Health Sciences Education Symposium
Presentation Format
Poster
Type of Activity
Research
Original Presentation Date
2024
Date of Submission
October 2025
Abstract/Short Description
PURPOSE: The Objective Structured Clinical Examination (OSCE) is a clinical assessment used in medical education to demonstrate common clinical skills used in medical scenarios. While every LCME-accredited medical school is required to use OSCEs to assess student’s clinical skills, each medical school has slight variations to the course set up. In such standardized workshops, students have an opportunity to practice and demonstrate their competency in and integration of various clinical skills including medical interviewing, physical examination, clinical reasoning, note documentation, and professionalism.
Unfamiliarity with the OSCE format that is used to test clinical competence has been associated with significant test anxiety in learners across health science graduate programs (Brand 2009). Test anxiety has been shown to negatively affect performance. This pilot study describes a near-peer-led intervention that exposes medical students to an OSCE-like examination setting and format and explores the interventional impact on the summative OSCE experience. These findings aim to inform medical educators, institutions, and students about effective interventions that can influence student performance in standardized clinical assessment.
METHODS: Ten medical students enrolled in a pre-matriculation program received three hours of near-peer instruction on basic clinical skills and completed a pre-survey to assess prior experience, confidence, anxiety, preparedness, and academic self-concept (ASC). An OSCE-like “practice exam” intervention followed, consisting of a written exam, clinical skills station, patient encounter, and timed encounter note. Encounter notes were graded using a standardized rubric used by the Practice of Clinical Medicine office by Virginia Commonwealth University School of Medicine. Survey data was quantitatively analyzed (p< 0.05). Informed consent was obtained. A second round of surveys was sent to students prior to and following their summative OSCE during the fall semester 2023 and is still being reviewed.
RESULTS: OSCE-related pre-survey scores (pre-matriculants; n=9) included measures of perceived confidence (mean=29.22; SD+/-8.74), anxiety (mean=3.67; SD+/-2) preparedness (mean=3.56; SD+/-1.24), and ASC (mean=3.20; SD+/-0.43). Pre-intervention confidence was positively correlated with feelings of preparedness (r=0.69) and negatively correlated with encounter note scores (mean=59.92%; SD+/-16.96). We are currently in the process of analyzing OSCE-related post survey scores and plan to incorporate comparison data between pre- and post-OSCE data.
CONCLUSIONS: Preliminary data revealed ranges in student confidence and ASC, and moderate levels of anxiety and preparedness related to OSCE. Results suggest that perceived high confidence may not be strongly associated with high performance. Follow-up survey and performance data will help assess interventional impact. Demonstrating the benefit of this intervention may support integration of near-peer-led simulation training into the formalized curriculum, thus, allowing all students the opportunity to acclimate to the OSCE format through a holistic practice exam approach. The power of this study was limited due to the small pre-matriculant cohort size. Additionally, there was not a structured teaching method that was used by the near-peers that would afford exact replicability of the lessons imparted on the pre-matriculants. This study also incorporated a survey that incorporated questions from other validated questionnaires that assessed preparedness such as the Self-Directed Learning Readiness Scale and Likert Type Scale to make it more appropriate for an OSCE-like setting. As such, the study’s survey on its own may require additional research to validate its use in similar studies. Further studies would likely need to include a larger sample size and a more formalized and structured teaching method for the skills tested on OSCEs.
References
Brand, H. S., & Schoonheim-Klein, M. (2009). Is the OSCE more stressful? Examination anxiety and its consequences in different assessment methods in dental education. European journal of dental education: official journal of the Association for Dental Education in Europe, 13(3), 147–153. DOI: 10.1111/j.1600-0579.2008.00554.x
Fisher, M., King, J., & Tague, G. (2001). Development of a self-directed learning readiness scale for nursing education. Nurse education today, 21(7), 516-525. DOI: 10.1054/nedt.2001.0589
Harrell, K. M., Rawls, M., Stringer, J. K., 4th, Edwards, C. D., Santen, S. A., & Biskobing, D. (2023). Understanding Academic Self-Concept and Performance in Medical Education. Academic medicine : journal of the Association of American Medical Colleges, 98(9), 1032–1035. DOI: 10.1097/ACM.0000000000005224
Rights
© The Author(s)
Is Part Of
VCU Medical Education Symposium
First Author Information
Darius Lacy, VCU School of Medicine