medigraphic.com
ISSN 2007-5057 (Print)
Investigación en Educación Médica

2020, Number 36

<< Back Next >>

Inv Ed Med 2020; 9 (36)

A Collaborative Objective Structured Clinical Examination Project at Three Medical Schools in Mexico

Martínez-González A, Sánchez-Mendiola M, Olivares-Olivares SL, Grimaldo-Avilés JA, Trejo-Mejía JA, Martínez-Franco AI, Alpuche-Hernández A, Furman GE

Language: Spanish
References: 35
Page: 58-69
PDF size: 551.70 Kb.


ABSTRACT

Purpose: The logistical and human resource challenges of implementing Objective Structured Clinical Examinations (OSCE) impede its widespread use in resourceconstrained medical schools. The goal of this study is to describe a multi-school collaboration, its processes and scholarly products.
Methods: Three Mexican medical schools obtained a grant from the National Board of Medical Examiners (NBME) Latin American Awards Program. The project involved the development of a formative OSCE to assess clinical competence in undergraduate medical students at the end of internship, and to obtain validity evidence for its use. A formal consortium was created to develop and share OSCE stations. Faculty development workshops were implemented.
Results: A nine-station OSCE was designed by the three schools’ consortium. A total of 81 examiners and 36 standardized patients were trained. A rubric was developed, and a software application created to capture the data. The test was used with 93 medical students. Cronbach’s alpha was 0.94 and G-coefficient 0.80. Several scholarly products were created.
Conclusions: In resource-limited countries, the shared development and use of OSCE stations is a viable option for medical schools. International organizations can be successful catalyzers for implementing complex testing methods in developing countries. The products can be shared with other medical schools in the country and Latin America.


REFERENCES

  1. Fernandez N, Dory V, Ste-Marie LG, Chaput M, Charlin B, Boucher A. Varying conceptions of competence: an analysis of how health sciences educators define competence. Med Educ. 2012 Apr;46(4):357-65. doi: 10.1111/j.1365- 2923.2011.04183.x. PMID: 22429171

  2. Boursicot K, Etheridge L, Setna Z, Sturrock A, Ker J, Smee S, Sambandam E. Performance in assessment: consensus statement and recommendations from the Ottawa conference. Med Teach. 2011;33(5):370-83. https://doi.org/10.310 9/0142159x.2011.565831

  3. Abdelaziz A, Hany M, Atwa H, Talaat W, Hosny S. Development, implementation, and evaluation of an integrated multidisciplinary Objective Structured Clinical Examination (ECOE) in primary health care settings within limited resources. Med Teach. 2016;38(3):272-9. https://doi.org/10. 3109/0142159x.2015.1009018

  4. Trejo-Mejía JA, Martínez-González A, Mendez-Ramírez I, Morales-López S, Ruiz-Pérez LC, Sanchez-Mendiola M. Evaluación de la competencia clínica con el examen clínico objetivo estructurado en el internado médico de la Unihttps versidad Nacional Autónoma de México. Gac Med Mex. 2014;150(1):8-17.

  5. López-Bárcena J, Trejo J, Sánchez AJ, Muñoz G, González- Torres, A, García-Bonilla C. Comprehensive evaluation of the competences in the training of physicians in Mexico: an interinstitutional study. Rev Fund Edu Med. 2015;18(1):55-61.

  6. Apkon M, Mattera JA, Lin Z, Herrin J, Bradley EH, Carbone M, Holmboe ES, Gross, CP, Selter JG, Rich AS, Krumholz HM. A randomized outpatient trial of a decisionsupport information technology tool. Arch Intern Med. 2005;165(20):2388-2394.

  7. Lucio C, Nigenda J, García M, Olivares S. Clinical competence assessment: development of a mobile app to enhance patient centerderness. Dev Learn in Organ. 2019; https:// doi.org/10.1108/DLO-08-2019-0186.

  8. Sabiote R. (2015). Teoría y práctica del análisis de datos cualitativos: Proceso general y criterios de calidad. Rev Intern de Cienc Soc y Humanid. 2015;15(2):133-154.

  9. Lane S, Raymond MR, Haladyna TM, Downing SM. Test Development Process. In: Lane S, Raymond MR, Haladyna TM, Editors. The Handbook of Test Development, New York, NY: Routledge. 2nd edition; 2016. p 3-18.

  10. Navas, MJ, Fidalgo AM, Gabriel C, Suárez JC, Brioso A, Gil G, Martínez-Arias R, Sarriá E. Métodos, diseños y técnicas de investigación psicológica, Madrid: Editorial Uned; 2012.

