Transcranial direct current stimulation modulates neuronal activity and learning in pilot training. Frontiers in
Human Neuroscience, 10, 25. doi:10.3389/fnhum.2016.00034
82. OSCE 創新學習與雲端大數據高峰論壇
Flight path deviation between subjects and autopilot
有刺激比較能控制
Choe, Jaehoon, Coffman, Brian A, Bergstedt, Dylan T, Ziegler, Matthias, & Phillips, Matthew E. (2016). Transcranial direct current stimulation modulates neuronal
activity and learning in pilot training. Frontiers in Human Neuroscience, 10, 25. doi:10.3389/fnhum.2016.00034
84. OSCE 創新學習與雲端大數據高峰論壇
OSCE很有壓力
Majority of the students stated that the OSCE was very stressful (75.5%) and more
than half of them found the exam more stressful than the other exams (51.1%).(Selim,
Ramadan, El-Gueneidy, & Gaafer, 2012)
An OSCE could then be seen as limiting for students who lack verbal skills as well as
for those who are unable to overcome nerves during a stressful event.(Baid, 2011)
OSCE might hinder their performance as a result of the stress of being assessed in a
simulated environment (Hemingway, Stephenson, Roberts, & McCann, 2014)
The OSCE was seen as stressful to students (Bouchoucha, Wikander, & Wilkin, 2013)
85. OSCE 創新學習與雲端大數據高峰論壇
造成壓力的原因
Students' stress and anxiety are related to the new experience with OSCE
Students were stressed by the lack of enough time to deal with the scenario in some
stations.
Selim, A. A., Ramadan, F. H., El-Gueneidy, M. M., & Gaafer, M. M. (2012). Using Objective Structured Clinical Examination (OSCE) in undergraduate
psychiatric nursing education: Is it reliable and valid? Nurse Education Today, 32(3), 283-288. doi:10.1016/j.nedt.2011.04.006
87. OSCE 創新學習與雲端大數據高峰論壇
危機同時也是轉機
An opportunity for students to develop skills in presenting information to others and
managing stressful clinical situations which are essential aspects of intensive care
nursing practice.
Learning to manage anxiety during an OSCE may actually help overall performance of
clinical skills in practice (Byrne & Smyth, 2008)
Baid, H. (2011). The objective structured clinical examination within intensive care nursing
education. Nursing in Critical Care, 16(2), 99-105. doi:10.1111/j.1478-5153.2010.00396.x
88. OSCE 創新學習與雲端大數據高峰論壇
如何設計可提升正向情感的測驗回饋?
Liu, Chia-Ju, Huang, Chin-Fei, Liu, Ming-Chi, Chien, Yu-Cheng, Lai, Chia-Hung, & Huang, Yueh-Min*. (2015).
Does gender influence emotions resulting from positive applause feedback in self-assessment testing?
Evidence from neuroscience. Educational Technology & Society, 18(1), 337-350.
90. OSCE 創新學習與雲端大數據高峰論壇
Two tests
the controlled task the experimental task
30 students (15 males, 15 females; mean age ± S.D. = 19.2 ± 2.0 years) participated in this experiment.
97. OSCE 創新學習與雲端大數據高峰論壇
A correlation of 0.85 was obtained
A comparison of model estimates for the mid-Atlantic region (black) against Disease Control and Prevention (CDC)-
reported influenza-like illness ILI percentages (red), including points over which the model was fit and validated.
Ginsberg, J., Mohebbi, M. H., Patel, R. S., Brammer, L., Smolinski, M. S., & Brilliant, L. (2009). Detecting
influenza epidemics using search engine query data. Nature, 457(7232), 1012-U1014.
98. OSCE 創新學習與雲端大數據高峰論壇
Google Flu Trends 的成功
1. Data 分析能夠創造神奇般準確的結果。
2. 每一個 Data 都能不被遺漏,使得舊有的統計抽樣方法過時。
3. 不用再煩惱 Data 間的因果關係,因為統計的相關性會告訴我們我們想要的資
訊,科學的或是統計的模型不再需要,因為套一句 2008 年在 Wired 發表的論文
《 The End of Theory 》裡的話:「有了足夠的資料,數字會自己說話」。
Big data- are we making a big mistake
http://buzzorange.com/techorange/2014/06/04/big-data-making-big-mistake/