Construction of OSPE/OSCE Stations - PowerPoint Presentation

Slide1

Slide2

Construction of

OSPE/OSCE Stations

Prof. Tahmina Begum

FCPS, MD, MMEd

Slide3

Objectives

Basics of OSPE/ OSCE

Planning of OSPE/ OSCE station

Construction of OSPE/ OSCE station

Slide4

O

Objective

S

Structured C Clinical E Examination

How to construct ?

Slide5

O

S

C

E

Objective :

As examiners use a pre-determined checklist with marking scheme for evaluationStructured :

Because task is specified as well the marks. Every student will face same problem & perform the same task within same time frame

Clinical:

Because the tasks are representative of aspects of those faced in real clinical situation

Examination

Slide6

OSCE/OSPE

, an assessment format

where clinical competencies are assessed

-

Uniformly

- Objectively

Slide7

OSCE/ OSPE

It is a performance assessmentBased on

authentic tasks

such as activities, exercises or problems that require students to show---

What they can do

Slide8

An OSCE is focusing on

the ability to apply knowledge

Perform particular procedure

interpretations of knowledge in clinical settings interact effectively with patient/ SP make justifiable conclusions

Slide9

The

various competencies

is assessed in different

Stations

through which the candidates rotate until they complete a cycle

Slide10

10

3

2

9

5

7

4

8

6

1

Slide11

Principle ….

Questions are prepared on the basis of the objectives of the course

Task/ skill

to be tested is given to the student in the form of a specific question in a

Station

(Task assigned to the student) Each station focuses on testing a particular skill/ area of competency

Slide12

OSCE Stations

-

Procedure

Question

Slide13

Procedure stations-

- students are asked to perform a procedure/ lab test, history taking, system exam, com skill)

- requires an observer .Question stations- practically oriented questions are asked (data interpretation, image, picture, X-ray, write a prescription). - answers to be written on an answer sheet - scoring is done using a standard answer & marking scheme

Organization ….

Slide14

Principle ….

Observer- keen but silent

Observer/ Assessors scores the performance on a

checklist

Checklist is prepared in advance by the consensus of examiners before exam

Checklist is prepared by

breaking the skill

into vital components

All students are assessed on the same set of questions to make the assessment

uniform

&

to ensure

standardization

Slide15

Checklist is the

heart

of OSCE /OSPE

Slide16

Structured marking scheme-

to reduce examiners variability & discretion

Provision of negative scoring for important omission / mistake

Preparation of 50% stations from

must know

part, in which low scoring may be associated with significant consequencePrinciple

Slide17

Materials

for OSPE

Data

Photograph

X-Ray/CT ECG Instruments Patient /Simulated patientsModels

Specimens

Others e.g-

Nebulizer

Slide18

Tasks on the Materials for construction of OSPE stations

Identification of a Specimen

Interpretation of ECG / X Ray / C T Film/ MRI

Interpretation of Photographs of clinical/ lab findings

Procedure on a dummy

Interaction with Simulated Patient Writing prescriptions What would you do type of scenarios

Slide19

Planning an individual station

Identify

competencies

to be assessed (learning objectives

/

domains)Identify content / material / problem Write appropriate task for candidates related to learning objectives Write

instructions

for candidates/ observers

Develop

checklist

/ standard answer

Marking scheme

Slide20

Domains

Knowledge

Skills

Attitude

Slide21

Synthesis

Analysis

Application

Comprehension

Recall

Evaluation

Levels of cognitive domain

Slide22

Example

Objective:

To measure blood pressure

Domain: knowledge,

skill, attitudeSystem: CVSTask: Measurement the BPInstruction:

Please measure the blood pressure of 50 year old patient

Time:

5 mins

Marks:

