The document discusses Objective Structured Clinical Examination (OSCE) which is used to assess clinical competence of students. It involves students demonstrating skills at various stations using standardized patients. The document outlines the history, purpose, planning and administration of OSCEs. It notes the method was developed in the 1970s and is now widely used globally to evaluate skills like history taking, physical exams, and procedures in an objective structured manner.
Define objective structured clinical/ practical examination
Identify the ways in which OSCE/ OSPE differs from conventional practical examination
Realize the circumstances that necessitated introduction of OSCE/ OSPE
Identify the Advantages and Disadvantages of OSCE/OSPE
Plan and organize the conduction of an OSCE/ OSPE
Define objective structured clinical/ practical examination
Identify the ways in which OSCE/ OSPE differs from conventional practical examination
Realize the circumstances that necessitated introduction of OSCE/ OSPE
Identify the Advantages and Disadvantages of OSCE/OSPE
Plan and organize the conduction of an OSCE/ OSPE
This is my latest PPT on the Principles of student assessment in medical education which is illustrated with suitable pictures, diagrams for understanding better..
These are the assessment tools in which the components of clinical and practical competencies are tested in simulated environment using agreed check list or rating scale and students rotate round a number of stations some of which have observers with check list.
Assessment in CBME Competency Based Medical Education Dr Girish .B CISP 2 MCIDr Girish B
Assessment in CBME Competency Based Medical Education by Dr Girish .B, Associate Professor, Department of Community Medicine, Chamarajanagar Institute of Medical Sciences (CIMS), Chamarajanagar, Karnataka
clinical teaching methods
purposes
principles
models of clinical teaching methods
adult learning
types of learning
types of clinical teaching methods and their advantages and disadvantages
methods of teaching
Indian citizens possessing foreign nursing qualification are examined individually & after examination the syllabi and conformation from concerned foreign authorities, the nurses are granted approval for registration in India with the recommendation of equivalence committee under Section 11(2)(a) INC Act. 1947.
This Presentation is on Effective clinical ,practical skill teaching . When it comes to MBBS Students we rely on our traditional teaching methods. i have tried to include new teaching methodologies to make teaching effective
This is my latest PPT on the Principles of student assessment in medical education which is illustrated with suitable pictures, diagrams for understanding better..
These are the assessment tools in which the components of clinical and practical competencies are tested in simulated environment using agreed check list or rating scale and students rotate round a number of stations some of which have observers with check list.
Assessment in CBME Competency Based Medical Education Dr Girish .B CISP 2 MCIDr Girish B
Assessment in CBME Competency Based Medical Education by Dr Girish .B, Associate Professor, Department of Community Medicine, Chamarajanagar Institute of Medical Sciences (CIMS), Chamarajanagar, Karnataka
clinical teaching methods
purposes
principles
models of clinical teaching methods
adult learning
types of learning
types of clinical teaching methods and their advantages and disadvantages
methods of teaching
Indian citizens possessing foreign nursing qualification are examined individually & after examination the syllabi and conformation from concerned foreign authorities, the nurses are granted approval for registration in India with the recommendation of equivalence committee under Section 11(2)(a) INC Act. 1947.
This Presentation is on Effective clinical ,practical skill teaching . When it comes to MBBS Students we rely on our traditional teaching methods. i have tried to include new teaching methodologies to make teaching effective
Nilofar Loladiya
MSN OBG
Simulation has been used widely in the clinical training of health-care students and
professionals. It is a valuable strategy for teaching, learning and evaluating clinical skills
at different levels of nursing and midwifery education: undergraduate, postgraduate and
lifelong education (Park et al., 2016; Martins, 2017).
Simulation has a positive impact on students, educators, and the individuals, groups
and communities they care for, as well as on education and health organizations. The
principal aims of simulation as a teaching method are to improve quality of care and
ensure patient safety.
The WHO document Transforming and scaling up health professionals’ education and training (WHO,
2013) strongly recommends the use of simulation. Recommendation 5 states:
Health professionals’ education and training institutions should use simulation methods
(high fidelity methods in settings with appropriate resources and lower fidelity methods in
resource limited settings) of contextually appropriate fidelity levels in the education of health
professionals.
