The use of a formative OSCE for developing clinical skills necessary for undertaking cervical cytology

The use of a formative OSCE for developing clinical skills necessary for

undertaking cervical cytology

S. Hughes

Consultant, Centre for Contraception and Sexual Health, Nottingham, UK

Introduction: The teaching and assessment of clinical competence has

always been a key feature of medical and nursing education. Historically, ‘on

the job’ learning and assessment was prominent. Concerns about the robustness

of this approach, lack of clinical opportunities has led to more formalised and

standardized approaches. National guidelines are in place for the content and

quality of cervical cytology screening training but implementation is variable

and many training programmes fail to address the fundamental issue of developing

and assessing clinical competencies. Within this context, it seemed appropriate

to develop, implement and evaluate an alternative way of developing and

assessing competence in clinical cytology screening through the use of a

formative OSCE.

Study design: The study examines 3 key questions: Can an OSCE (Objective

Structured Clinical Examination) be developed that assesses the competencies and

skills necessary for undertaking cervical cytology screening. Can the use of

appropriate and timely feedback make the OSCE an acceptable and useful form of

formative assessment? Is a formative OSCE an acceptable means of developing and

assessing clinical competency in cervical cytology screening for doctors and

nurses working in the community. 6 interactive stations were developed using a

matrix of components of competency and related skills and tasks. The OSCE was

run on 3 occasions and 15 participants and 4 facilitators and 2 role players

took part. The OSCE was evaluated by qualitative methods including a participant

questionnaire, facilitators and role player questionnaire, group feedback, lead

facilitator comments and analysis of scores.

Results: The semi-structured questionnaire completed by participants

and facilitators showed high rating in relation to usefulness for learning,

interesting, challenging/thought provoking. An open question about ‘thoughts

and feelings about OSCE’ revealed 70% of comments to be positive. The number

of participants meant statistical analysis of the marks was inappropriate.

Overall, observational analysis revealed scores above 70% for all stations.

Conclusions: In response to the 3 main questions. The findings showed

that an OCSE is very suitable for assessing competencies in clinical skills

necessary for cervical cytology. The feedback from all individuals involved in

the OSCE was very positive with the only negative area being performance anxiety.

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