Abstract:

Introduction:
Since its first use by Harden in 1975, the Objective Structured Clinical Examination (OSCE) is the basis of medical assessment in the UK, North America and Australia. Nowadays in our environment, it has been implemented in several medical schools, in specialized training and for the certification of specialist. The strength of this test is inherent to the blended assessment methods, so that it is sufficiently able to explore three of the four levels of Miller´s pyramid: know, know-how and show-how. It is an internationally validated test for students before the degree. This format allows to evaluate a broad sample of cases, each with a different examiner improving reliability, but they are expensive and complex in its implementation, so that with large samples examined cannot be done in one day. For the validity of the test, several measures must be established in order to prevent cheating and plagiarism.

Objectives:
The present work determines the impact of the transmission of information between students on the validity of an OSCE test performed on three consecutive days, by analyzing variations in overall test scores and by groups of skills: History-taking, physical examination, recall of knowledge, practical procedures and communication skills.

Material and Methods:
New methodologies have been implemented in the clinical practices of the subjects Pediatrics at the Medical School in the University of Valladolid, Spain. An evaluation was performed using an Objective Structured Clinical Examination (OSCE), with 12 stations in order to evaluate the skills development. 145 students of 6th of Medicine were evaluated, performing 2 simultaneous wheels in 3 consecutive days: 48 students on the first day, 47 the second day and 50 the third day.

Results:
A significant correlation between notes during OSCE and the global notes during the degree (r =0.468, p <0.0001) and Classical Pediatrics scores (r =0.424, p <0.0001) has been found, but there were no significant differences for these variables during the three days of the test. Better overall OSCE results were found in consecutive days test: first day 7.08 + 0.86, second day 7.32 + 0.76, and third day 7.57 + 0.7 (p = 0.0022). For skills groups best results were found in consecutive days of testing, significantly, in physical examination: 8.03 + 0.88 first day, second day, 8.66 + 0.66 and 8.86 + 0.89 third day (p <0.001) and management of clinical situations: First day 6 29 + 0.83, second day 6.55 + 0.90 and third day 6.90 + 0.88 (p = 0.002), but there were no significant differences in history-taking, communication skills and practical procedures.

Conclusions:
Transmission of information between students who performed OSCE tests on consecutive days, affects the overall results, improving the skills of physical examination and diagnosis and management of clinical situations, but do not affect history-taking, communication skills and practical procedures.

Keywords:

Objective Structured Clinical Examination (OSCE), communication skills, practical procedures.