A large proportion of nursing and midwifery education curricula worldwide is dedicated
to the acquisition of clinical skills. At the beginning of the learning period in clinical
settings, students should be able to develop safe and timely evidence-based interventions
without being interrupted by supervisors due to technical errors that may jeopardize
patients’ and students’ safety. In clinical practice with actual patients, students should
be self-confident and feel that others trust them; they should feel capable of performing
tasks without errors and be confident that the supervisor and other team members
believe in their abilities.
From an ethical perspective, invasive procedures should not be taught or practised on
real people; instead, trainees should be able to train in simulated, controlled and safe
environments, allowing them to make errors and learn from them with no harmful
consequences to any person. This ensures absolute respect for human rights by protecting
patients’ dignity and guarantees the quality of nursing care, even during health
professionals’ learning processes.
OSCE is an approach to the assessment of clinical competence in which the components of competence are assessed in a planned and structured way, with attention being paid to the objectivity of the examination (HARDEN 1988)
OSCE is an assessment tool in which the components of clinical competence such as history taking, physical examination, simple procedures, interpretation of lab results, patient management problems, communication, attitude etc. are tested using agreed check lists and rotating the student round a number of stations some which have observers with checklists.
objectivity - state in which something is based only on facts and evidence.not influenced by personal feelings or opinions in considering and representing facts.
Standardisation - a level of consistency or uniformity to certain practices or operations within the selected environment. develop and maintain uniformity
Marking scheme for each station is structured and determined in advance.
Each station is manned by one or two examiners to assess the candidate's performance of the required task and award marks based on predetermined and documented criteria called checklists (marking guides).
Candidates rotate through the stations,completing all the stations on their circuit.
All the candidates take the same stations and are assessed on same tasks
Best OSCE stations are created from real clinical scenarios
Miller’s pyramid model divides the development of clinical competence into four, hierarchical processes.1 On the lowest level of the pyramid is ‘knowledge’, tested by written exams and traditional multiple-choice questions (MCQs)
.2 The next level stands for ‘application of knowledge’, assessed by essays, clinical problem-solving exercises and extended MCQs.
3 The third tier of the pyramid represents ‘clinical skills competency’, assessed by standardized patient exercises, simulations and clinical exams.
2 Finally, on top of the pyramid is ‘clinical performance’, assessed by direct observation in real clinical settings.2
The lower level processes account for the cognitive components of competence and involve classroom-based assessments, while the two higher tiers of the pyramid account for the behavioural components of clinical competence, which involve assessment in simulated and real clinical settings.
Heart muscle disease, is a type of progressive heart disease in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart muscle's ability to pump blood is less efficient, often causing heart failure and the backup of blood into the lungs or rest of the body.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
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Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
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CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
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2. • Objective – Examiners use a checklist for evaluating the trainees.
• Structured – Trainee sees the same problem and perform the same
tasks in the same time frame.
• Clinical – the task are representative of those faced in real critical
situations.
2
3. The Objective Structured Clinical Examination (OSCE) is
an assessment method based on a student's performance that
measure their clinical competence.
3
4. Definition
• OSCE is a form of performance – based testing used to measure
candidate’s clinical competence.
• During OSCE, candidate observed and evaluated as they go through a
series of stations in which they interview, examine and treat
standardized patients who present with some type of medical
problems.
4
6. Standardized patients are individuals who have been trained to
exhibit certain signs and symptoms of specific conditions under certain
testing conditions.
Most OSCEs use "standardized patients (SP)" for accomplishing
clinical history, examination and counselling sessions.
Standardized patients may be professionally trained actors, volunteer
simulators.
6
7. Introduced in 1963 by Barrows and Abrahamson, the
term SP is “the umbrella term for both a simulated patient (a well
person trained to simulate a patient's illness in a standardized way)
and an actual patient (who is trained to present his or her own illness in
a standardized way)” (Barrows, 1993, p. 443).
