OSCE 1
PEMBUATAN SOAL &
INSTRUMEN EVALUASI
KETERAMPILAN MEDIK
DENGAN OSCE
Simple model of competence
Knows Shows how Knows how Does P rof e ssion a l a u th e n ticity
OSCE 3
Testing formats
Knows
Knows how
Shows how
OSCEsEMQs, SEQs Professional practice MCQs Behaviour~ attitude/skills Cognition~ knowledge
Does
OSCE 4Develop a Plan
Make decisions about your OSCE
- Summative?
- Level of training being assessed? - Clinical objectives or mix of
patient problems to be assessed? - Length and number of stations? - What competencis are being ass? (history taking, communication skills, problem solving etc)
OSCE 5
First steps in Developing an OSCE case
1. Describe the purpose of the case (i.e. define
the competencies you are testing)
2. Develop the case n instruction to the test
takers
3. Create the scoring instruments (checklist,
follow up questions and answer keys
Step 1: Purpose
State the purpose of the station
“Demonstrate ability to perform an appropriate physical examination for abdominal pain secondary to appendicitis and be able to identify positive findings.”
Statement of purpose is your guide for what
OSCE 7
Step 2: Instructions
Write the case and instructions to the student
Include patient’s name, age, setting (e.g., emergency, clinic, hospital ward), relevant
background information (if any); specify the task and time limit
Example:
Marie Beckett, 16 years old, has come to the Emergency Room with a 16-hour history of abdominal pain.
In the next five minutes, conduct a focused and relevant physical examination.
As you proceed, explain what you are doing and describe your findings.
OSCE 8
Step 3:
Scoring Instruments
Checklists are useful when assessing
Thoroughness or key elements Student (beginner) levels of ability Procedural tasks
Limited time available for training markers and/or
for marking
Rating scales are useful when assessing
Behaviours
Emphasis is on “how well it is done” rather
than on “done / not done”
Higher levels of expertise
Emphasis is on judgment rather than
thoroughness
OSCE 9
How is it done ?
A Clinical competence to be tested is broken
down into specific skills
A Specific skill is tested at a time
It is organized in the form of several stations Each station tests a particular skill
For each skill, a checklist is prepared Checklist contains essential steps and
precautions to be observed
How is it done ?
Each step has its own score proportional
to the importance of the step/precaution
Each component is tested at one fixed
station by the same examiner
The students rotate through several such
locations
Time allocated for each station: 4-7
minutes, 10 – 20 minutes
OSCE 11
How is it done ?
Categories of the station :
Procedure or performance station Question or interpretation station
The examiner’s checklists & student’s
answer sheets are marked according to predetermined scheme
OSCE 12
MENGEMBANGKAN OSCE
Menyusun Kisi-kisi
Menyusun Soal/Skenario
Melakukan Seting Station Koordinasi Dengan Observer Persiapan Pasien Simulasi Menyusun Check List
OSCE 13
Menyusun Soal/Skenario
• Kompetensi yang diharapkan (SKDI)
• Waktu tiap soal (station)
• Aspek yang terkait
History taking skills
Clinical examination
Procedure skills
Formulation of investigations
Interpretation of investigations
Soal
• Topik
• Instruksi kandidat
• Instruksi penguji
• Daftar tilik
instrumen penilaian
• Instruksi pasien simulasi
• Daftar peralatan
• Penulis
OSCE 15
MENYUSUN
DAFTAR TILIK
Tiap item hanya menyangkut satu issue
Gambaran rekaman perilaku mahasiswa ditulis dalam bentuk butir (item)
Tiap item dapat diobservasi dan diberi nilai
Daftar tilik untuk 10` cukup 10-20 item
Item yang PENTING perlu diberi tanda, dengan pembobotan yang lebih besar
Hasil:
NILAI / STATION =
NILAI YANG DIPEROLEH TOTAL NILAI
X 100
OSCE
16
Dokumen yang diperlukan
penilai/pelaksana OSCE
Daftar mahasiswa
Daftar observer/penilai
Daftar pasien simulasi/sukarelawan
Daftar peralatan
Instruksi untuk mahasiswa
Instruksi untuk penilai Daftar seluruh “stasiun”
Lembar jawaban
OSCE 17
Pass Mark ?
Clinical procedural skills : 100 % (A) Physical examination : 100 % (A)
History taking : 80 % (A)
Interpretations : 80 % (A)
Investigation : 80 % (A)
Management : 80% (A)
CONTOH UJIAN OSCE
Heteroanamnese dari ibu yang mempunyai
anak sakit Melakukan prosedur aseptik Melakukan pemeriksaan hepar Pemeriksaan reflex Melakukan pemeriksaan kadar gula darah Evaluasi hasil laboratorium Membaca hasil EKG
OSCE 20
Station 8 Station 7 Station 6 Station 5 Station 4 Station 3 Station 2 Station 1 Interstation Rest station
I believe that teaching without testing is cooking without tasting (Ian Lang)
28 Des 07 OSCE 21
BLOOD PRESSURE MEASUREMENT
Level of Student: Cardiovascular Block
STATION INFORMATION
28 Des 07 OSCE 22 Rating
Blood Pressure Measurement
STATION INFORMATION
DomainDiscipline
History taking Surgery
The student to be assessed The 2nd year student
Problem + Diagnosis Acute Urinary retention
Purpose of Station Demonstrate ability to perform
an appropriate history taking for acute urinary retention secondary to benign prostatic hyperplasia and be able to identify positive findings
28 Des 07 OSCE 24
Candidate’s Instructions
Patient name: Mr Abdullah Age: 65 years
Where: in Emergency Room
Time allowed: in the next ten
minutes
Task: history taking
Related Information: patient was
complaining about inability to void.
28 Des 07 OSCE 25
Instruction to the Students: You are a medical student
doing your surgical practice emergency. You are about to see Mr Abdullah, who has a voiding problem. In The first 6 minutes take a focused history of this patient’s problem. At 6 minutes, you will hear a knock at the door. The examiner will then verbally ask you some questions regarding this patient. At the end of 8 minutes, the examiner will provide you with feedback on your performance
28 Des 07 OSCE 26
No Item Item
weight
√ if performed
1 Greets and introduces self to patient in a professional manner 1
2 Asks how patient would like to be addressed 1 3 Defines objective (student explains what he/she is going to do) 1 4 Asks how long patient has had inability to void 1 5 Asks how patient first notice of his complain 1 6 Asks about the changing of his voiding pattern 1 7 Asks if the patient feeling a lower urinary tract symptomps (hesistancy,
urgency, intermittency, weak stream, dysuria, post voiding dribbling)
4 8 Asks if patient has ever had any urinary symptom in his life 1 9 Asks if patient had suffered from hematuria 2 10 Asks what treatment patient has used so far for his hematuria 1 11 Ask if patient has had similar inability to void before 1 12 Asks if anyone in family has inability to void 1
Rating 1=fail, 2= borderline, 3=meet expecations, 4= exceeds expectations Initiation of interview 1 2 3 4 Listening skills 1 2 3 4 Questioning skills 1 2 3 4 Organization of questions 1 2 3 4 Attitudes 1 2 3 4
Non verbal communication 1 2 3 4
Closing 1 2 3 4
Global Rating - overall judgment of studen’s performance
28 Des 07 OSCE 28
Assigment
Develop one OSCE case that will use a
standardized patient.
Identify he level of students to be assessed
and purpose of the case(i.e.define the competencies that are being assessed)
Prepare the case and the instructions to the
student
Develop the checklist/rating form, possible