10

Slide23

Check list for the observer: Marking

a) Greeting 0.5

b) Introducing yourself 0.5

c) Taking permission 0.5

d) Explaining the procedure 0.5e) Performing the task- 1. expose the area 1.0

2. choose the appropriate sized cuff 1.0

3. fix the cuff 1.5

4. palpate the brachial artery 0.5

5. place the stethoscope 1.0

6. inflate the cuff and record blood pressure 1.0

7. deflate and remove the cuff 0.5

8. maintain the sequences 1.0

f) Providing thanks to patient 0.5

Slide24

Planning of station

Objective: To interpret the ECG

Domain: Knowledge

Content/ material: ECG

Task: interpretation of ECG

Instruction: Please read the ECG & answer the questionsChecklistMarking with weight

Slide25

Instruction: Please read the ECG of a 3-year-old child and answer the following questions

What is the ventricular rate?

Write down the QRS axis

What impression you have by examining the chest leads?

Name 2 important conditions where such abnormalities are seen

Slide26

Checklist

Components Score

92-96/min 2.0

Right axis deviation (135-150) 3.0

Right ventricular hypertrophy/ RVH 3.0

Any two of the followings: 1 ×2= 2.0 - tetralogy of Fallot - Atrial septal defect - Pulmonary

stenosis

- Pulmonary hypertension

Slide27

Example

Objective:

To nebulize a patient

Domain:

knowledge, skillSystem: Resp SystemTask: Nebulization of a patientInstruction: Please nebulizing a child with acute severe asthma

Time:

5 mins

Marks:

10

Slide28

Instruction:

This 4-year-old child weighing 16 kg suffering from acute severe asthma & needs nebulized salbutamol. You are supplied all necessities. Please start nebulizing. You are not required to counsel before starting

Slide29

Checklist for observer

Instruction +

Please observe the student’s performance and tick the appropriate boxes in the checklist

Pl write down the code no. of the candidate on the top of the checklist

Slide30

Procedure

Done

Not done

Setting up

the machine

√Select salbutamol solution, not syrup √ Draw 0.3-0.4 ml of salbutamol solution & pour into the medicine chamber √

Select normal saline. Not other

distractor

fluid

√

Draw 2-3 ml of normal saline & pour into medicine chamber

√

Attach the cover & the mask properly

√

Keep the container upright all the while

√

Switch on & observe for proper functioning

√

Total score

Slide31

Procedure

Done

Not done

Setting up

the machine

1.0Select salbutamol solution, not syrup1.0Draw 0.3-0.4 ml of salbutamol solution & pour into the medicine chamber1.5Select normal saline. Not other distractor fluid1.0Draw 2-3 ml of normal saline & pour into medicine chamber

1.5

Attach the cover & the mask properly

1.0

Keep the container upright all the while

2.0

Switch on & observe for proper functioning

1.0

Total score

10

Slide32

Planning an individual station

Identify

competencies

to be assessed (learning objectives- domains)

e.g. communication skill/ attitude Identify content area (system / problem/ disease) e.g. Hemophilia

Identify appropriate

task

for candidates related to learning objectives

e.g. counseling

Write

instructions

for candidate

e.g. please read the scenario given below & counsel the parent

Write the appropriate

scenario.

next

Develop

checklist / standard answer & Marking scheme

What & Why

How

Slide33

Example of counselling station with checklist & marking scheme

Instruction to the student:

Please read the scenario given below & counsel the mother

Scenario: A 5 years old boy has been diagnosed as a case of Haemophilia . He is the only son of his parent. Please counsel the mother/parent regarding genetic aspects of the conditions and recurrence risk using the pedigree chart.

Slide34

Slide35

Sl. No

Points of reference/ components

Done

Not done

1.

Greeting/building rapport



2

.

Introducing yourself



3

.

Asking mother whether she knows about disease



4.

Informing about nature of illness

a

)

It is a genetic disorder



b

)

Due to deficiency of clotting factor



c)

Mainly the male child is affected



d)

1/3

rd

of the cases there may not be any family history



4.

Informing about the risk of recurrence



Checklist

Slide36

Sl. No

Points of reference

Done

Not done

a)

50% male children have chance to be affected

b)

50% of the female children will be carrier

5.