7
8. OSCE is a modern type of examination often used in health
sciences ( medicine, dentistry, nursing, pharmacy and physiotherapy) to
assess clinical skill performance and competence in skill such as
communication, clinical examination, medical and nursing
procedures, exercise, manipulation techniques and interpretation of
results.
8
9. “The OSCE is an approach to the assessment of
clinical competence in which the components of competence
are assessed in a planned or structured way with attention
being paid to the objectivity of the examination.”
- Ronald Harden.
9
10. History of OSCE
• OSCE was developed in University of Dundee (Scotland) in the early
1975 by Dr.Harden and his colleagues.
• After some modification it was described in detail on 1979.
• This method was the subject of an international conference in OTawa
in 1985 and experience were exchanged about OSCE & OSPE.
• Globally using now.
10
11. When to conduct the OSCE?
• Entry level
• Formative assessment
• Summative assessment
• Job interview
11
13. Features of the Objective Structured Clinical Examination (OSCEs)
•Stations are short
•Stations are numerous
•Stations are highly focused
•Candidates are given very specific instructions
•A pre-set structured mark scheme is used
•Reduced examiner input and discretion
13
16. Complex stations for
postgraduate student could test
varying skills including management
problems, administrative skills,
handling unpredictable patient behavior
and data interpretation. These
assessments and many others are
impossible in traditional clinical
examination.
16
17. OSCE in nursing
The OSCE is designed to assess ability to competently apply
professional nursing or midwifery skills and knowledge. It is set at the
level expected of nurses and midwives as they enter the profession (at
the point of registration).
17
18. Purpose of the OSCE
Measure clinical skills
Match assessment to intended constructs
Promote structured interaction between student and examiner
Make structured marking scheme possible
Present all candidates with the same test
Promote objectivity.
18
19. Uses of OSCE
Generally, the following range of practical skills are typically assessed in
nursing using OSCE,
Interpersonal and communication skills
History taking skills
Physical examination of specific body systems
Mental health assessment
Clinical decision making, including the formation of differential diagnosis.
19
20. Contd.,
• Clinical problem – solving skills
• Interpretation of clinical finding and investigations
• Management of a clinical situation, including treatment and referral
• Patient education
• Health promotion
• Acting safely and appropriately in an urgent clinical situation
• Basic and advanced nursing care procedure practices.
20
36. Day before exam
Setting station
Sign boards
Communication/debriefing with all team members
Debriefing to students
Ensuring entire plan in place
A dummy run
36
37. On the Day of exam
Ensuring stations
Ensure confidentiality
Training simulated patient
Debriefing to team
Debriefing to students
Managing student flow
37
41. A 54-year-old heavy smoker with a 20-year history of COPD, confirmed by spirometry, and previous
gastric ulcer presented to the emergency room with mild mid-epigastric pain, nausea and vomiting evolving
over 3 days.
He reported taking a traditional herbal tea made of Retama (approximately 1000 mL) which caused
subsequent symptom deterioration and acute confusion.
On examination, the patient had no fever and was confused with a Glasgow coma score of 13/15.
His abdomen was soft. The remainder of the physical examination was unremarkable. Chest X-ray, ECG, CT
brain scan and laboratory blood tests were normal. Arterial blood gas (ABG) analysis on room air disclosed
severe respiratory acidosis with hypercapnia and high bicarbonate level (pH=7.14,
pCO2=11 kPa, =36 mmol/L) as well as severe hypoxaemia (paO2=5.4 kPa).
Subsequently, because of a rapid deterioration of the level of consciousness, as assessed by a fall in
Glasgow coma score (GCS) to 6/15, the patient required intubation, sedation and mechanical ventilation. His
blood pressure and pulse fell substantially soon after he was placed on the ventilator.
41
42. Positive aspects of OSCE stations
Simulated OSCE stations
They are controlled and safe (BLS)
Feedback from modern sophisticated
simulators can be obtained.
Simulators are readily available
within required.
Simulated stations can be tailored to
the level of skill to be assessed.
Real life OSCE stations
It provide actual competence of a
person on performance because
idealized ‘textbook’ scenarios may
not mimic real life situations.
