Feedback after OSCE: A comparison of face to face versus an enhanced written feedback

Abstract

Background The Objective Structured Clinical Exam (OSCE) is a useful means of generating meaningful feedback. OSCE feedback may be in various forms (written, face to face and audio or video recordings). Studies on OSCE feedback are uncommon, especially involving Asian medical students. Methods We compared two methods of OSCE feedback delivered to fourth year medical students in Malaysia: (i) Face to face (FTF) immediate feedback (semester one) (ii) Individualised enhanced written (EW) feedback containing detailed scores in each domain, examiners’ free text comments and the marking rubric (semester two). Both methods were evaluated by students and staff examiners, and students’ responses were compared against their OSCE performance. Results Of the 116 students who sat for both formative OSCEs, 82.8% (n=96) and 86.2% (n=100) responded to the first and second survey respectively. Most students were comfortable to receive feedback (91.3% in FTF, 96% in EW) with EW feedback associated with higher comfort levels (p=0.022). Distress affected a small number with no differences between either method (13.5% in FTF, 10% in EW, p=0.316). Most students perceived both types of feedback improved their performance (89.6% in FTF, 95% in EW); this perception was significantly stronger for EW feedback (p=0.008). Students who preferred EW feedback had lower OSCE scores compared to those preferring FTF feedback (mean scores ± SD: 43.8 ± 5.3 in EW, 47.2 ± 6.5 in FTF, p=0.049). Students ranked the “marking rubric” to be the most valuable aspect of the EW feedback. Tutors felt both methods of feedback were equally beneficial. Few examiners felt they needed training (21.4% in FTF, 15% in EW) but students perceived this need for tutors’ training differently (53.1% in FTF, 46% in EW) Conclusion Whilst both methods of OSCE feedback were highly valued, students preferred to receive EW feedback and felt it was more beneficial. Learning cultures of Malaysian students may have influenced this view. Information provided in EW feedback should be tailored accordingly to provide meaningful feedback in OSCE exams.

Students’ and examiners’ perception of feedback practices following OSCE in Uniport

“…This seems to be agreeable with the suggestion of Black and McCormick (2010) that greater emphasis be placed on oral feedback as opposed to written feedback because oral or face to face feedback creates opportunities for the students to dialogue with the examiners. On the other hand, it disagrees with the report of Ngim et al (2021) who observed that students preferred individualized written feedback. Whether written or verbal, the important thing is that it should be individualized and this fact was corroborated by the report of Mulliner and Tucker (2015) that students preferred individualized verbal and written feedback.…”

“…Concerning the timing of the feedback, research advocates that feedback is only useful to students when it is given in a timely manner (Lowe & Shaw, 2019;Mulliner & Tucker, 2015;Ngim et al, 2021). In this study, almost two-third (63.75%) of the examiners reported that the feedback was given immediately or soon after the OSCE.…”

“…Majority of the examiners (92.50%) and students (95.74%) reported verbal feedback as the form of feedback given to the students. Ngim et al (2021) also reported similarity in the views of students and staff concerning different aspects of feedback practices following OSCE.…”

“…There is an increasing preference for individualized feedback (Mulliner & Tucker, 2015;Ngim et al, 2021;Saunders, 2018;Shrivastava, Shrivastava, & Ramasamy, 2014) while making a case for individualized feedback argued that students are individuals with different learning styles, strengths and weakness and adapting the feedback to these individual differences will make the feedback more effective. However, this study revealed that majority of the examiners reported that the feedback with the students was class-based (48.75%) and sub-group based (30.00%).…”

“…One unique benefit of OSCE is that it offers chances for individualized feedback on clinical competence. For example during OSCE, students are made to mandatorily rotate through 7 to 10 stations designed to assess competence and examiners assess their performance objectively using a marking scheme (Ngim et al, 2021). This offers opportunities to provide individualized and timely feedback to help students improve their clinical skills.…”