Asking mother anything she wants to know more

6.

Use of pedigree chart

7.

Attitude in general

a)

Body language

b)

Attention paid

c)

d)

Easy language

Eye to eye contact

Checklist,cont’

Slide37

Slide38

Instruction: Please study the photograph and answer the following questions:

1

. 

Describe the rash with distribution.

 

2.   If this Pt. has recently been started on a treatment for epilepsy, what do you think that the condition is?  3.   What type of decision-style could have protected physician from the kind of embarrassment that may have arisen from its development? 

4.    In the early phase of evaluation of the patent, what

laboratory investigations would you have suggest?

5.     What events would you try to prevent in

managing this patient? 

Slide39

1: Extensive, confluent macular rash of skin over front

of trunk, face and ear;extensor surface of forearm, hand and fingers and muco-cutauneous junction of mouth.

2: Steven-Johnson Syndrome.

3: Shared decision making by informing parents.

4: Complete Blood count.

LFT S. Electrolyte S. Creatinine Urine R/M/E5: Renal failure & Cross infection.

Slide40

Slide41

Instruction: Please look at the X-Ray of 2 days old newborn & answer the questions given below

What is the diagnosis?

What are the two main presenting features after birth?

What complication may occur if not treated promptly?

What is the initial management?

Slide42

Checklist

Oesophageal

atresia

4.0

i) excessive oral secretions 1.5 ×2=3.0 with episodes of coughing ii) choking iii) cyanosisc) Aspiration pneumonia 2.0d) i) Nasogastric suction 0.5 ii) I/V fluid 0.5

Slide43

Instruction:

Please describe the features the lesions in these 5 patients and suggest a diagnosis for each

D

A

B

C

E

Slide44

Answer

A …… MRSA (Staph infection)

B……. Furuncle

C……. Bullae

D…… Erysipelas

E……. Cellulitis

Slide45

Instruction:

Please describe the features the lesions in these 4 patients and suggest a diagnosis for each

A

B

C

D

Slide46

Answer

A …… Herpes simplex

B……. Cold sore

C……. Frost bite

D…… Chicken pox

Slide47

Example

Objective:

To interpret a data

Domain: Knowledge

Material: Data on ABGTask: Interpretation of a data Instruction: Please interpret a data on ABGTime: 5 mins

Marks:

10

Slide48

Instruction:

Please study the ABG data of a 30-year-old gentleman & answer the accompanying questions

ABG data:

FiO2-0.4, pH-7.33, PaO2 -90mm of Hg, PaCO2-68mm of Hg, HCO3-32, BE-7.3 meq, SaO2- 99%, Atm pressure- 760 mm of Hg

Slide49

Questions

Which of above parameters would you use to calculate A-ADO2?

What does the term A-ADO2 signify?

What is the PaO2/FiO2 ratio here?

Name the respiratory parameter signified by PaO2/FiO2 ratio

In the above case, what are the metabolic/ respiratory process at workWhich of the processes is the primary & which one is the secondary & why?Are the two processes fully compensating one another?Which 2 Relevant data needed for calculating oxygen flux are missing in the above list?

Slide50

Instruction: A 50-year-old man with uraemia started to vomit since night. Please study the ABG report with electrolytes & answer the following questions.

pH-7.30, HCO3-15, PaCO2-40, Na-140, K-3,CL-95

Calculate the anion gap (AG)

What does the AG indicate here?

Calculate the Bicarbonate gap (BG)

What does the BG indicate here?

Slide51

Example

Objective:

To counsel a patient

Domain:

Communication skill (attitude)Material: Simulated patientTask: Counselling of a patient Instruction: Please inform a patient regarding therapeutic option

Time:

5 mins

Marks:

10

Slide52

Scenario:

A 42-year-old bank officer, normotensive, with BMI -23, has recently been diagnosed as a diabetic. He has learnt about aetiology, natural course of the disease & therapeutic goal. He is well motivated.