They allow assessment of complex
skills which may not be possible at
simulated stations.
42
43. contd.,
Scenarios that are distressing to
real patients can be simulated.
(Dyspnea condition)
In simulated stations, the patient
variable in examination is
uniform across trainees.
Real life situations may be more
cost-effective.
43
44. Problems of using OSCE in the Indian scenario
Lack of feasibility due to time constrains
Shortage of training for use of OSCE.
Shortage of observers/examiners
Lack of interest in examiners
Lack of enforced guidance for practical examination by universities.
44
45. Advantages of OSCE
• More valid than the traditional approach to clinical examination.
• Examiners can decide in advance what is to be tested and can then
design the examination to test these competencies.
• Examiners can have better control on the content and complexities.
• More reliable because variables of the examiner and the patient are
removed to a large extent.
• More practical because it can be used with a large numbers of students.
45
46. Contd.,
• Emphasis can be moved away from testing factual knowledge to
testing s wide-range of skills including advanced clinical skills.
• The use of checklists by examiners and the use of multiple choice
questions results in a more objective examination.
46
47. Contd.,
• Uniform scenarios for all candidates
• Availability
• Safety, no danger of injury to patients
• No risk of litigation
• Feedback from Actors (simulators)
• Allows for Recall
• Stations can be tailored to level of skills to be assessed
• Allows for demonstration of emergency skills
47
48. Disadvantages of OSCE
• Students knowledge and skills are tested in compartments and they are
not tested on their ability to look at the patient as a whole.
• Demanding for both examiners and patient.
• Examiners are required to pay close attention to the students repeating
the same task on a number of occasions.
• The time involved in setting up the examination is greatest than for
the traditional examination.
• Maintaining uniform difficulty levels is not always possible.
48
54. Assess the patient X, identify the three priority nursing needs
1. ________________
2. ________________
3. ________________
54
55. Conduct mental status assessment of patient A and identify three
abnormal findings.
1.___________
2. ___________
3. ___________
55
56. Carry out Pre-ECT Nursing care of patient Y and record the procedure:
__________________________________________________________
__________________________________________________________
__________________________________________________________
_________________________
56
60. Patient G has a prescription of 1200ml fluid for 12 hours. How
many drops per minute nurse will be administrator through macro drip
set?
60
61. T. Olanzapine 7.5Mg
Mention indications, and any 3 nursing considerations for this medicine:
Indication:___________
Three Essential Nursing Considerations
1. ___________
2. ___________
3. ___________
61
64. Nursing Students' Perceptions of the Objective Structured Clinical Examination:
An Integrative Review
Amy N.B. Johnston, et.al,
March 2017 Volume 13, Issue 3, Pages 127–142
Highlights
•Assessment of clinical skills is essential for education and safe practice.
•Student engagement with clinical assessment is critical.
•Objective structured clinical examinations (OSCEs) are used to assess clinical skills.
•Evidence suggests that students find OSCEs highly stressful.
•Time for OSCE preparation is critical to reduce student anxiety.
•Clear examination processes throughout the OSCE are important for student success.
•Appropriate environment for the OSCE is important for assessment veracity.
•Feedback on OSCE is important for students.
64
65. Objective Structured Clinical Evaluation Effectiveness in Clinical Evaluation for
Family Nurse Practitioner Students
Nancy D. Beckham,
October 2013 Volume 9, Issue 10, Pages e453–e459
Retrospective data were analyzed for FNP students (n = 52) who had
completed six OSCEs and the three requisite clinical courses. Performance scores on
OSCEs were compared with clinical course grades.
OSCEs can identify student weaknesses and strengths and help faculty guide
students in strategies to improve clinical skills. The results provide needed evidence
for the use of OSCEs, especially in terms of graduate nursing education.
65
66. Conclusion
• The OSCE has several district advantages. In view of these, the nurse
educators can adopt it as an objective method for clinical evaluation.
• This will help the students to improve their clinical competence.
• The emphasis is on assessing what students can do rather than what
they knows.
• Therefore, OSCE gives direction for attaining the ultimate aim of the
teaching – learning process.
66