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ISSN: Print -2349-0977, Online - 2349-4387
MEDICAL EDUCATION: EVOLVING METHODOLOGIES
Year : 2014  |  Volume : 1  |  Issue : 3  |  Page : 222-227

Development of clinical skills in ophthalmology: Significance of objective structured clinical examinations


1 Department of Ophthalmology, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram, Wardha, India
2 Department of Ophthalmology, Government Medical College, Nagpur, Maharashtra, India

Correspondence Address:
Smita Singh
Department of Ophthalmology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2349-0977.157767

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Introduction: Currently, skill assessment methods for medical students in formative assessment are inconsistent. Our objective was to: (1) Develop an Objective Structured Clinical Examination (OSCE) assessing performance of basic clinical ophthalmic examination (2) remedy deficiencies in knowledge, skill. Materials and Methods: Objective Structured Clinical Examination stations and checklists were developed and validated following approval of institutional ethics committee. Postgraduate student volunteers served as both simulated patients and scorers; however, one station (eye drop instillation) used a mannequin with a faculty member as an observer, scorer. Third MBBS students (n = 61) were oriented. A four station pilot examination was done. After Posting#1 spanning 2 weeks, an eight-station OSCE (7 min. duration each) assessed examination of visual acuity, color vision, ocular motility, pupillary reaction; anterior chamber depth measurement; confrontation, digital tonometry, and eyedrop instillation. Common deficiencies identified were addressed through an interactive demonstration. Six weeks later, following Posting#2, the same test was repeated. Aggregated and paired scores were compared using Student's t-test. Feedback was obtained from students, simulated patients, and faculty. Results: Mean first session score was 22.4 ± 4.66 over 40 (56%); highest being for visual acuity; lowest for eyedrop instillation. Mean score in the second was 30.2 ± 4.3 (75.5%). Paired t-test showed t = 13.73 (P < 0.0001). 77.2% students preferred change in assessment methodology; 100% voting for OSCEs. Conclusions: Feed-back from initial assessment followed by the additional focused teaching session improved students' clinical skills. All were unanimously convinced of the need to change current assessment system. OSCEs are a simple, effective way to both learn and assess clinical examination skills.


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