Instruction

: Please explain the therapeutic options available for him

Slide53

Checklist with marking scheme

Building rapport 0.5

Introducing himself 0.5

Mentioning the treatment options

a) Diet 1.5

b) Drugs 1.5 i) Oral hypoglycemic agent ii) Insulin c) Regular exercise 1.54. Possibility of control by these options 1.5 a) Diet alone—40-50%

b) Oral hypoglycemic ..20-30%

c) Insulin required …. 20-30%

5. Diet

a) Using different proportion 1.0

b) Avoiding sugar 1.0

5. Control of blood sugar is often partial with diet & exercise 1.0

6. Use of easy language 0.25

7. Eye to eye contact 0.25

Slide54

Scenario

: A 4-week-old baby presents with a H/O vomiting for 3 days. Despite the vomiting the baby is eager to feed. O/E he is dehydrated &

afebrile

. Serum biochemistry shows:

sodium -128

potassium-3.0chloride-86urea-6bicarbonate-36……………………….pH- 7.5…………………………………

Instruction:

please read the above scenario and answer the following questions

Slide55

Instruction:

Please study the attached picture & answer the following questions

What does the picture represent?

Write 2 abnormalities present in the picture

What is your comment on this data set?

Mention 2 clinical conditions leading to this abnormalityMention 2 ways of distinguishing between these 2 conditions

Slide56

Checklist with marking

Spirogram/ Spirograph/ Spirometry 2.0

a) Reduction of FEV 1 1.5

b) Reduction of FEV1/FVC 1.5

3. Obstructive lung disease 2.0

4. a) Bronchial asthma 1.0 b) COPD 1.0 c) chronic bronchitis 0.5 d) emphysema 0.5 5. a) Clinical evaluation 0.5 b) Reversibility test 0.5

Slide57

Scenario:

A-70-year-old man has been suffering from dementia

Instruction:

Please read the scenario given above & psycho-educate his family members sitting before you regarding non-drug management of the patient

Slide58

Checklist with marking

Sl. no

Components

Done

Not done

1Greetings2Introducing yourself3Educating them about the disease, course & prognosis4Maintaining optimal environment

5

Encouraging family members to show concern,

love, support & positive attitude

6

Stimulating memory

by showing pictures, discussing past experiences, listening to music, recalling them as it preserves quality of life

7

Motivating patient to perform the activities

of his likings

8

Encouraging to have daily routine- eating, bathing, dressing, using telephone etc

9

Informing them about the problem of incontinence & covering the mattress

10

Educating them that they have to support the daily activities

as the patient is dependent

11

Concluding with thanks

Slide59

Example

Objective:

To break a bad news

Domain: Communication skill (attitude)

Material: SP Task: breaking a bad newsInstruction: Please break a bad news to parentsTime:

5 mins

Marks:

10

Slide60

Scenario:

A 10-year-old boy, the only child of parents has recently been diagnosed as a case of ALL

Instruction:

Please disclose this bad news to the parents using Kaye’s 10 steps to breaking bad news

Slide61

Checklist with marking

Sl

no

Components

Done

Notdone1Building rapport & preparing parentsGreetingIntroducing yourselfListening the parents story & elicit the facts2Asking what they already know3

Giving a warning about the disease

4

Allowing denial

5

Explaining parents about

the nature of illness

Prognosis

6

Listening to the concerns

7

Sharing the feelings with

empathy

8

Summarizing

& planning the treatment

9

Offering availability

Chemotherapy

Specific- bone marrow

transplatation

10

Overall

attitude

Eye to eye contact

Use of easy language

Attention paid

Attentive listening

Slide62

Slide63

Instruction to the candidate

Look at the photograph and answer the following questions

.

Q1.

What do you see in this photograph?

Q2. List 5 most important physical findings you may expect in this disease.Q3. What is the likely diagnosis?Q4. Mention 2 mechanisms on how this problem happened.Q5. What is the long term consequence of this disease?

