Abstract:

Introduction:
Since the academic year 2012-13, a Structured Objective Clinical Examination (OSCE) is a final exam of the Subject “Clinical Practice of Pediatrics” in the Faculty of Medicine of Valladolid. This examination was established within a Teaching Innovation Plan, in which one of the proposed objectives was not only to change the way of evaluating our students, also to analyze the changes, the consequences of the same ones annually and establish actions of improvement to implant in the following courses.

Material and methods:
The OSCE was done during these 4 years, in the month of June, at the end of the practices of the subject. The duration of the examination for the first 3 years was 4 hours, taking place over the course of 3 days, however, in the last course we did a mini OSCE, to adapt to the needs of the Faculty and reducing the duration of the same to 2: 30 h, being able to complete it in a single day in shift of morning and afternoon.
We analyzed the scores obtained in each of the OSCE stations, during the courses 2012/13, 2013/14, 2014/15 and 2015/16, of all the students who studied the subject “Clinical Practice of Pediatrics”, comparing the results of each year and between them and after the teaching changes introduced to detect areas with worse scores

Objectives:
Analyze the results of the students in an OSCE throughout 4 academic years.
Analyze the results in each of the stations after making changes in the teaching methodology
Establish new areas for improvement

Results:
If we analyze the 7 stations that have remained the same during the days, we objectified a statistically significant improvement between the results obtained in the first year and those of the last year. (See Table 1)

Table 1. Scores of stations
MEAN MEAN MEAN MEAN p value
YEAR 2013 2014 2015 2016
Station 1 83,19 78,01 79,91 83,84 0,30
Station 2 71,90 72,27 74,02 81,20 p<0.001
Station 3 66,96 59,13 62,75 79,95 p<0.001
Station 4 69,96 68,24 75,02 85,61 p<0.001
Station 5 84,43 91,68 82,47 85,60 0,31
Station 6 81,08 80,31 85,95 87,82 p<0.001
Station 7 75,97 73,57 77,22 80,14 p<0.001

“p value <0,05 “

The stations: 1,2 and 6, which value technical skills, received specific practical training, emphasizing each year in the deficits found in previous years, achieving better scores with statistically significant differences in two of them.
Regard to the stations which most valued professional performance in the clinical setting (3, 4 and 5), we aimed to improve the results in the two first OSCEs after implementing two new seminars that included techniques of anamnesis and physical exploration, these differences being statistically significant.
Regarding results obtained in the accomplishment of a bibliographical search, in spite of influencing its necessity and establishing the same as a mandatory task during the rotation, we have not achieved an improvement in the final score.

Conclusions:
The realization of an OSCE as final examination meant a change in the methodology of the Subject that should be analyzed. Analyzing the global results, by stations, between years, has served to detect areas for improvement. After each improvement action, the impact of these actions must be evaluated in the shortest possible time, thus establishing their effectiveness.

Keywords:

OSCE, Pediatrics, Score.