Using Interprofessional OSCE-Based Simulation Collaboration to Teach Obstetrics to Second-Year Medical Students

Abstract

BACKGROUND: We have shown that it is possible to introduce an obstetric simulation program to preclinical 2nd-year medical students. In the second year of our obstetrics simulation curriculum for 2nd-year medical students, we introduced OSCE assessment in collaboration with the nursing school educator with the program occurring in the nursing school simulation center in November 2015. METHODS: Students rotated through three stations: 1) simulated vaginal delivery demonstrated by nurse educator and OBGYN resident; 2) MFM faculty gave interactive presentation on fetal heart rate (FHR), a student nurse then role played with students and they were assessed by OSCE format; and 3) OBGYN resident and faculty taught and assessed students on cervical dilation using cervical models. Students completed surveys on attitude, knowledge before, after and 7 months postcurriculum. RESULTS: Of 95 students, mean scores for the FHR OSCE were: identifies FHR baseline=0.97, identifies FHR variability=0.92, provides accurate identification of periodic pattern=0.73, identifies FHR category=0.67 and orders appropriate medical interventions=0.93. For the cervical station OSCE, the mean score on cervical examination skills after training was 75%. For the knowledge questions on obstetrics and fetal heart rate monitoring, students obtained a mean prescore of 2.57±0.09, postsimulation the mean score increased to 3.24±0.11 (P=.12). Presimulation; students scored their comfort level with obstetric procedures as 12.2±0.63, after simulation the mean score increased to 28±0.63 (P<.001). DISCUSSION: We have demonstrated the feasibility of an OSCE-based inter-professional educational curriculum utilizing nursing, physician and resident faculty instructing medical students and nursing students jointly. For FHR teaching, the concept of FHR category was the most challenging for the students to grasp. The course improved students' short-term knowledge but had dropped back to baseline by 7 months. Students' comfort level increased immediately posttraining and decreased but was still higher than baseline at 7 months. Further curriculum development is undergoing on increasing long term knowledge gain.

Evaluation of an OSCE’s implementation and a two-step approach for a theoretical and practical training program in Obstetrics and Gynecology

“…Dental students described the OSCE as a superior method for evaluating their clinical skills and for presenting questions applicable to real-life clinical situations ( 43 , 49 ). Furthermore, students attending an OSCE in Oakland show an improvement in long-term knowledge, supporting the benefit of an OSCE for their future careers ( 10 ). The students answered that the OSCE as an assessment method called attention to their weaknesses even before receiving the official results.…”

“…The development and implementation process of an OSCE in the revised curriculum using Kern’s six-step approach was successful based on (1) the satisfactory results of the 113 students passing the OSCE ( 18 , 19 ), (2) the results of the poll, and (3) the answers to the open inquiries: (1) The comparability with other OSCEs is demonstrated by a similar average result of 85% ( 10 , 11 , 19 ). This may be caused by the similarity of the OSCE stations and the tested skills and competencies required to treat a certain patient profile ( 8 , 9 , 11 ).…”

“…Therefore, the objectives of OSCEs are adapted to each discipline. In obstetrics and gynecology, the reported OSCE includes topics covering a wide spectrum of clinical skills, such as a pelvic examination ( 8 , 9 ), simulation of delivery ( 10 ), examination of a vaginal wet mount to diagnosing vaginitis and/or a sexually transmitted disease ( 8 ), and a breast examination ( 8 ), and assesses competencies such as the interpretation of cardiotocograph or laboratory results, for example, reflecting ovarian failure ( 11 ), management of risk factors and their complications in pregnancy ( 12 ), or the treatment and handling of a miscarriage ( 13 ). Virtual OSCEs have recently been described as a response to the COVID-19 pandemic ( 14 ).…”