Slide64

Answers

Marking scheme

1. Bilateral webbing of neck 1

2. 5 i) Short stature ii) Lower nuchal hair line iii) hypoplastic nail iv) Shrilled chest v) Cubitus valgus--------------------------------------------------------------------------------------------------- vi) Co archtation of aorta (0.75) vii) High arch palate (0.75) viii) Micrognathism (0.5) ix) Pectus carinatum (0.5) x) Mental deficiency (0.5) 3. Turners syndrome 1

4. i) Complete monosomy 1

ii) Deletions 1

5. Infertility 1

Total Marks 10

Slide65

Example

Objective:

To find out the abnormalities in CTG

Domain: Knowledge

Material: CTG tracing Task: Interpretation of CTGInstruction: Please study the CTGTime: 5 mins

Marks:

10

Slide66

Scenario:

A lady at her 38 weeks of pregnancy admitted with labour pain. On admission, her cervical os is 3 cm dilated. A CTG was done on admission. Another CTG was done 4 hrs after the 1

st

one.

Instruction:

Please study the tracings & answer the followingsMention the type of tracingsList 3 important findings in the 2nd CTGWhat is the most probable cause of this condition?What should be the next steps of management?

Slide67

Example

Objective:

To demonstrate the technique of taking Pap’s Smear

Domain: S

killMaterial: Dummy Task: Demonstration of the technique of taking Pap’s SmearInstruction: Please demonstrate the technique of taking Pap’s Smear Time:

5 mins

Marks:

10

Slide68

Instruction:

Please demonstrate the technique of taking Pap’s Smear in a dummy with aseptic precaution and assemble the required logistics before the procedure

Slide69

Checklist with marking

Components

Done

Not done

Select required logistics

a) Cusco’s speculum b) spatula c) glass slide d) Koplik’s jar √ √ √ √2. Wear gloves

3. Exposure of cervix

a)

introduce speculum

b) fix the speculum

√

√

4.

Take smear

a) use

Ayre’s

spatula

b) narrow end inserted against

Cx

canal

c) broad end against external

os

d) Rotate spatula 360 degree

√

√

√

√

5.

Prepare slide

a) smear slide

b) put slide inside

Koplik’s

jar

6

. Remove speculum & gloves

√

√

√

Slide70

Checklist with marking

Components

Done

Not done

Select required logistics

a) Cusco’s speculum b) spatula c) glass slide d) Koplik’s jar 0.5 0.5 0.5 0.5 2

. Wear gloves

0.5

3. Exposure of cervix

a)

introduce speculum

b) fix the speculum

0.5

0.5

4.

Take smear

a) use

Ayre’s

spatula

b) narrow end inserted against

Cx

canal

c) broad end against external

os d) Rotate spatula 360 degree

1.0

1.0

1.0

2.0

5.

Prepare slide

a) smear slide

b) put slide inside

Koplik’s

jar

6

. Remove speculum & gloves

0.5

0.5

0.5

Slide71

Slide72

Instruction: Please observe the supplied imaging/ photograph & answer the following questions

Identify the imaging/ photograph

Write down 3 important findings

Mention 4 causes where this type of lesion can be found

What may be the angiographic finding of this lesion?

Slide73

Checklist with marking

This is an OCT of the macular area 3.0

a) Multiple cystic spaces are present 1.5

b) Macula is thickened 1.5

c) Foveal depression is absent 1.5

3. a) DM 0.5 b) CRVO 0.5 c) BRVO 0.5 d) Following intraocular surgery/ trauma 0.54. Flower petal appearance 0.5

Slide74

Slide75

Instruction to the candidate

This is a photograph of a 5 yea

rs old boy. Please study the photograph and answer the questions given below

Q1.Name 5 important features the you observe in this photograph?

Q2. What is the most probable diagnosis?

Q3. Enumerate 5 investigations that will help you to achieve the diagnosisQ4. How will you treat the patient? Mention the name of the drug with duration.Q5. Name 5 symptoms that may help in monitoring the response to the treatment.

