Abstract:

Introduction:
The assessment of psychomotor skills for medical students is one of the few essential components in evaluating Orthopaedic clinical examination skills. ‘Objective Structured Clinical Examination’ (OSCE) is recognized as a comprehensive method for assessing clinical performance and is a potentially effective tool in evaluating psychomotor skills. The authors’ objective was to determine the perception and attitude of examiners and to explore possible factors affecting student performance in the conduct of OSCE as a tool to evaluate the psychomotor skills in Orthopaedics among undergraduate medical students.

Methodology:
The authors conducted a prospective cohort study for 303 year 4 medical students, comprising of 128 females and 175 males in 2011-2012, for end of posting OSCE. The examiners assessed the students’ psychomotor skills when they conducted examination of hand, spine, knee, hip and shoulder joints. The examiners’ feedback on their perception and attitude towards the conduct of OSCE for examining psychomotor skills was collected using a set of self-administered questionnaire developed by the authors. Student performance was analyzed by gender and sequence rotation of OSCE station.

Results:
Most examiners gave positive perception and attitude towards the conduct of OSCE in Orthopaedics. Students performed better in the examination of hand, knee joint & spine and relatively worse in examination of hip & shoulder joint. Female students did significantly better in hand, knee and shoulder joint examinations (p < 0.001). Sequence of the OSCE stations in which the students were rotated was not associated with the students’ performance.

Conclusions:
Our study demonstrated that OSCE is well-perceived and accepted by examiners as an assessment tool for psychomotor skills in Orthopaedics. Other factors contributing to students’ performance are prior clinical exposure and teaching in previous postings to other discipline where some musculoskeletal system examination and presentations are taught. We should also consider varying teaching styles among clinical tutors on physical examination while designing questions and setting a standardized marking system for OSCE in Orthopaedics, which contribute to reflecting the actual level of clinically-relevant knowledge and psychomotor skill acquisition among medical student.

Keywords:

Objective Structured Clinical Examination (OSCE), Clinical Education, Clinical Performance, Instructional Methods, Personal Characteristics/Attitudes.