Russian Federation
Russian Federation
The relevance of the research problem is due to the need to update theoretical views and practical actions to create new methods for an objective and structured assessment of the communication skills of students at a medical university. The purpose of the article is to prove the suitability, reliability, feasibility of an objective structured clinical examination (OSKE) as a tool for assessing the communication skills of residents in simulated conditions during the intermediate certification of students. The leading research method was an experiment on the development and implementation of three stations within the framework of the OSKE to assess the communication skills of 77 residents who completed the training course in the discipline "Communication skills" necessary information and resistance to doctor's recommendations. The article shows that experts highly assess the level of formation of general communication skills and skills of explaining information to the patient among the majority of examinees. It was revealed that communication skills associated with persuading the patient to follow the doctor's recommendations require improvement. Based on the methods of oral questioning and questioning, as well as psychometric analysis of the exam results, it has been proven that the developed OSKE is a reliable and valid tool for assessing the communication skills of residents in simulated conditions. The materials presented in the article can be used for intermediate and final certification of students in residency, as well as in the process of teaching future doctors the skills of communicating with patients at clinical departments. The technology of the exam, developed by the authors, will make it possible to fairly objectively assess communication skills, to cause the examinees to experience a sense of fairness in assessment, which is one of the factors in the emergence of a positive attitude towards improving the activity of professional communication.
objective structured clinical exam, communication skills, checklist, residents, experts, standardized patient
1. Vasilieva E.Yu., Davydova N.G., Skripova N.V. Professional'no oriyentirovannyy ekzamen po distsipline «Stomatologiya» [Professionally oriented exam in the discipline "Dentistry"]. Hamburg: LAP LAMBERT Academic Publishing GmbH&Co.KG Publ., 2017. 119 p.
2. Zhuravlev R.A. Perekhod k pervichnoy spetsializirovannoy akkreditatsii spetsialistov [Transition to the primary specialized accreditation of specialists]. 2019. Available at: https://fmza.ru/accreditation_experts/metodicheskie-materialy (accessed 14 July 2020).
3. Kan K.Z., Ramachandran S., Gont K., Pushkar P. Objective Structured Clinical Examination (OSKE): AMEE Manual No. 81: Historical and Theoretical Perspectives. Meditsinskoye obrazovaniye i professional'noye razvitiye [Medical Education and Professional Development]. 2014, I. 3 (17), pp. 18-52. (In Russian).
4. Kan K.Z., Ramachandran S., Gaunt K., Pushkar P. AMEE Guideline No. 81: Objective Structured Clinical Examination (OSKE). Part 2. Organization and management (under the editorship of Balkizov, Z.Z. and Semenova, T.V.). Meditsinskoye obrazovaniye i professional’noye razvitiye [Medical education and professional development]. 2014, I. 2 (16), pp. 23-40. (In Russian).
5. Perechen' prakticheskikh navykov (umeniy) [The list of practical skills (abilities)]. Available at: http://fmza.ru/fund_assessment_means/stomatologiya/perechen-prakticheskikh-navykov-umeniy/ (accessed 11 July 2020).
6. Prikaz Ministerstva zdravoohranenija RF ot 22 dekabrja 2017 g. N 1043 n «Ob utverzhdenii srokov i jetapov akkreditacii specialistov, a takzhe kategorij lic, imejushhih medicinskoe, farmacevticheskoe ili inoe obrazovanie i podlezhashhih akkreditacii specialistov» [Order of the Ministry of Health of the Russian Federation of December 22, 2017 N 1043 n «On approval of the terms and stages of accreditation of specialists, as well as categories of persons with medical, pharmaceutical or other education and subject to accreditation of specialists»]. Available at: http://www.garant.ru/hotlaw/federal/1166941/#ixzz6SG40CWPL (accessed 14 July 2020).
7. Riklefs V.P., Muldaeva G.M., Dosmagambetova R.S. Organizacija i provedenie ob#ektivnogo strukturirovannogo klinicheskogo jekzamena (OSKJe) [Organization and conduct of an objective structured clinical examination (OSKE)]. Available at: http://rosomed.ru/ckeditor_assets/attachments/58/2014-6c-02.pdf. (accessed 12 July 2020).