Slide76

Answers Marking scheme

1. 0.5x5=2.5

i) course/ugly face

ii) Protruded tongue

iii) Thick lips iv) Depressed nasal bridge v) Short neck 2. a) Hypothyroidism 2+0.5 b) Hurler,s syndrome 3. a) Thyroid hormone assay 0.5x5=2.5 b) X-ray of the wrist

c)serum cholesterol

d) ECG

e) Thyroid scan/USG

L-Thyroxin for life long 1

a) General well being .3x5=1.5

b) Appetite

c) Sleep

d) Bowel habit

e) Heat/cold intolerance

Total Marks 10

Slide77

OSPE-Instruction: Prepare a blood smear

Sl

no

Components

Marks

1Slides cleanedSatisfactoryNot satisfactory2Slide selected as spreader yesno

3

Method of making slide

Amount of the blood

The blood spread along the whole edge of spreader

Angle

of spreader with slide

Correct

Yes

correct

Incorrect

No

incorrect

4

Quality of the smear

perfect

hopeless

Slide78

Mark the attachment of capsular ligament of hip joint on the bone

Sl

no

Components

Done

Not done1Identified the bone correctly2Selected the upper end3Marked correctlyAnteriorly at trochanteric line

Posteriorly

at the middle of the neck

Checklist

Slide79

Please do a bed side test for albumin

no

Components

Done

Not done

1Fill test tube ¾ th with urine2Heat the tube by tilting so that the upper half is heated only3Check for turbidity4

Acidify with acetic acid

5

Check acidification with litmus paper

6

Observe the top of the solution for turbidity

& interpret

Slide80

Some points to remember during construction of an OSPE Station

Slide81

Important issues should be

considered first rather than a trivial one.

Must know

Useful to know

Nice to know

Slide82

Must know

Useful to know

Nice to know

Slide83

Language should be Clear,

Simple &

Easily Understandable.

Slide84

Instruction must be specific

Please examine the lower limbs of this patient.

Please carryout a motor neurological examination of the lower limbs of this patient.

Slide85

Proper Weight should be given to the important points in the checklist

Slide86

Time : 5 Minutes

Demonstrate knee & Ankle jerks

Demonstrate jerks of both upper & lower limbs and ankle clonus.

Time & Task should be Consistent

Slide87

Each station focuses on testing a particular skill/ area of competency

Instruction: Please do the lumber puncture on a dummy and counsel the parents regarding the justification of the procedure

There are 2 skills/ competencies

1. Procedure

2. Counselling

Slide88

Always consider level of learning

Slide89

Synthesis

Analysis

Application

Comprehension

Recall

Evaluation

Levels of cognitive domain

Slide90

Instruction: Followings are the physical findings in three cases shown in tabulated form. Please write the possible diagnosis from the scenario given below

Physical findings

Case 1

Case 2

Case 3

PulseNormal or reducedWide pulse pressureNormal or sharp upstrokeJVPNormal Indistinguishable due to prominent carotid pulsationNormal initiallyApexTappingDisplaced laterally and downward

Displaced laterally and downward

Precordial

palpation

Right

ventricular heave

Diastolic thrill at left

sternal

edge

Pansystolic

thrill

Auscultation

Loud P2

with low pitched diastolic murmur in apex

Soft A 2with

high pitched diastolic murmur at 3

rd

and 4

th

space

Soft S1 with pansystolic murmur radiating to

axilla

Possible diagnosis

Slide91

Test matrix (blueprint)

Competence categories

CVS

RS

Neuro

GI

GU/Renal

MSS

Endo/Metab

Haem/Oncology

Other

Intervieing

skill

Physical Exam

X-Ray

Data interpretation

Insrument

Write prescription

Communication & Patient Education

Slide92

Test matrix (blueprint)

Competence categories

CVS

RS

Neuro

GI

GU/Renal

MSS

Endo/Metab

Haem/Oncology

Other

Interviwing

skill

Physical Exam

X-Ray

Data interpretation

Insrument

Write prescription

Communication & Patient Education

Slide93

Please look at the instruments A B C and answer the following questions

1. Identify the instrument

2. Write 4 indications of its use

3. Mention the complications

4. Write the contraindications of LP

Problems ???

