Development, validation and initial outcomes of a questionnaire to examine human factors in postgraduate surgical objective structured clinical examinations

Abstract

The recognition and further investigation of human factors in OSCEs is needed to improve examiner experience and behaviour in order to influence delivery, candidate experience and quality assurance of these examinations.

Does Changing Examiner Stations During UK Postgraduate Surgery Objective Structured Clinical Examinations Influence Examination Reliability and Candidates’ Scores?

“…Recent work has enabled the Royal Colleges' examinations departments an option to allow switching to occur at lunchtime in an attempt to minimize some of these potential "unseen" variables. 13 The current study has reassuringly found that station reliability remained consistent regardless of whether switching occurred or not. Furthermore, reliability was maintained irrespective of the number of examiners changing stations.…”

“…Although we have evidence of better examiner morale because of switching OSCE stations at lunchtime from a number of sources, not least the examiners themselves, a follow-up study is required to evaluate the level of morale more fully. Use of our validated questionnaire 13 would assist in further studies. In the meantime, Royal College examination departments now have the option to switch examiners and this practice has been completely adopted by the English College, which has the greatest candidate numbers.…”

“…13 Several of the communication stations (such as history taking) require minimal examiner interaction, thereby increasing the likelihood of fatigue and disengagement. In response to feedback from examiners, it was agreed that examination departments could allow MRCS examiners to change stations at lunchtime, enabling a different scenario to be examined in the afternoon session.…”

A cultural change to enable improved decision-making in forensic science: A six phased approach

“…The body of knowledge concerning judgement and decision-making and human factors is broad, encompassing a wide range of theories, and addressing a broad range of attributes, going far beyond the consideration of cognitive bias alone which has become a focus within decision-making within forensic science [95]. Indeed, there are many aspects of psychological and human factors theory that have been applied to other domains that involve human expertise (such as medicine [110] or aviation [111]), or have been used by psychologists to explore or explain human decisions. Edmond et al [112] presented a number of such theories from human perception, memory, expertise, decision-making, communication and feedback in relation to the forensic science process so as to highlight the potential application of these theories within forensic science, encouraging forensic practitioners to engage with such research in order to maximise the outcome of their forensic interpretations.…”

Human factors awareness and recognition during multidisciplinary team meetings

“…Human failures can be readily categorised into four main domains or levels and form the basis of the well‐known Swiss cheese model of medical error: the influence of the employing organisation, preconditions to unsafe acts (including personal factors such as fatigue), unsafe supervision and unsafe acts themselves (summarised in Table ). The human factors analysis and classification system (HFACS) expands on these domains and has been used to evaluate and improve safety across many different healthcare settings including “near miss” analysis and postgraduate surgical examinations . This model is widely used in aviation to explain the layers of defence and how accidents happen because the “holes in the Swiss cheese.” Pilots are trained in distraction management.…”