8. Sizova Zh.M. Nauchno-metodicheskoe soprovozhdenie akkreditacii specialistov zdravoohranenija [Scientific and methodological support for the accreditation of healthcare professionals]. Available at: https://fmza.ru/accreditation_experts/metodicheskie-materialy (accessed 14 July 2020).
9. Standarty kontrolja kachestva obuchenija v medicinskom vuze [Standards for quality control of education in a medical university]. Arhangel'sk: Sev. gos. med. un-t Publ., 2012. 283 p.
10. Cleland J.A., Abe K., Rethans J.-J. The use of simulated patients in medical education: AMEE Guide No 42 // Med. Teach. 2009. Vol. 31. P. 477-486. DOI:https://doi.org/10.1080/01421590903002821
11. Epstein R.M. Assessment in medical education // N. Engl. J. Med. 2007. Vol. 356. P. 387-396. DOI:https://doi.org/10.1056/NEJMra054784
12. Harden R., Lilley P., Patricio M. The Definitive Guide to the OSCE, the Objective Structured Clinical Examination as a performance assessment, Edition: 2016. Publisher: ELSEVIER. 2016. 384 p.
13. Harden R.M., Stevenson M., Downie W.W., Wilson G.M. Assessment of Clinical Competence using Objective Structured Examination // BMJ. 1975. Vol. 1. P. 447-451. DOI:https://doi.org/10.1136/bmj.1.5955.447
14. Hollingworth T., Ryme J. OSCEs for the MRCOG Part 2. Self-assessment guide. Second edition / Hodder Arnold. 2011. 200 p. DOI:https://doi.org/10.1201/b13212
15. Kurtz S.M., Silverman J.D., Draper J. Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press (Oxford) [Jelektronnyj resurs] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5060313/ (accessed 12 July 2020).
16. Newble D. Techniques for measuring clinical competence: Objective structured clinical examinations // Med.Educ. 2004. Vol. 38. P. 199-203. DOI:https://doi.org/10.1111/j.1365-2923.2004.01755.x
17. Pell G., Fuller R., Homer M., Roberts T. How to measure the quality of the OSCE: A review of metrics - AMEE guide no. 49 // Med. Teach. 2010. Vol. 32. P. 802-811. DOI:https://doi.org/10.3109/0142159X.2010.507716
18. Shumway J.M., Harden R.M. AMEE Guide No. 25: The assessment of learning outcomes for the competent and reflective physician // Med. Teach. 2003. Vol. 25. P. 569-584. DOI:https://doi.org/10.1080/0142159032000151907
19. Silverman J.D., Kurtz S.M., Draper J. Skills for Communicating with Patients. Radcliffe Medical Press (Oxford) [Jelektronnyj resurs] Available at: https://www.gp-training.net/training/communication_skills/calgary/index.htm (accessed 12 July 2020).
20. Tavakol M., Dennick R. Post-examination interpretation of objective test data: Monitoring and improving the quality of high-stakes examinations: AMEE Guide No. 66 // Med. Teach. 2012. Vol. 34. P. 161-175. DOI:https://doi.org/10.3109/0142159X.2012.651178
21. Tombleson P., Fox R.A., Dacre J.A. Defining the content for the OSCE component of the PLABoard examination development of a blueprint // Med. Educ. 2000. Vol. 34. P. 566-572. DOI:https://doi.org/10.1046/j.1365-2923.2000.00553.x
22. Townsend A.H., Mcllvenny S., Miller C.J., Dunn E.V. The use of an objective structured clinical examination (OSCE) for formative and summative assessment in a general practice clinical attachment and its relationship to final medical school examination performance // Med. Educ. 2001. Vol. 35. P. 841-846. DOI:https://doi.org/10.1046/j.1365-2923.2001.00957.x
23. Turner J.L., Dankoski M.E. Objective Structured Clinical Exams: A Critical Review // Fam. Med. 2008. Vol. 40. P. 574-578.
24. Wilkinson T.J., Frampton C.M., Thompson-Fawcett M., Egan T. Objectivity in Objective Structured Clinical Examinations: Checklists Are No Substitute for Examiner Commitment // Acad. Med. 2003. Vol. 78. P. 219-223. DOI:https://doi.org/10.1097/00001888-200302000-00021