Slide94

Instruction: Study the supplied film and answer the following questions

Give the title of the film

What are the findings?

What are the diagnoses?

Problems????

Slide95

Instruction: A-58-year-old male presented with generalized weakness, persistent cough with severe bodyache for 2 months. A chest X-Ray film is supplied to you. Answer the following questions

Q 1. Write down 2 important findings

Q 2. Write down 3 differential diagnoses

Problems???

Slide96

Scenario:

A 14-year-old boy presented with difficulty in walking, frequent fall & speech difficulty for 2 years. Examination showed ataxic gait, nystagmus on lateral gaze, loss of vibratory sense & extensor planter response

What is the most likely diagnosis?

What information you want to know from the F/H that may support your diagnosis?

Mention other physical features that you may expect in this case

Name the anatomical sites that are involved here Problem????

Slide97

1. How many information, features, anatomical sites

????

2. Higher level of knowledge

but

can be assessed in written test

Slide98

Instruction:

Please examine the 70 years old simulated patient with long standing discharging right ear, recently developed blood stained discharge with deep boring earache

Slide99

Checklist with marking

Sl

no

Components

Properly done

Partially doneNot done1Greeting & introduction2Explanation about the procedure3Examination of both ear

Inspection of

pinna

, external auditory canal, deep meatus,

postaural

region with proper use of light

Palpation of post aural &

subauricular

region

Examination with aural speculum

Examination of aural discharge & smell

Examination of auditory system

Tunning

fork test-

Rinne

, Weber, ABC

4

Examination of nose &

nasopharynx

a) Anterior

rhinoscopy

b) Posterior

rinoscopy

c) Examination of oral cavity

d) Looks for

trismus

5

Examination of neck nodes

6

Examination of cranial nerves (vii, ix, x, xi, xii)

7

Total marks

Slide100

Scenario:

A 25-year-old expecting lady admitted with P/V bleeding at 35 weeks of gestation

Instruction:

Please read the scenario & answer the questions below

Mention 2 causes of her problem

How can you differentiate these 2 condition?Write down the plan of investigationHow will you treat the lady?

Slide101

A 50-year-old female patient attended OPD with recent onset of vertigo & vomiting. She has dimished corneal sensation

Name 2 important ocular signs

Name 3 possible associated lesions

Write 3 investigations

What is your diagnosis?

Slide102

Checklist with marking

a) Papilloedema 1.0

b) Esotropia 1.0

2. a) Neurofibromatosis 1.0

b) Menigioma 1.0

c) Aqueductal stenosis 1.03. a)Contrast CT/ MRI 1.0 b) CSF study 1.0 c) Audiometry 1.04. Acoustic neuroma 2.0

Slide103

Instruction:

Please place an arterial line in radial artery by over the needle technique with running commentary

Slide104

Checklist

Sl

no

Performance

Perfect

ly doneDone Partially correctNot done/imperfectly done1Self introduction/explanation/consent2Land marks identification: between distal radius & flexor carpi radialis tendon

3

Assessment of the perfusion by Allen’s test

4

Checking the tray

5

Placing the forearm in position (Roll below

the wrist)

6

Hand wash

& wearing the gloves

7

Sterile

field preparation & sterile drapes on the field

Total score

Slide105

Summary of construction of OSPE

Step 1- Identification of competency

Step 2-Selection of content/ disease/ system

Step 3- Construction of item

a) Instruction

b) Scenario c) Questions d) Checklist & marking Step 4- Pack upStep 5- Sending to ……

Slide106

Conclusion

Use of checklist ensure

objectivity

Prior agreement

among teachers on checklist & marking scheme ensure validity & reliability

Each examinee is facing the same question & doing the same task that ensure fairness & standardization Used correctly highly successful instrument to assess clinical competency