  11. Escudero, ME. El proceso de investigación comercial, Madrid: Editorial Editex; 2014.

  12. Kane MT. Validating the interpretations and uses of test scores. J Educ Meas. 2013;50(1):1-73.

  13. American Educational Research Association., American Psychological Association, National Council on Measurement in Education. Joint Committee on Standards for Educational and Psychological Testing (U.S.). Standards for educational and psychological testing. 230 p. Available from: https://www.aera.net/Publications/Books/Standardsfor- Educational-Psychological-Testing-2014-Edition

  14. Kreptul D, Thomas RE. Family medicine resident ECOEs: a systematic review. Educ Prim Care. 2016;27(6):471-7.

  15. Harden RM. Revisiting Assessment of clinical competence using an objective structured clinical examination (ECOE). Med Educ. 2016;50(4):376-9.

  16. Patricio MF, Julião M, Fareleira F, Carneiro AV. Is the ECOE a feasible tool to assess competencies in undergraduate medical education? Med Teach. 2013;35(6):503-14.

  17. Trejo- Mejía JA, Blee-Sánchez GB, y Peña-Balderas J. (2013) Elaboración de estaciones para el examen clínico objetivo estructurado (ECOE). Inv Edu Med. 2013;3(9):56-9.

  18. Park RS, Chibnall JT, Blaskiewicz RJ, Furman G, Powell JK, y Mohr CJ. Construct validity of an Objective Structured Clinical Examination (OSCE) in Psychiatry: Associations with the Clinical Skills Examination and other indicators. Academ Psychiatry. 2004;28(2):122-8.

  19. Vogt P. Quantitative research methods for professionals. Boston: Pearson/Allyn and Bacon; 2007.

  20. Brailovsky CA, Grand’Maison P. Using Evidence to Improve Evaluation: A Comprehensive Psychometric Assessment of a SP-Based OSCE Licensing Examination. Adv in Health Sci Edu. 2000;5(3):207-19.

  21. Brannick MT, Erol-Korkmaz HT, Prewett M. A systematic review of the reliability of objective structured clinical examination scores. Med Ed. 2011;45(12):1181-9.

  22. Lawson DM, Till H. Predictors of performance of students from the Canadian Memorial Chiropractic College on the licensure examinations of the Canadian Chiropractic Examining Board. J of Manip Phys Ther. 2006;29(7):566-9.

  23. Streiner DL, y Norman GR. Health Measurement Scales: A practical guide to their development and use. Oxford: Oxford University Press; 2008.

  24. Wass V, Van der Vleuten C, Shatzer J, y Jones R. (2001). Assessment of clinical competence. Lancet. 2001;357(9260):945-9.

  25. Hernández LS, Trejo JA, Marín, Y. Diseño de un ECOE para evaluar habilidades clínicas en neurología en estudiantes del quinto año. Inv Edu Med. 2017;6(24):248-54.

  26. Auewarakul C, Downing SM, Jaturatamrong U, y Praditsuwan R. (2005). Sources of validity evidence for an internal medicine student evaluation system: an evaluative study of assessment methods. Med Edu. 2005;39(3);276-83.

  27. Baig LA, Violato C. (2012). Temporal stability of objective structured clinical exams: a longitudinal study employing item response theory. BMC Med Edu. 2012;12(1);121-7.

  28. Boulet JR, McKinley DW, Whelan GP y Hambleton RK. Quality assurance methods for performance-based assessments. Adv Health Sci Edu. 2003;8(1):27-47.

  29. Donnon T, Paolucci EO. A generalizability study of the medical judgment vignettes interview to assess students’ noncognitive attributes for medical school. BMC Medical Education. 2008;8(1):58-65.

  30. Hatala R, Marr S, Cuncic C, y Bacchus CM. (2011). Modification of an OSCE format to enhance patient continuity in a high-stakes assessment of clinical performance. BMC Med Edu. 2011;11(1):23.

  31. Vallevand A, Violato C. A predictive and construct validity study of a high-stakes objective clinical examination for assessing the clinical competence of international medical graduates. Teach Learn Med. 2012;24(2):168-76.

  32. Espinosa-Vázquez O, Martínez-González A, Sánchez-Mendiola M, Leenen I. Análisis de un examen clínico objetivo estructurado en odontología desde la teoría de la generalizabilidad. Inv Edu Med. 2017;6(22):109-18.

  33. Lucchetti G, Ezequiel OS, Lucchetti AL. An ECOE with very limited resources: Is it possible? Med Teach. 2017;39(2):227. https://doi.org/10.1080/0142159x.2017.1270443

  34. Martínez-González A, Sánchez-Mendiola M, Méndez-Ramírez I, Trejo-Mejía JA. Grado de competencia clínica de siete generaciones de estudiantes al término del internado médico de pregrado. Gac Med Mex. 2016;152:679-87.

  35. Burdick WP. Global faculty development: lessons learned from the Foundation for Advancement of International Medical Education and Research (FAIMER) initiatives. Acad Med. 2014;89(8):1097-9.




2020     |     www.medigraphic.com